When to “fire” your therapist.
A couple of weeks ago Jules brought to light an important point about ending therapy in response to the post, Ending Therapy and Saying Good-Bye. She wrote,
As someone who got stuck in America’s mental health system for nearly 2 decades…I appreciate what you are saying…It was only the final therapy relationship that even mentioned that this [ending] was a goal – that I’d learn the skills to be my own therapist (figuratively speaking). I am glad she gave voice to the topic.
Hence, the question is, “How do you know when to break it off if therapy is not working?” Arnold A. Lazarus and Allen Fay developed a scored questionnaire to asses if it is time to leave. If you are in therapy, take the test on Lazarus’ Think Well blog and let me know what you think.
Here are my recommendations. First, you are a consumer and you pay for a service. Hence, you have the right to fire your therapist. However, if there is a pattern of firing one therapist after another, there probably is another issue, which needs to be addressed. Consequently, I encourage a client to come for a few sessions to process the decision to leave.
When it comes to leaving, be honest with yourself and your therapist about why you are leaving. It is an opportunity to develop assertiveness skills and to feel empowered. Also, it can be a sign you have grown. If you feel it is a poor match ask your therapist to give you several referrals to other therapists.
Another reason to end therapy is your problem has been resolved. Hence, every so often, progress should be assessed between you and your therapist. Stephen Borgman, the author of Spectrum Solutions blog, suggests using Scott Miller’s outcome rating scale.
One more way to assess if therapy is working for you is to evaluate how your life is improving and if you have a sense of satisfaction. To look for the red flags of a bad therapist I suggest Kimberly Key post, Is Your Therapist Re-Traumatizing You.
Finally, a different expertise is warranted. There is no way all therapists can work with all problems. Trust your intuition.
Read the series:
Part One: When to Seek Help
Part Two: Interview Questions
Part Three: Help Yourself
Part Four: Ending Therapy and Saying Good-bye
(c) 2011 Brenda Bomgardner, MA, NCC
Brenda; thanks for bringing up some helpful solutions and ways to give check and identify helpful and not so helpful therapy relationships. I’ll definitely share this in my own circle of influence:)
Jules,
I am glad the information is helpful. I am interested to know if you have anything to add from your experience. You have wisdom from a first hand journey.
Also, I will eventually post concerning on the issue of medication. It is a controversial topic.
I appreciate your willingness to speak out about your heroic journey from abuse to empowerment.
Hugs, Brenda
I’m sure I do have plenty I could add, Brenda although I’m not sure what I could contribute here in this venue. In the context of traumas…”waking up” from that drug induced stupor and realizing the life and physical health that I lost to this oppression and abuse is excruciatingly painful; much worse than anything I survived as a child and I survived some really horrible violations. May I suggest – scientific journalist Robert Whitakers (2010 IRE award) book Anatomy of an epidemic, the story of Anna from the http://www.annainstitute.com and Charles Whitfields work on “Psychiatric Drugs as agents of trauma” here: http://nhne-pulse.org/wp-content/uploads/2010/12/Psychiatric_Drugs_As_Agents_of_Trauma_JRS508.pdf
And while I find your series on trusting your intuition etc…to be full of really great information until I overcame the learned helplessness and victimhood state of mind I could not take the adult steps to protect myself. I had to learn to overcome the core issues that influenced my unhealthy relationship choices to finally stop re creating the abuse in my adult and therapy relationships.
On medication – that is another controversial topic and one that is quickly becoming an issue that SAMHSA is beginning to question as living in the USA or other developed countries that rely on drugs is a major indicator that one who is “diagnosed” will never fully recover, while in other countries many – I believe the statistics are like 80% – do fully recover from “SMI”.
I appreciate your interest and validation of my feelings and experiences, Brenda.
Jules,
Again, I am pleased to have your contributions added to our conversation. It is with discussion that the pros and cons of almost any issue can be explored and exposed.
I agree with you as to being able to be “awakened” before you can see the way into empowerment and self-care. You have made great strides in your healing from multiple traumas to be able to be strong enough to share your story.
Pulitzer Prize Finalist, Robert Whitaker, is helping to create a platform to engage in world wide discussion on the topic of abuse by prescription. He has identified and labeled the abuse as Drug Stress Trauma Syndrome.
My goal is to help clients move towards emotional wellness with skills they can retain for a lifetime. I use Acceptance and Commitment Therapy-Training to help achieve this with the clients.
I wonder if there are other readers out there who would like to add anything to the conversation.
Take care, Brenda
On your note of awakening – I need to clarify that the “awakening” in my context was two separate events.
First I had to overcome the drugged stupor of 15 years of abusive poly pharmacy and literally reclaim the functions and use of my mind and go through the de-toxifying of my brain and body.
Only then could the insightful awakening of truth take place.
And second; the steps you describe seem appropriate in healthy balanced relationships but not so much when the therapist is an abuser. Just as in intimate abuse, the therapist can come off as the “good guy” who has this “horrible” client.
Victims who are told they have a problem with firing therapists may actually have run across several really bad therapists; I had several in the almost 2 decades that reinforced that something was wrong with me when I complained, questioned or challenged their “therapy”. It was only in the final therapy relationship that I was found safety. Those trained to be victims in the original abuse are the prime target for these kinds of relationships in therapy and had I not survived this I wouldn’t know to even raise these questions.
Anyway – thanks for giving this issue voice, Brenda. And I’d love to hear about others view on the idea of when to fire a therapist. 🙂
Jules,
I am glad you made the clarifications!
I believe it is difficult for “trained victims” to have the knowledge or skill of being able to assess what is considered a “standard of care” level of appropriate care.
Victims have a tendency to develop a high level of tolerance for inappropriate behavior, including within a therapeutic relationship. I hope you hear me as advocating for the victim (survivor).
Colorado Department of Regulatory Agency (https://dora.colorado.gov/) is established to protect the public from unethical behaviors and practices.
I respect your courage and strength of voice.
Kindly,
Brenda