Community Psychiatry’s Summer Thompson, DNP, PMHNP-BC was featured in HelloGiggles discussing how to change therapists.
Walking into your therapist’s office for the first time (or, lately, Zooming them) can feel like a rom-com meet-cute: You lock eyes across the room and a warm sense of trust floods your system. You see personal growth on the horizon, and you know this other person will help you get there—or maybe not.
Some therapeutic relationships—particularly if you’re unpacking trauma or dealing with a difficult diagnosis—can take some time to really flourish, requiring weeks and weeks of sessions to build up a rapport.
But sometimes, even after months of regular sessions, you still might not feel that professional chemistry. Maybe your therapist’s style is grating or you just don’t think they’re what you need.
Then comes the therapist-patient version of the “it’s not you, it’s me” breakup speech. It can seem awkward, but it doesn’t have to be. Moving on from a therapist that just didn’t work out is normal. Therapists expect it to happen, Dr. Summer Thompson, DNP, and psychiatric-mental health nurse practitioner, tells HelloGiggles. “As clinicians, we work with so many people. We’re not going to get weird about it. It’s not a bad thing,” she says.
And if you prepare yourself well enough to end one therapeutic relationship to start another, going through that process can actually benefit you, allowing you to get the help you need through a relationship with someone that you trust. Here’s how to approach switching therapists if you haven’t found the right one for you.
How to change therapists:
1. Trust your instincts.
“In modern society, we get gaslighted on things, and as a result, we don’t trust our instincts or our guts,” says Dr. Thompson. “When you walk into a room or a situation and get that weird feeling or sense that it doesn’t feel right…[listen] to what your gut is telling you.” She suggests giving a new therapist two or three sessions to see how you warm up to each other. “A good therapist isn’t going to dive into the hard stuff in the first couple of sessions, and if they do that, then you need to run away because it’s not appropriate,” Dr. Thompson says. If your gut is telling you the therapist isn’t right after those sessions, listen to it.
2. Get closure.
You shouldn’t ghost your dates, and you shouldn’t ghost your therapist. “A lot of times people just run away and have this thing that sits over their shoulder,” says Dr. Thompson. She recommends keeping your message simple but direct by calling (versus texting or emailing) and letting them know that you’re going to look for someone else to work with.
And don’t worry, your therapist really won’t take it personally. “I think patients really worry that our feelings are going to be horribly hurt,” says Dr. Thompson. “But I almost respect patients who end it more because they are able to stand up for themselves, and that’s a very good therapeutic indicator that [they’re] doing okay.”
3. Find someone new.
“When therapy is done well,” says Dr. Thompson, “it should be really uncomfortable. We’re not talking about all the fun fluffy stuff. Your therapist’s job is to sit down with you and discuss those really hard topics that you find are limiting you from getting to where you want to be in your life.” So it’s vital for you to start with the kind of person you’re going to feel comfortable doing that work with.
Perhaps you prefer to share emotional experiences with a man versus a woman. Or maybe you want someone who’s closer to your own age. Or maybe you want someone who shares or specializes in your sexual orientation or religious background. Look through online databases from places like Psychology Today, or ask for recommendations from friends. If you have health care that covers therapy, start by looking at who is in network and filter your options from there.
4. Reflect on what didn’t work.
Just like it’s not a great idea to jump from one romantic relationship to the next without figuring out what went wrong and what you’re looking for, going from one therapist to another without sitting down and mapping out why you’re making that change isn’t recommended.
By reflecting on what didn’t work, you can reduce the risk of finding yourself in the same position again, says Dr. Thompson. That’s something you can then share with your next therapist. For example, Dr. Thompson had a patient who started with her recently who let her know that her last therapist pushed her to discuss and process her trauma before she was ready. “It was really, really important for her to think about it and [to tell me], ‘You can’t do that to me, I can’t handle it,’” she says.
5. Share your story however you see fit.
If you were transferring schools, you could have your academic records sent over. If you were starting a relationship with a new primary care physician, you could ask for your medical files. But while therapists do keep notes on their patients, says Dr. Thompson, they’re rarely comprehensive. Most of their documentation is for insurance and billing purposes, and they avoid keeping detailed notes because their records can be subpoenaed, and they want to protect your privacy. Mental health professionals who prescribe medicine, like Dr. Thompson, do keep notes on those decisions, but no therapist is likely to have a neat, synthesized file of your backstory and progress. Instead, the responsibility for delivering that context is up to you.
At your first session with a new therapist, you can come prepared with a summary of what you’ve covered in previous therapeutic relationships and a list of the things you’d like to work on, or you can let that information come out organically. “There’s no wrong way to do therapy,” says Dr. Thompson. “It’s about what’s important to you as the patient. You walk into that room, and you say, ‘I need this.’”
6. Set reasonable expectations.
Dr. Thompson previously served in the Air Force and equates the process of therapy to the process of treating big, deep wounds. “They take wet gauze and pack it into the wound, and it’s there overnight,” she says. “Then they tear it out. It’s excruciating, but they do it again. And again. What ends up happening is that it heals from the inside out, and you’re left with this nice scar.” The good news is you can go through this process with the help of someone you trust, so long as you’re willing to sit in the discomfort and learn from it.
It can be hard to walk away from a not-quite-right therapist and look for someone who’s better aligned with what you need. But it’s worth it in the end.
“We learn so much from things that don’t work out the way that we thought they would,” says Dr. Thompson. “If you figure out what you don’t like about a therapist, and you learn something about yourself, then that’s a win.”