Finding a Therapist Who Will Listen to Client Feedback

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Reader’s Question

In general, how is it recommended to resolve differences with your therapist?

I have ‘quit’ three therapists due to differences of opinion with them.

The first wanted me to change my major of study, because she thought I would be better off as a research psychologist than in my chosen field. I tried to understand her, but I didn’t agree with her conclusions, and I told her as much. She continued to pressure me, so I eventually voted with my feet.

The second wanted me to immediately switch to a new medication, after my first experiment with medication left me unable to focus enough to cross the road by myself — an unacceptable side effect. I would have preferred to ease off the medication and then review, when I was not feeling drugged out. I did not feel like she heard me, so I felt unsafe and voted with my feet, going cold turkey off the medication. Luckily, I was on a medication without disastrous withdrawal symptoms.

The third put me under pressure to convert to his preferred religion, and would often try to bring me back to religious issues when I wanted to talk about stuff that was more relevant to me and my life — work, study, relationships etc. He would tell me that I should do stuff because it was religious — as if religion was an authority in itself. When I started refusing to talk about religion, he told me that all intelligent people loved talking about religion. I had to make a formal complaint about him.

I do not think that any of this was appropriate, although they all clearly thought that it was. How can I resolve differences with a future therapist effectively?

Psychologist’s Reply

Finding a therapist that’s a good fit can take time, but it certainly shouldn’t feel as invalidating as the experiences you’ve described. It’s no wonder you’re concerned about how to feel heard and get your needs met when you decide to approach therapy again.

As you’ve discovered, different therapists have different approaches to therapy — some of which might fit for some people, but not for others. While some clients might want someone who discusses issues in the context of religion, the very same thing may be very offensive to another individual. When therapists can’t adapt to their clients’ needs or goals, often clients do exactly what you did — “vote with [their] feet.” What I’m hearing you ask, however, is how to work through conflict with a therapist in a more effective way than just leaving. It’s a great question, and approaching it with a therapist might offer you a therapeutic experience and skills to use in other parts of your life as well.

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First, it sounds like you might want to do more research or interview potential therapists to see how their style fits with yours. Often you can read descriptions on their websites or in directories to see if what they share sounds like it fits your values. For example, my guess is that someone who offers religious counseling may not be a good fit for you and may not be able to shift enough to become a good fit for you.

Second, you might search for a therapist who welcomes feedback and actively engages in the process of asking for and accepting client feedback, and then adapts as needed with each session. A fairly new but well-researched approach called “Feedback-Informed Therapy (FIT)” actually exists that addresses this very concern. Experienced therapists who practice FIT use it in addition to their clinical skills and their therapeutic approach (such as cognitive-behavioral therapy, interpersonal therapy, humanistic, etc.) to help make sure clients are getting what they need from therapy.

I would encourage anyone in your situation to explore the useful, short guide that offers questions to ask a new therapist on the Heart and Soul of Change website. (Editor’s Note: The site takes its name from a great book that we’ve reviewed separately on our main site.)

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