Therapy Made Me Worse!

Clearly, as a therapist, I believe that therapy can work.  Whether for individuals working through life’s issues or for couples trying to improve their relationships, good therapy can provide the tools to get there.

That said, I have heard stories from friends and even my own clients of therapy where they not only felt it didn’t help, but perhaps even felt worse. So let’s talk about some of the most common reasons that can happen.

The first has to do with the fit between therapist and client. Some say this is the most important predictor of a successful outcome. If you have a therapist who is present for you, shows acceptance and empathy, listens well, and you are making progress toward the goals of the treatment plan you created together, you probably know you have a good fit. It doesn’t have to feel comfortable all the time – in fact, personal growth can be anything but comfortable. But they are there with you to offer the assistance you need to work through it. 

Sometimes it’s not a fit. This can be for any number of reasons, or no obvious reason at all.  Let me share with you some of the reasons that I’ve been told:

* The therapist had no experience in my problem, and didn’t seem interested in learning about it.

* She was always running late and seemed distracted. She took phone calls during my session.

* He took notes the whole time. Never looked at me, never said much.

* I live in a small community, and my therapist violated my confidentiality in a social setting we both share.

* She constantly told me what to do. I needed to find my own answers.

* He insisted we talk about my childhood, and I wasn’t ready. I started having panic attacks after our sessions – it was too much, too fast.

* She talked about herself the entire hour. I just sat there and listened.

Those are a few of the statements I have heard. Now, I have to take all of them with a grain of salt. The therapists in question were not present to explain their side, and I am certain there have been a few clients just as unhappy with me for one reason or another. It’s hard to judge what happened, but the fact that these are the clients’ perceptions make them matter.

There are some challenges that we, as therapists, experience with clients that can hamper the outcome of therapy, as well.  Maybe that will be another video someday. 

I am a fan of, for lack of a better word, shopping around a little for a therapist. There may be hundreds where you live, so starting with an online search in your area is a typical way to begin. Check out the practitioner’s profile, visit their webpage, and see if they offer a brief, free consultation. Before you call, make a few notes on your primary issue and the type of person you’d like to help you. Some people feel more comfortable with a male therapist, or someone who is older. A consultation isn’t a session, but it can give you a chance to get a sense of the therapist and to express your needs and goals. Many people give more research to the choice of a car mechanic than they do when they choose a psychotherapist, so prepare a little and have an idea of what you need.

I have to add again that even the very best therapy is going to feel uncomfortable sometimes. You may be discussing deep-seated, painful issues. But you should feel that your therapist is present and engaged in what the process is like for you.

If you are experiencing dissatisfaction with your therapist, it is absolutely okay to bring it up. “I notice our sessions are only 30 minutes, because we routinely start late every week. Can we talk about that?” or “What I would like most to focus on is my marriage. Can we discuss that today?” or “I feel this is moving too fast for me. I want to explore my past, but I am struggling with how worked up I am when I leave each session.”  Good therapists welcome questions and ways to collaborate on the process. That’s our job. When there are questions or roadblocks, often working through them together can be a great benefit.

If there is truly no fit between client and therapist and you can’t work it out, it’s okay to switch providers. This is your journey. Your therapist can provide you with a few names of other practitioners, and there should be no hard feelings.  You have every right to the best therapy you can find. So identify what that looks like for you, ask for what you need, and keep making progress. 🙂

What do the letters after my counselor’s name mean??

LMFT (or MFT) Licensed Marriage and Family Therapist

LPCC: Licensed Professional Clinical Counselor

LCSW: Licensed Clinical Social Worker

Ph.D: The person holds a doctoral degree. Check to see if they are a Licensed Psychologist or hold one of the licenses above

Psy.D.: The person holds Doctor of Psychology degree

M.D.: Medical doctor. Psychiatrists are medical doctors.



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