“If I didn’t like my therapist, I would totally ghost her,” admitted my friend on a Marco Polo video chat after she read my article last week on how to fire your therapist. My friend was thoughtful enough to read my blog (twice) and then give me her honest feedback. I find it invaluable. It opened a discussion about the nature of the therapy relationship and I asked around to see if anyone else shared my perspective.
How Therapists See Therapy
As therapists, many of us hold a perspective that is largely different than those who are clients or who are unfamiliar with therapy. For therapists, it comes down to our philosophy about therapy. One of the most important components is the therapeutic relationship. This construct changes depending on the theoretical orientation of the therapist. Some approaches are more directive, while others are more reflective. Some counselors are completely closed books, while others use lots of self-disclosure.
I’m a highly relational person, and that carries over into my therapy practice. I am a highly relational therapist. Many of my clients I would befriend if I weren’t their therapist. I have to manage the ethical boundaries that prevent us from “hanging out” or sharing equally in the relationship. I believe that therapy works best when the therapist and client develop a foundational relationship on which they build tools, interventions, and changes.
Relationships in Other Service Professions
In talking to an attorney friend, I learned that people in that profession can feel the same way. You always have to keep the job as the bottom line–do good work–but you also develop a sort of relationship with people to whom you return often for service. As a math teacher, my husband knows the mandate is that kids have to be able to pass tests. But in order to be a really good teacher, he has to be able to form relationships and trust with his students.
There are some service professions in which the relationship foundation is either unnecessary or minimal. I can have my car fixed without knowing much about my mechanic. My teeth cleaning appointment recurs every six months without me feeling close to my hygienist. (I would actually say any service relationship is better with a degree of warmth.) But most service professions are by nature different from therapy. Of any of them, you need a warm and supportive relationship with your therapist the most.
Does that mean that only warm and fuzzy therapists do good work? Of course not. There are some situations in which a more directive, institutional approach may be warranted. Many people stabilize and heal in therapy situations in which they know virtually nothing of their therapists. I just think there is so much to be gained by having a close therapeutic relationship whenever possible.
How Clients See Therapy
For my friend who said she would ghost a therapist who was not working out for her, I realized that she had a fee-for-service expectation of therapy. She wanted to get in and get out in the minimal amount of sessions. Her goal was to get tools and solutions for problems that had arisen in her life or family. There’s nothing wrong with this, and it can actually be done with a relational therapist like me. An upfront conversation is needed, regardless of goals and approach.
The point of the intake assessment is for the therapist to understand the problems and issues that the client is bringing in. The point of the informed consent conversation is that the client can understand how the therapist operates. In my experience, many therapists are not very thorough in their discussion of the informed consent document. They jump right into listening to the problem without establishing the foundation for the relationship. They almost never have a conversation about what to expect for termination. In fact, my friend said that she had never had a therapist discuss a termination plan with her.
Keep in Mind
Last week I suggested that both therapists and clients should be willing to have one last conversation together to go over what worked, what didn’t work, and what steps a client could take for the future. There are a few precautions or acknowledgements I would like to add:
- If your therapist does something that you consider abusive or egregiously unprofessional, don’t go back. In fact, you can report that person to the Board of Behavioral Sciences (in California, or similar board in other jurisdictions). Please, please, please: Do not report a therapist who just pisses you off by saying something you found offensive. Save BBS reports for things like sexual misconduct or breach of confidentiality.
- If you don’t value your therapist’s opinion, don’t ask for recommendations. However, you have paid for her observations, experience, and training. You might not like what she suggests for the future, but don’t cheat yourself out of the growth you may experience by having a professional give honest feedback.
- Don’t feel the need to take care of your therapist’s feelings. Your therapist may feel very sad that you’re leaving, but she should never try to talk you into staying. Her job is to help you find your voice and respect you when you use it.
- If you decide to have a break-up conversation with your therapist, leave a voicemail or text ahead of time. Set the expectation that you want to end. Then you can dedicate the session to wrapping things up and ending on a good note.
- None of my suggestions apply when the therapy relationship encounters logistical problems such as scheduling conflicts, insurance funds running out, or someone moving away. Most of the time therapy ends like this, somewhat unfinished, and without closure. These articles are specifically talking about the times when you realize that your therapist is not a good fit.
Let’s Have a Conversation
I loved having the conversation with my friend who basically did not agree with what I wrote. And I would love to have conversations with you, too! Tell me what you think: Would you have a break-up conversation with a therapist who wasn’t a good fit? Or would you ghost her? Do you think of therapy more as a relationship, a service, or both? Email firstname.lastname@example.org, comment on the blog, or find me on Facebook and Instagram @soulgritresources.