Breakups are a fact of life. Whether your connection is friendly, romantic or professional, many relationships run their course. But what happens when the person you need to cut ties with is your therapist?
Indeed, therapy has been on the rise throughout the pandemic.
“The prevalence of depression and anxiety symptoms during COVID-19 have doubled,” said Mary Alvord, Ph.D., a Maryland-based psychologist.
The upside is that an increase in mental health concerns has also led to the destigmatization of therapy for many Americans.
“I think one of the silver linings of the pandemic is people’s recognition that seeking therapy is a healthy and valuable life choice,” said Nadine Kaslow, Ph.D., a professor of psychiatry and behavioral sciences at Emory University School of Medicine.
But experts say there are instances when a patient and practitioner aren’t a good fit and that it's helpful to know when to move on.
“The patient is the person who can and should feel comfortable deciding if and when to end therapy or change therapists,” said Lynn Bufka, a clinical psychologist at the American Psychological Association. “It’s important to remember that as a patient, you are the one whom this relationship is supposed to benefit, so you can and should be in the driver’s seat regarding whether this relationship is the right therapeutic relationship for your needs.”
Here are nine signs that the relationship isn't working for you.
Your therapist forgets who your sessions are for.
While it’s common for a therapist to draw from personal experience to teach lessons or illustrate examples of recommended tools and techniques, if they talk about themselves too much, it may be time to say goodbye. “The doctor-patient relationship is not a friendship nor reciprocal in nature,” said Dr. Christine Crawford, associate medical director of the National Alliance on Mental Illness. “It’s the one time in life when you get to be selfish and only focus on yourself and your problems.” What’s more, “too much personal info shared by your therapist is crossing a boundary,” she added.
Your therapist isn’t listening.
Crawford also warned that “therapy is not a one-size-fits-all model,” and that therapists need to adapt teaching styles and techniques to accommodate the patient, which means learning what the patient’s unique needs and objectives are. “If a therapist is unable or unwilling to adapt or modify their approach to meet your needs, then that may become problematic,” Kaslow said.
There is a lack of respect.
"The relationship between client and therapist is one of the biggest predictors of success in therapy,” said J. Stuart Ablon, Ph.D., director of Think:Kids at Massachusetts General Hospital. Because that relationship is so important, if you feel like your therapist doesn’t respect or value you, it’s time to find one who does. What’s more, “if your therapist says things that are microaggressions or discriminatory in any way, that’s a red flag,” Kaslow warned.
You lack trust in the therapist.
As with most relationships, trust in therapy is vital. “It can take a few sessions before you feel comfortable with a new therapist, but if after that period you still don’t feel a sense of trust, it may be time to find someone new,” said Cortney S. Warren, a board-certified clinical psychologist based in California.
Crawford shared a similar tip, highlighting why trust is crucial. “If you’re ever worried about being totally honest with your therapist, that’s a red flag,” she said.
You notice unethical behavior.
Run for the hills if you ever witness your therapist being dishonest or unethical, multiple experts said. Examples of unethical behavior include encouraging a patient to lie (especially if it’s to “protect” the therapist), asking a patient to fill out a health insurance form inaccurately to make sure they qualify for coverage, billing a patient differently than was agreed to or asking a patient to meet at a location or under circumstances that make them uncomfortable. “If a therapist does something unethical, no matter how small, that is very concerning and should serve as a major red flag,” Kaslow said.
You're not making progress.
“It’s always time to move on when you feel like you have hit a block and ... feel like you are digressing,” said Jimmy Noorlander, a clinical social worker at Deseret Counseling in Utah.
Erin Berman, Ph.D., a clinical scientist at the National Institute of Mental Health, had a similar take. “It is important to set goals and measure them in therapy. If you feel that you are not making progress or that your symptoms are getting worse, it’s important to reassess the therapy situation,” she said.
You're relying on your therapist too much.
“A good sign of being overly dependent on your therapist is that you always have to ask them for approval or if you feel you have to run any change in your life past them to make sure you’re making the right choice,” Noorlander said.
Boundaries are not respected.
No relationship can thrive without healthy boundaries. That’s especially the case between therapists and their clients. “Contact shouldn’t occur outside of the therapy session very often,” Crawford said, adding that if a therapist asks for any kind of personal favor, “it’s a red flag and you should let them know right away that it made you uncomfortable.”
A therapist becomes defensive about their therapeutic approach.
While every therapist has their own style and technique, it’s a bad sign if they become defensive when a patient expresses discomfort or offense at something their therapist says or does.
“There’s nothing wrong with telling your therapist that something they told you doesn’t sit well or sound right to you. If doing so makes them at all combative, it’s OK to not return,” Crawford said.
It’s important to note that the above examples apply to most types of therapy, but some approaches, such as “dialectical behavior therapy” can be more intensive. It’s also worth mentioning that personal growth will always be an uphill battle no matter who is helping with the climb.
“Therapy can be really hard,” Warren advised. “If your therapist is pushing you and you find it hard, that may not be a sign that you need another therapist — it may be a sign that therapy is working.”
How to break the news to your therapist:
Recognizing the signs that you need to ditch your therapist can be easy compared to actually doing so, but that doesn’t mean things have to get weird. “If you just had one or two sessions with your therapist, a simple phone call or email notification letting them know you’re moving on is fine — preferably at least 24 hours before your next appointment,” Kaslow said.
But if you’ve developed a relationship with your therapist over many sessions, telling them in person might be cathartic to both parties. “I always tell people to be honest with their therapist about why they are changing,” Noorlander said. “It also gives the therapist a chance to reflect back to see if there is anything they want to do differently in the future.”
Warren added: "If you enjoyed your previous therapist, I would encourage you to ask them for a referral to someone else — which most will happily do. Be as specific as you can about what you want to work on moving forward and what you’re hoping to work on in your next therapy."
In the end it’s helpful to remember that therapy is about you and that it’s perfectly appropriate and normal to want to try a new therapist or approach.