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Mar 28

Should You Fire Your Therapist?


By Chris Iliades, MD.   Which relationships are the most important to you — your family members, your partner, your long-time best friend?

For many people with depression, there’s another type of bond altogether that can impact life in a significant way: The relationship with your therapist. Regular sessions with a counselor can be an integral step to successfully treating depression — in fact, a recent review of 38 studies of talk therapy published in the American Journal of Psychiatry concluded that talking with a therapist is an effective form of depression treatment, while a combination of therapy and medication tends to be the most beneficial. And that’s why it’s so important that this relationship is healthy and thriving (and assessed every now and again).

Here’s the first thing you should do to ensure your therapist is a good match: “Figure out if you are in the right type of therapy,” says Katherine Krefft, PhD, a psychologist in Buzzards Bay, Mass. Talk therapy can be given by a psychiatrist, a psychologist, or a clinical social worker — and counseling comes in a number of different forms.

“Anyone who’s considering talk therapy should go into therapy with some clear goals for what they want to accomplish,” adds Mackenzie Varkula, DO, a psychiatrist at the Cleveland Clinic. “Pick a time frame and ask yourself if your goals are being met.”

And if your goals aren’t being met? It may be time to find a new therapist.

How to Assess Your Therapist

Just because a therapist is good doesn’t mean she’s a good therapist for you. As with any relationship, there needs to be trust, communication, and a meeting of the minds. How can you tell if the relationship is working?

If you find yourself answering “no” to most of these questions, your therapist may not be the right match for you:

  • Do you have good chemistry with your therapist? “You should know early on if you have the right comfort level. If you find yourself holding back and unable to share and be completely honest, it is not a good start,” says Dr. Varkula.
  • Do you want to go back for another therapy session? If you feel positive about the sessions after the first few appointments and want to continue, Krefft says, that’s a good sign that the therapeutic relationship has gotten off on the right foot.
  • Do you have a positive attitude about therapy in general? Feeling negatively about your therapist could be due to bad chemistry, but it could also be due to a bad attitude on your part. “Some people go into therapy thinking it won’t work because of past experiences,” Varkula says. “Just like any relationship, you shouldn’t give up until you have given therapy a fair chance to work.”
  • Are you learning about yourself? “During the early part of therapy, you should already be learning new things about your emotions and behaviors,” Krefft says. “Your therapist should be giving you tools to start working on some changes.”
  • Are you able to draw on what you’ve learned in everyday life? “After being in therapy for a while, you should be able to start using your therapy tools in the real world between therapy visits,” says Varkula.
  • Does your therapist show you respect? “A good therapist should give you unemotional positive support,” Krefft says. “You should never feel like you are being judged.” You should also not feel that you are being told what to do, but rather that you are being listened to and respected, she adds.
  • Is your life getting better? “After some time in therapy, you should start to see some positive changes in your life that come from using the knowledge and the tools you are getting,” says Krefft. “You should not feel dependent on your therapist — you should feel as if you are learning how to figure things out.”

Also keep in mind that treatment for depression can change over time. Just as with other relationships, the therapy relationship may have changing needs. “As situations change, you may be able to end therapy or you may need to change to a therapist with different abilities,” says Varkula.

A good therapy relationship takes a good therapist and a good patient. Ask yourself if you are holding up your end of the bargain. “Therapy requires work and commitment,” Krefft says. “It’s not just like talking to your best friend. You can do that for free.”

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