Ask A Therapist: How Do I Know If A Therapist Isn’t A Good Fit For Me?

In Ask A Therapist, our therapists answer questions about therapy, mental health, and healing practices. Today, Sam answers the question: How do I know if a therapist isn’t a good fit for me? And if they aren’t - what do I do?

Connect with Sam at Samantha@RoomToBreatheChicago.com.

Connect with Ramya at RamyaMK@RoomToBreatheChicago.com.

Interview transcript {edited for clarity}

Ramya: Hello, everybody. Welcome back to our Ask a Therapist segment. Today we have Samantha with us, who's a clinician at Room to Breathe. I will let her introduce herself just a little bit and talk about the question that she's chosen today. 

Sam: Thanks, Ramya. So my name is Samantha Allweiss, pronouns are she and her. I am a therapist and Director of Social Responsibility and Inclusion through Room to Breathe. What that typically means is thinking about: how are we as clinicians supporting one another? How are we supporting our community? And how are we ensuring that we are upholding best practices and thinking about decolonizing our therapeutic work to make it as inclusive and accessible for folks as possible?

So yeah, I think that covers the majority of it, I would say I work primarily with adolescents and adults. I specialize in working with folks in the queer population, people who have chronic pain and chronic illness. And really thinking about accessibility for folks in the clinical space and in the medical fields. 

Ramya: Yeah. Awesome. Thank you. And what's the question that you have picked out for us today? 

Sam: Yeah, so the question that I wanted to ask has two parts to it.

But - so the first part is, how do I know if a therapist maybe isn't a good fit for me? And then what do I do if I determine that? 

Ramya: Mhmm, yeah. So I'll let you open with your thoughts. I know, it's a question that I've gotten several times from my own clients and other people. But I'll let you start. 

Sam: Yeah, absolutely. Thank you. And then if there's anything Ramya that you want to add to this, please feel free.

Yeah, a couple of initial thoughts. I think it takes some time to build trust and safety in a therapeutic relationship. So the focus maybe isn't initially on do you feel safe sharing everything with your therapist after the consultation call, or even the intake session, right?

But at the same time, you want to make sure that you're feeling comfortable bringing the, like primary aims of your therapeutic work, some of like the primary themes into the space. So if you're wanting to talk, for example, about non-traditional relationship dynamics, you want to make sure that you're not censoring that content out, because maybe something the therapist has said, or the things that they're not saying, indicate that you might not feel comfortable bringing that into the space. So one thing that I always suggest with folks is being really explicit about what you want to work on and making sure that the therapist can be affirming about that. 

So for example, if you're queer, bringing that into the space that you want to talk about your queer identity, you want to talk about kink, polyamory, something that you want to make sure the therapist is comfortable speaking to, and ask explicitly, what is your knowledge on this topic? What do you know about it? What education have you sought out in this specific space? And make sure that they can speak to that like you get a right to ask your therapist those questions too. Even if you haven't done it in the consultation call or intake, if you've been working with them for a while, but you realize there's topics that you haven't brought up. We see this around death, sex, money and finances those are like the three taboo subjects sometimes in a therapeutic space. If you realize you haven't brought it in, it's okay to ask your therapist explicitly. And then if you might know that they're not a good fit, because they might not have had that level of education, or comfort that you're seeking, their response isn't indicating or bringing to you a sense of safety, about talking about that topic any further in this space.

Yeah, and then there might be some particular things that you want to focus on, right? If it's eating disorder, or substance use, you might notice that your therapist isn't a good fit, because they don't have particular training in that area.

Yeah, I'm wondering, Ramya, if there's any, anything you want to add to that? 

Ramya: Um, I guess, just like a follow up question of how would one bring up with their therapist that they're feeling like there's a mismatch? 

Sam: Yeah, this can be a really tricky one, because we tend to work with fellow caretakers, when we think about our client population, so there can be a tendency to want to protect the therapists’ emotions or feelings. So I always make clear to my therapist that that, or to my clients, that as a therapist, that isn't your responsibility in this space. So you can be direct, it's absolutely okay, we as therapists get training on how to have these hard conversations, and how to ensure we're upholding the client's desires and their needs at the forefront of our session. So you don't have to caregive, you can just say, Hey, I am noticing that I'm not bringing this into this space. Or I'm noticing, I'm not feeling comfortable talking about this. Can we? Can we talk about what's going on or not going on here? Or, you know, I'm noticing that I really want to work on this. And I had mentioned this, but we're not really talking about it. Can we work on that? And see how your therapist responds to that. Because what they're saying both our verbal and nonverbal communication might be the things that you're picking up on, that aren't really establishing safety for you. So you're getting more information through that. 

Ramya: Yeah, for sure. I think feedback is something that I invite with my clients, and it's something that I'm very mindful of, of being like, Does it still feel like a good fit for you? every couple of sessions. Or what more do you need from me? And so we almost get in the habit in our therapeutic relationship of discussing, No, I liked this. And I feel like I need more of XY and Z. And so it opens the door and invites people to feel empowered to ask and advocate for themselves too, which is such a valuable skill in therapy, but also in life, because I feel like we're not always taught how to advocate for ourselves or ask for what we need too.

So I know that's something that me as a therapist, I try very hard to do that. And I would want clients and future clients to know that it's totally okay to be direct. Because, yes, we're humans. And yes, we have feelings. And - it's our clients space, we want to make sure that they're getting what they want out of it. 

Sam: Yeah, exactly. And we have space in supervision to process our feelings, a lot of us are in our own therapeutic work. So it's not the responsibility of our client, to care for our emotions in that moment. It's our responsibility to care for theirs. And so yeah, I think that piece of inviting feedback is a really important part of a therapist’s work. And I think sometimes if it's not explicitly happening, a client can feel like they don't have permission or believe they don't have permission to do that. But you get to bring it in, at the end of the day, we're working for you, with you too and alongside you, and all of those things, but if you're not getting out of it, or if you're not walking away from a session feeling like okay, there was a useful component of it, then you're more likely just to leave therapy. So let's have conversations first, about what's not happening. That might be more helpful because the client holds so much information and such a wealth of wisdom about their experience that can deepen the therapeutic work so much if they're willing to bring that in. 

Ramya: Yeah, um, I think another follow up question that I have for you is sometimes it can be awkward when, you know, we bring up like, say, I'm your client, and I bring up like, hey, Samantha, I think there might be a mismatch here, or I feel like maybe I'm not getting as much of this, and we didn't really talk about it. And we process and kind of unpack that. And then there can be kind of an awkward energy that comes up with that afterwards, how would you suggest working through that, and like healing through that in the therapy space, too? 

Sam: Yeah, you know, I think ruptures are inevitable in a therapeutic relationship, just like any relationship when you work together long enough. And I think a lot of the responsibility in that moment for repair is on the therapist, making it clear with the client, what they're going to do differently. And sometimes, you know, being explicit that this does not impact the desire to work with the individual. And I think sometimes we can sit with the discomfort, I think, one thing I say, oftentimes, in the therapeutic work is I think it's meant to be comfortably uncomfortable. And sometimes what's showing up for the client is like you said, they haven't been in a space when it's been okay to advocate for themselves. So they might be experiencing guilt, and shame, they may be projecting on to the therapist, what they think the therapist thinks about them now, that they’re a difficult client, they don't want to work with them anymore. So I think the client can absolutely name that. So the therapist can be like, Oh, wow, that has not been my experience. Let's talk about this. And let's be explicit about the fact that this relationship very much still exists with respect for them as client. So like, that deeper process of not just what’s said, but what you're feeling during the session, you can bring that in, because that's part of the change, too. And I find, again, with clients who are advocating for themselves for the first time, guilt is virtually universal. And guilt is one of those emotions that, it means that we're scared a relationship is breaking down. So you get to ask the therapist, Hey, are we okay? I feel a little guilty, I'm a little bit worried, so that the therapist can demonstrate to you that the relationship is still maintained. 

Ramya: Yeah, that's beautiful. I love how you said that. I think that also just lends to this idea that there can be ruptures, that there can be gaps, that you can work through with your therapist and continue the therapeutic relationship in a therapy space, just because there may be a rupture, or something's not matching up does not mean that you have to end therapy services right then and there with that person. It can be a process of determining if you can bridge that gap. Or if it is better to switch to someone else. Like it can be a variety of things, it doesn't have to automatically mean an ending. 

Sam: Absolutely, yeah, I think that's a really good point that sometimes we end relationships, because we're scared of having the hard conversations. So let therapy be a space where you're trying out the skills of having a hard conversation. It's lower stakes, that person has no other influence in your life. They're not a friend, they're not a family member. So I say to my clients frequently, let's try out stuff in our relationship that you haven't been you've wanted to do, but you haven't felt okay to do in other relationships. And that the relationship itself can be such a vehicle for change for us as clients, that allowing space for that can be sometimes the most powerful piece not just bringing in what's going on in your day to week, but bring on in what's it like to be in relationship in general with a therapist who is a human, too.

Ramya: Yeah. For sure. Um, as we're winding down here, if you would want listeners to take away one thing from our little chat today, what would it be?

Sam: Ooh, really good question. I think that it's okay to be direct. That the therapist can tolerate that, that your therapist will respect and care for you through that. And that the primary focus of therapy is getting what you want from it and working towards the goals that you determine. And so if that's not happening, it warrants a conversation. And I would suggest having conversations before ending the therapeutic relationship, because oftentimes, there's something that can be done if it's not feeling like the right fit to help it to - help the therapist recalibrate, but sometimes we don't get brave, and then we just end a relationship that could have been really fruitful. 

Ramya: Yeah. That's great. Thank you so much for joining today. I always love our little chats together.

And listeners, hope you're able to take something away from our chat today. And please make sure you give us feedback and ask us any other questions that you want us to cover in this little segment.

Thank you and Samantha hope you have a wonderful day. And all of our listeners have a great day. 

Sam: Bye. Take care.