Have you ever had a therapist? Do you know someone who does (or did)? How long did it last? If it ended, why did it end? Sadly, for many of my clients, their therapy ended because they either lost interest, did not feel they were growing and learning, did not see any changes in their behaviors, thoughts, or emotions, and/or felt the therapist was not benefiting them in any way. Finding a good therapist who upholds ethical practices and who is able to provide clients with competent therapy is difficult. It is even more difficult to find a therapist who is naturally nurturing and caring. It may take multiple rounds of therapy before a client is able to determine if the kind of therapy they are receiving is either good or bad. By the time a client notices that their therapy is useless, it is too late and much money, time, and energy has been spent. After a bad experience like this, many clients walk away from therapy and never turn back. This article will discuss 8 reasons for why clients refuse to return to therapy after bad experiences. The purpose of this article is to highlight some of the common challenges of therapy and when it is time to say you’ve had enough.

It is a real fact that some therapists and other mental health professionals are unable or unwilling to connect to clients and their problems. Connecting to clients is a job in and of itself. It can be psychologically and emotionally draining. But isn’t that what being a therapist or mental health professional is all about? If you would ask a college student why they are interested in the field of psychology they would most likely tell you they are interested because “I want to help people.” That’s a wonderful thing!

But the sad part is when a therapist is unable to connect to client’s because they lack appropriate ethical and moral characteristics to actually be useful to client’s in need. There is no real way to become “more ethical or moral” but we can certainly strive to improve ourselves everyday. Sadly, some therapists are so blinded (sometimes by their academic experiences, associations, or credentials) that they are unable to see where they need to improve and make changes. These therapists are sometimes the one’s who are hit with lawsuits and ethics complaints.

Therapists who are unable to see the error of their way(s) often engage in the following 8 behaviors which results in a loss of clients and referrals:

Using Contracts: Have you ever heard of the “suicide contract” or the “behavioral contract?” These contracts can either make or break a situation and unfortunately, they typically break a situation. Depending on the way in which it is written, the contract can be very inflexible, unrealistic, and even imprisoning for most clients. A contract has a way of enforcing “laws” and rules that have been agreed upon by the client and the mental health professional. For some people, the suicide contract has saved their life. But for others, it doesn’t matter at all. The behavioral contract can also pose problems as it often sets up too high of expectations that may or may not be able to be reached and which can result in a loss of self-esteem if the expectations are never reached. I am not a fan of contracts used in therapy to alter behavior. There is very little research to support its use.
Promising Confidentiality: Each time I see a child or adolescent in therapy, I explain and discuss confidentiality including privacy and ethical practices. I often tell youths that most things in therapy are private and will not escape the office or get back to their guardians. Unfortunately, I cannot promise that everything will be private especially if the youth is self-injurious, engaging in risky sexual behavior, is using multiple drugs or forms of alcohol, is reporting rape by a same age peer, or hiding secrets that are detrimental. This also applies to adults. For example, many marriage and family therapists struggle with when to inform a spouse that his or her spouse has a sexually transmitted disease. For many ethical therapists, this information would have to be discussed with the spouse sooner than later. No therapist can promise confidentiality but a mental health professional can certainly inform clients that they will attempt to uphold their right to privacy and confidentiality as much as possible without harming others or the client.
Judgmental Stance: Unfortunately, there are therapists who simply should not be therapists. Just because someone has obtained credentials does not make them “qualified.” This is one of the reasons why I encourage many of my clients and families to “interview” their therapist and make sure they would be a good fit with the therapist. A therapist who is judgmental or coming off as judgmental is not going to help a client to learn, grow, and change. If you feel judged, examine why you feel this way because it could be the therapist and not you.
Lack of cultural/ethnic sensitivity: Someone who is unable to relate to you because of your culture or ethnic identity is someone who needs further education in order to be an ethical therapist. It is a fact that many mental health professionals have areas of expertise and areas of weakness. For example, my area of expertise is trauma of children and adolescents while my area of weakness would be working with adolescent sex offenders. It is not unlikely that you will run into a therapist who has absolutely no experience with biracial/multi-racial, African American, Asian, Native American, or Hispanic individuals in therapy. When this occurs and you feel a disconnect, move on. It is okay to tell the therapist that you feel you would benefit from a different kind of therapeutic experience.
Dominating the session: No therapist is the same. Many come from different walks of life, educational programs, training programs, cultures, social environments, age groups, etc. Many also have different life perspectives, religious orientations, and spiritual philosophies. As a result, it is important to look elsewhere if you have a therapist who dominates the conversation every therapy session so much that you only have a short period of time to ask questions, explore ideas, or process emotions. Both therapist and client can be at a disadvantage in a session. What I mean by this is that some client’s dominate the session so much that therapists may have only a short period of time to help client’s connect the dots between ideas. It is important that both therapist and client are able to freely express themselves and communicate during a session.
The “know-it-all” stance: It is never a good thing when a therapist thinks that they are so significant that they are unable to relate to a client and his or her experience. A humble and thoughtful therapist is a good therapist because they can relate to their client’s while also frequently checking within themselves to see how they can improve and support their clients. A “know-it-all” therapist will not take the time to do this. Why should they if they are already special?
Flightiness: Believe it or not, there are a lot of therapists who struggle with their own emotions and emotional reactivity. Irritability, verbosity, and becoming easily angered by a client will inevitably end negatively. No client wants to talk with a therapist who cannot control his or her own emotions. How can a mental health professional help you if they cannot control their own emotions? Move on.
Poor bed side manners: The one thing that is never taught in college and graduate school is how to be compassionate, understanding, and kind to clients who are in need of help. While college and graduate students are studying psychological concepts, various mental illnesses, and approaches to therapy, they are missing the most important lesson of all which is to perform one’s job with proper judgment, compassion, and kindness. Mental health professionals who speak over their clients, come across as judgmental and uncaring, and who have the “know-it-all” attitude, should either strive to improve or never work with clients. These mental health professionals often create more problems than they do solutions.
QUESTIONS

What are some things that maybe you have struggled with in your own therapy?
Do you know someone who has never had success in therapy due to the personality, behaviors, or thoughts of the therapist?

As always, feel free to share your experiences below. The only way to grow and learn is to share!

I wish you well

Photo Credit: Ben Sutherland

Originally Posted @ Psych Central

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