How do you fire a psychologist or counselor?


Counseling and Therapy

By David Joel Miller.

Is it hard to say goodbye to your therapist?

There are several reasons you should say good-bye to a counselor and a few reasons you shouldn’t  Let’s look at these reasons first and then the how second.

Times you should stop seeing the therapist

1. If you have made the progress you need to make.

In managed care, we draw up a treatment plan. The goal is not a complete elimination of the symptoms. That would keep even normal humans in treatment forever. The goal of treatment should be to reduce the symptoms to a manageable level and to teach the client to be able to manage those symptoms in the future.

If your symptoms are under control and you feel you have the tools to live life without staying in therapy, you may be ready to move on. Ending this episode of therapy does not mean that you will never return to therapy with this or another counselor. It means that right now you don’t have a need to keep going to therapy.

2. If you are making NO progress.

Ethically a counselor should stop seeing you and refer you to someone else if they can’t help you. Sometimes we counselors want so much to be helpful it is hard to see when we are not the one that can help this client.

Your bringing up the idea of ending therapy may come as a relief for your counselor who has been trying to think of a good way to tell you that you need to see someone else. Therapists do not want to abandon clients in need and it is hard for them to stop trying.

Sometimes a self-help group, peer counseling or a friend support system is what you need just now.

Reasons you shouldn’t stop seeing this counselor

1. It is getting painful or difficult to talk about your problems.

Quitting therapy when the work gets hard or painful is a sure way to stay in your problem. When the work gets hard it is tempting to blame the therapist and change. It takes time for the new counselor to get to know you and you can put off really facing the issue for a while. This makes moving from one therapist to another tempting. Eventually, that issue will come up again and the pain is back.

Running from problems has kept a lot of people sick. Sometimes we use drugs and alcohol or romantic encounters. Other times people just change counselors. Either way evading your issues will not get you better.

2. There will be negative consequences if you stop.

If you were court ordered or need to complete the sessions to get your license back then stopping is a really bad idea.

If you are facing consequences as a result of stopping, think carefully before you do so. This probably means there are things about yourself you do not want to face.

How do you stop therapy?

There are oh so many ways but a few are more recommended than others. Counseling is all about the relationship and if you have been together with this counselor for any length of time you should have a good enough relationship to talk with them about this.

Most counseling relationships do not go one forever. Eventually, there will be a “termination stage,” to your counseling that involves the counselor preparing you to stop coming. If you bring this up the counselor should be willing to talk about where you are in the process, what else they think you need to accomplish and how you two will go about ending the counseling relationship.

If you have given this a try and the relationship is not working you owe it to yourself to tell the counselor that. Sometimes that discussion will result in taking a new approach and you will begin to make the progress you need to make.

With an independent private practice counselor, this can be as simple as saying no to another appointment and calling around to make an appointment elsewhere. If you have insurance that is paying for the treatment you should talk with your insurance provider about who else can see you and be prepared to give some reason why you need this change.

If you go to a large agency they may have rules and procedures for therapist changes. You need to ask how you go about doing this. While you may need to talk with a supervisor or administration about your desire to change you should always think of this as advocating for yourself and for the care you need.

If you find this especially difficult look for a case manager or patients advocate that can help you with the process.

Making progress in counseling is about finding a provider that you can develop a good working relationship with and then about doing work. Here is wishing you the best on your process of recovery.

David Joel Miller, LMFT, LPCC

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For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings, and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

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14 thoughts on “How do you fire a psychologist or counselor?

  1. I actually had therapy this winter and had to “fire” him… I think/thought he was only in it for the money, he didn’t seem to help me in the end… when I look back: only the first visit was usefull.
    He thought I was afraid for nothing, but in the end I was right in being fearful… what I feared is what happened and I got better support from people online… which is very bad, don’t you think? (I mean a therapist should be better than the internet)

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  6. Unfortunately the termination threat ignites some therapists into the counselor’s version of the controlling, wounded spouse, exploding in rage, and employing every manipulation in their arsenals to impede client abandonment. And because the client has been lulled into viewing these jerks as wise “authority figures,” the lies and contradictions can inflict untold damage.

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    • Thanks for the comment and for detailing your experiences. My view – there are bad therapists and they do damage. All therapists probably think they are better at this than they are. The problems generally is what the client says it is and they have every right to change providers or discontinue therapy if they chose to do so.
      I do not believe in the labels of “psychopathic-borderline- in denial-resistant-med seeking etc client” that some of my colleagues use to make treatment failures the clients fault. I do believe in Motivational interviewing, “tell me what you want to accomplish and how can I help you get there” and solution focused approaches. I do also believe that when therapy works it can be very beneficial, but therapy is not the only way to recover. Best wishes.

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      • This information has been helpful for me. I’d like to hear more about the “borderline-in-denial-resistant” excuse. When I sought therapy I mentioned the issue of copedendency, life transitions, and family boundary issues. I mentioned that I suspected that family members had personality disorders. The response I got was a question if anyone had suggested I had a personality disorder. This was in first session. Later when I complained about unavailability, I was told that they considered me to be outside of their “scope”. I mentioned that we had agreed to work on mindfulness training and that if something was outside of their scope they could refer me to someone else. They wouldn’t refer me other than to local community clinics. I was already working with 12-step groups and getting information online. What concerned me though was that they would want to label me as borderline. They were LCSW, and I don’t know what goes into getting a diagnoiss of borderline. Is it common to want to diagnose someone that quickly?

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      • Thanks for the comment. Sorry it has taken me so long to get back to you. You comment raised a number of questions and it deserves some good answers.
        I am working on some posts on several of these issues and some of them will be covered in a book I am working on.
        Here are the things that I think need more than a few sentences to answer.
        1. What is a counselors “Scope?” see post from 2/4/14 https://counselorssoapbox.com/2014/02/04/what-is-a-therapists-scope/
        2. Do therapists who are not members of a group have to follow a code of ethics?
        3. Who should be doing Mindfulness, mediation or spiritual trainings?
        4. Codependency
        5. Family Boundaries
        6. Life transitions (These transitions and the ways they can get us off track is the topic of the book I am working on. No title set yet.)
        7. The derogatory labels some therapist use in describing those clients they may find hard to work with.
        Please stay tuned over the next few weeks as I get these and some other posts written and up on the blog. Best wishes on your recovery.
        PS – Looks like your comment or two very similar ones, arrived from two different email addresses. Yours is not the only comment that arrives this way. Just wondering why this might be happening? Did you send it twice? Any tech people out there who might have an answer for this one?

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      • This has been helpful. I wanted to know more about the label of borderline-in-denial-resistant client” excuse. I initially sought therapy for codependence, life transitions and family boundary issues. I felt like family members had personality disorders. During first session I was asked if anyone had told me I had a personality disorder. Later I complained about unavailability and was told that they considered me outside their “scope”. I stated that we had agreed to work on mindfulness training and that if anything else was outside of their scope they could refer me to someone. They refused to refer me except to community clinics. My concern was if this was common to label someone borderline and how quickly a theapist might do that or what would be the motivation to do that? This was a LCSW in private practice and from my understanding if they are not registered with NASW, they don’t have to follow those ethical standards. I have been involved with 12-step and getting answers online. I didn’t think I was dependent after only 4 sessions. Now I’m confused about this experience.

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      • Thanks for the comment. Sorry it has taken me so long to get back to you. You comment raised a number of questions and it deserves some good answers.
        I am working on some posts on several of these issues and some of them will be covered in a book I am working on.
        Here are the things that I think need more than a few sentences to answer.
        1. What is a counselors “Scope?” see post from 2/4/14 https://counselorssoapbox.com/2014/02/04/what-is-a-therapists-scope/
        2. Do therapists who are not members of a group have to follow a code of ethics?
        3. Who should be doing Mindfulness, mediation or spiritual trainings?
        4. Codependency
        5. Family Boundaries
        6. Life transitions (These transitions and the ways they can get us off track is the topic of the book I am working on. No title set yet.)
        7. The derogatory labels some therapist use in describing those clients they may find hard to work with.
        Please stay tuned over the next few weeks as I get these and some other posts written and up on the blog. Best wishes on your recovery.
        PS – Looks like your comment or two very similar ones, arrived from two different email addresses. Yours is not the only comment that arrives this way. Just wondering why this might be happening? Did you send it twice? Any tech people out there who might have an answer for this one?

        Like

  7. A relative of mine wants to fire a therapist who has done nothing but ask intrusive questions about his finances and his very recent difficult divorce. The therapist got him to sign something that would give the therapist permissions to speak to his attorney or anyone connected to the divorce. He is going to write a letter terminating the therapist and revoking the permission but I wonder if that is all that is necessary to sever all bonds with this therapist?

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    • That sounds like a legal question and your relative may need to ask an attorney for legal advice. Here in California a client can revoke a release of information at any time but it needs to be in writing. The only exception to that would be a criminal justice release if the court, parole or probation were involved then it may not be revocable until a certain amount of time has passed. Not sure why the therapist would want this unless the therapy was part of the divorce proceedings. If that were the case then your family member needs to talk with their attorney about the consequences of revoking the release. Hope that helps.

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  8. Pingback: What if your Therapist loses their cool? | counselorssoapbox

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