# How do you know when to change therapist?



## Stilla (May 13, 2009)

Have any of you changed therapists and if so how long did it take you to change?

I sort of had a bad experience today and it's making me not want to go back and see her again but I've only gone three times. 
How do you know the difference between not giving it enough time and not clicking?


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## TicklemeRingo (Jan 11, 2013)

Hey congrats for starting therapy, Stilla! 

I don't really have any experience of changing therapists, unfortunately. But if you've have a bad experience it might be good to start looking around for someone else. I was able to tell pretty much straight away that the person I was seeing would be useful, so I don't know what else could really be revealed later if it isn't already.

I don't know. Either way, I hope you are able to keep seeing someone and get some benefit out of it.


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## SplendidBob (May 28, 2014)

I have two guides I use personally, and I have stopped seeing a psychiatrist and have rejected several therapists who failed.

1)When I leave after the session I need to be feeling better and not worse. The majority of therapists fail this, and make me worse. 

2)Proficiency. One of my issues (pure O OCD) is poorly understood by the majority of mental health professionals. It is very easy for me to tell within a few minutes of chatting whether a therapist has knowledge in this area. One that doesn't is going to make things worse for me. 

If I don't like the therapist for any reason, or come out feeling worse I don't see them again. Been burned too many times.


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## Stilla (May 13, 2009)

Hey thanks Ringo! 

I guess my gut feeling is that she's not right for me. Leaving today I felt even lower than before (which was already low) and having no experience with therapy before I'm not even sure if that's to be expected. Like are you supposed to feel worse before you feel better?

But thanks for answering, it has inspired me hearing your experiences with treatment!


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## Stilla (May 13, 2009)

Oh sorry didn't see your post until now @splendidbob. Seems like a good idea to have guidelines of some kind.


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## TicklemeRingo (Jan 11, 2013)

Stilla said:


> I guess my gut feeling is that she's not right for me. Leaving today I felt even lower than before (which was already low) and having no experience with therapy before I'm not even sure if that's to be expected. Like are you supposed to feel worse before you feel better?


 I think you should probably go with your gut feeling. While there may be some times in therapy where certain things (experiments, exercises) might make you feel bad, I think there should be a clear sense that it's heading in some positive direction, and that the difficult thing has a clear purpose. If it's all kind of vague it's probably not good. I think one of the best things therapists can do is provide clarity.

I think it kind of depends what type of therapy you are doing. Is it a specific kind, or just a general kind of 'sit on the couch and talk therapy'?

I was doing CBT. With CBT you want someone who makes you feel enthused and motivated. I had a sense that the person knew what they were doing, was enthusiastic and energetic about it, would motivate me, but also was an empathetic and intelligent listener - who could listen to my reactions and adjust things accordingly. Crucially (I think) they could clearly explain concepts to me so I had a clear understanding of the purpose of the therapy, and the direction we were heading in.

So I guess if you are feeling only uncertainty and a feeling of even more helplessness than before, that's probably not a good sign.



> But thanks for answering, it has inspired me hearing your experiences with treatment!


You're welcome


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## Stilla (May 13, 2009)

Hmm that does make sense! So far it's just been sitting and talk rather than cbt. 

Not sure how different the system is in Australia but did you ask for someone who specializes in cbt or did your therapist bring it up with you after awhile?

Also one final question that's more directed for everyone since I feel bad for asking you so many questions already.  but through therapy, cbt or regular, is it to be expected to be criticized? Like a tough love (minus the love) kind of thing were you're put down. Or are there actually therapist's out there who would be sympathetic to what you're feeling?


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## TicklemeRingo (Jan 11, 2013)

Stilla said:


> Not sure how different the system is in Australia but did you ask for someone who specializes in cbt or did your therapist bring it up with you after awhile?


Well what happened for me was first my GP referred me to a psychiatrist for an evaluation/diagnosis, after which the psychiatrist recommended CBT and set me up for a certain number of sessions with a therapist he thought was suitable (the number of sessions could be extended if needs be).

The good thing about that is all three of them (GP, Psych, Therapist) were all in contact and shared information (with my ok) so we were all on the same page and working in the same direction. It was nice knowing that a team of people were looking after me <:



> Also one final question that's more directed for everyone since I feel bad for asking you so many questions already.


 That's ok, I don't mind answering at all! :b



> but through therapy, cbt or regular, is it to be expected to be criticized? Like a tough love (minus the love) kind of thing were you're put down. Or are there actually therapist's out there who would be sympathetic to what you're feeling?


 No not at all! :shock (at least not in my experience) Quite the opposite. The therapist was hugely supportive, considerate and non-judgmental - I think that was an important part of the method, in fact.

As he explained to me, the old sort-of psychoanalytic style of sitting on a couch and talking about childhood for hours on end in the hope of getting to the root of some problem is supposedly not really all that beneficial for many people. These days it's not viewed as favourably as it once was by the profession. It's hugely time consuming (not to mention costly) and often the client/patient is just basically repeating things they already more or less know about themselves anyway. They get through months of therapy and realise they are pretty much where they started (or worse) with no idea how to overcome the problems.

We already know we have problems. It turns out it's not really always necessary to fully understand the 'root' of a problem before getting started overcoming it. A bit like untangling a long bit of string: We know it's become tangled. Understanding why it became tangled is not actually as important as previously assumed. The main thing is to untangle it. After that we can look back and see how it became tangled (I'm not sure that's such a great analogy, tbh ).

The idea of CBT and similar therapies is to simply get started overcoming the anxiety/anxious thinking that is holding you back. The "why" questions that therapy use to spend so much time on tend to reveal themselves along the way as you improve: in a sort of _"Oh *that's* what I was doing wrong before!" - _way. Hindsight, basically.

So no, that "tough love" thing is not part of it.

It's more _"Ok, so we know we have anxiety in this particular area, or about this particular thing. Let's design some experiments to see how we can overcome it in a gradual and careful way" -_By that I mean they help you to examine what your assumptions/thoughts/beliefs are at the moment, then set about testing those assumptions/thoughts in a kind of 'stepladder'/gradual exposure way.They then help you/support you to do them, to examine and compare results/plan improvements etc... So actually their support and encouragement is a huge part of that - that can only be done effectively in a non-judgmental and sympathetic way. So again, the 'tough love' thing is almost the complete opposite of that. _*Not*_ pushing you into too-much too-soon is a key part of the method, because doing so can backfire and simply reinforce problems.

If you're leaving the sessions feeling worse, de-motivated etc... that's probably not a good sign.

I will say that the only one thing that made me feel kind of bad was an experiment where we filmed me talking into a camera (so I could observe my speaking voice/body language). Looking back at the video made me feel uncomfortable for a few days after (although I think it was worth it in the long run). That wasn't a tough love thing though, the therapist was hugely sympathetic and supportive when I explained how it had made me feel.


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## Stilla (May 13, 2009)

Hey thanks again for such a thorough reply, it's really helpful to me. Have you ever contemplated going down the therapist route yourself? Because I'm pretty sure you'd be great as it. 


> The therapist was hugely supportive, considerate and non-judgmental - I think that was an important part of the method, in fact.


I mean this sounds like you :b

I have an appointment with a doctor on Monday about medicine and I think I'll ask him about if he can refer me to someone that specializes in CBT. Guess it won't hurt to ask at least.
I think that analogy is great and it sort of explains why a lot of people who go through psycho analysis continue to go for years and years because it won't actually make them feel better.

It's also sort of funny that you'd mention that you got filmed because my psychologist did start to film me last time but when I asked her if it was for me to see my body language she just wouldn't answer me. Did yours just tape your session, talking about anxiety or was it more like an actual conversation to see how you communicate? *apologies if that doesn't make sense*. But I could see how that could be very beneficial since it gives you an outward perspective on how you act around people. What kind of other experiments did you do? :3


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## Imbored21 (Jun 18, 2012)

When he pretends to care about your problems and then goes behind your back and tells your parents about everything and then sleeps with your girlfriend.


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## TicklemeRingo (Jan 11, 2013)

Stilla said:


> Hey thanks again for such a thorough reply, it's really helpful to me.


 That's ok  No problem.



> Have you ever contemplated going down the therapist route yourself? Because I'm pretty sure you'd be great as it.
> I mean this sounds like you :b


 Daaaww :blush That's sweet of you! I don't know...for some reason I can explain things much better with text rather than speech...so maybe an online only therapist :b



> I have an appointment with a doctor on Monday about medicine and I think I'll ask him about if he can refer me to someone that specializes in CBT. Guess it won't hurt to ask at least.


 Definitely! Do that :yes Hope it goes well.



> It's also sort of funny that you'd mention that you got filmed because my psychologist did start to film me last time but when I asked her if it was for me to see my body language *she just wouldn't answer me*.


 Wow! That's weird :shock



> Did yours just tape your session, talking about anxiety or was it more like an actual conversation to see how you communicate? *apologies if that doesn't make sense*. But I could see how that could be very beneficial since it gives you an outward perspective on how you act around people. What kind of other experiments did you do? :3


Well it was a specific exercise in which he would give me a random subject and I would then talk about it for 2 minutes, filmed. We planned for it by talking about and writing down any worries that I had about it, and how I predicted it would go (making predictions/testing assumptions/gathering evidence is a key part of CBT). The idea being to test assumptions and gather evidence....a bit like the way a scientist would in some ways - I found it allowed me to view my problems from a position of slight removal...in the abstract, as though they were somebody else's, which was useful.

The reason for doing this particular exercise was to examine my speaking voice (something I had expressed concern about previously), and physical signs of nervousness when in conversation.

I had predicted I would be self conscious about my appearance, but I kind of assumed it would be no different to looking in a mirror at home, but it really was quite different and I wasn't prepared for that. I underestimated how different it would be.

....to be continued :b (I'm heading out for a while now, will finish later)


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## Nibs (Jun 28, 2014)

I stopped going to my therapist when she insisted I "Just keep trying". Wtf thanks for the advice lady. I should have known from the beginning that she wasn't right for me when a majority of her office was covered with children books and toys.


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## Inknotmink94 (Mar 5, 2015)

If your not making progress or your not comfortable with them. That's when you should stop going.


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## Stilla (May 13, 2009)

TicklemeRingo said:


> That's ok  No problem.
> 
> Daaaww :blush That's sweet of you! I don't know...for some reason I can explain things much better with text rather than speech...so maybe an online only therapist :b
> Definitely! Do that :yes Hope it goes well.


Well I think you'd make a great online therapist that's for sure! 
And apologies for the late reply, I am very bad with procrastination.



> Wow! That's weird :shock
> 
> Well it was a specific exercise in which he would give me a random subject and I would then talk about it for 2 minutes, filmed. We planned for it by talking about and writing down any worries that I had about it, and how I predicted it would go (making predictions/testing assumptions/gathering evidence is a key part of CBT). The idea being to test assumptions and gather evidence....a bit like the way a scientist would in some ways - I found it allowed me to view my problems from a position of slight removal...in the abstract, as though they were somebody else's, which was useful.
> 
> ...


I mean wow that just seems like such a well planned out exercise. I could see how it's something you've built up and not a spur of the moment thing that it felt like in my situation. Your way was probably more beneficial as well. I think I'm actually going to try this on my own, you described the exercise so well I want to see what it's like. Will reply back with results. :3

(Also update and on topic sorta, I cancelled my last appointment but chickened out asking for a referral when I saw my doc, but got some meds at least)


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## TicklemeRingo (Jan 11, 2013)

Stilla said:


> I mean wow that just seems like such a well planned out exercise. I could see how it's something you've built up and not a spur of the moment thing that it felt like in my situation. Your way was probably more beneficial as well. I think I'm actually going to try this on my own, you described the exercise so well I want to see what it's like. Will reply back with results. :3


Cool!  Good luck with it.

If it's any help, maybe have a quick read over Modules 10 and 11 in this link: http://www.cci.health.wa.gov.au/resources/infopax.cfm?Info_ID=40

^It's similar to what my therapist and I did. It explains a bit of the planning stage of exposure exercises.

*But I hope that link won't put you off trying it your way - just looking at the link might make you think _"wow, that's a lot harder than I thought!"_ but it's really not. It's just described in great detail there, but the basic concepts are pretty simple. Don't let that link put you off.

Btw, the link is from this series of workbooks, from the place I went to for therapy.

You mentioned procrastination: That was always a _major_ problem for me too. It's very common with people who are prone to anxiety in other areas of life as well, as anxiety is a large part of the cycle of procrastination. It also has flow-on effects on your self-esteem, as I'm sure you've experienced.

As my therapist explained, people who are prone to anxiety tend not to have it in just one specific area of their lives, they also will maybe have some of the issues on that workbooks link above.

Looking down that list it might seem like _"I have so much wrong with me...I have such a huge mountain to climb!"_ But the good news is that making progress in one specific area seems to have a flow-on effect of helping in the other areas too. They all kind of work in similar ways: The thought processes are similar. Anxious thinking is a big part of all of them, so when you get control of anxious thinking in one area it helps in the others too.

I was doing that procrastination workbook with my therapist, and I've made plenty of progress. It's no longer as much of a problem as it was, thankfully. I'm planning a "how to overcome procrastination thread" soon, once I completely finish with the workbook, so I'll be sure to give you a shout when it's ready.



> (Also update and on topic sorta, I cancelled my last appointment but chickened out asking for a referral when I saw my doc, but got some meds at least)


Oh I see. That's ok. There's always another time for the referral. Hope the meds work out well


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## Jos1 (Mar 14, 2015)

Yeh a lot of times I felt worse after therapy and people told me that it was normal because it stirs emotions within.

But I'm seeing a psychologist at the moment, had 3 visits so far and I've felt better each time after seeing her.

The only difference between her and the few other therapists I've seen is I feel she really listens, is not judgemental and has a genuine caring personality, oh and she's female.


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## Riri11 (Mar 24, 2013)

Nabeel said:


> I stopped going to my therapist when she insisted I "Just keep trying". Wtf thanks for the advice lady. I should have known from the beginning that she wasn't right for me when a majority of her office was covered with children books and toys.


:um she didnt give you goals to follow in order to just keep trying.. heh I hope she was hot at least


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## Nibs (Jun 28, 2014)

Riri11 said:


> :um she didnt give you goals to follow in order to just keep trying.. heh I hope she was hot at least


Nope, no goals. Actually it kept running in circles. Every appointment seemed to be the exact same as before. Eventually she was like "ok great I'll see you in 2 months!" which became "ok great I'll see you in 4 months" and on and on... :|


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## meandernorth (Nov 12, 2014)

Nabeel said:


> Nope, no goals. Actually it kept running in circles. Every appointment seemed to be the exact same as before. Eventually she was like "ok great I'll see you in 2 months!" which became "ok great I'll see you in 4 months" and on and on... :|


Speaking from experience, that's when I switched. It became like the movie "Groundhog Day."


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## Nibs (Jun 28, 2014)

shorefog said:


> Speaking from experience, that's when I switched. It became like the movie "Groundhog Day."


I fell like she didn't know what to do with me. She should have admitted defeat and referred me to one of her colleagues. There are many other's in the practice so I'm not sure why she didn't do that; at the time I wasn't wise enough to ask for a different one.


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## meandernorth (Nov 12, 2014)

Nabeel said:


> I fell like she didn't know what to do with me. She should have admitted defeat and referred me to one of her colleagues. There are many other's in the practice so I'm not sure why she didn't do that; at the time I wasn't wise enough to ask for a different one.


Perhaps they try to manage caseloads and evenly balance the provider's clients. That still shouldn't stop the provider from acting in the best interests of the client. I mean no disrespect by switching but I need to put myself first.


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