Feeling stagnant? It may be time to 'break up' with your therapist

For years, my friend regarded her counsellor as something like a best friend. During therapy sessions, she confided in the woman over her first job, work promotions, her marriage and other family woes.

Then over time, my friend found the monthly sessions a chore to attend and she felt that the advice given by the counsellor was repetitive.

Even when it seemed clear that their sessions were not working out, my friend was riddled with guilt at the prospect of switching counsellors, considering the years of trust built up between them.

"She has known me for years ... and has seen me at my best and worst. I don't even know how to end things before switching," she lamented to me.

As we chatted over dinner, I felt like I was talking my friend through a breakup or divorce as she went through the stages of grief and contemplation.

Starting out with a counsellor usually involves sharing your life story. For my friend, the prospect of doing this again was daunting, let alone finding a new therapist who suited her.

My friend's hesitation was understandable – after all, it's not easy to cut off someone who knows so much about you.

For people who use these services, when should you consider changing your therapist? And if you do, how can you make the process as easy as possible?

IS IT TIME TO MOVE ON?

Ms Priscilla Shin, principal psychotherapist at Range Counselling Services, said: "Sometimes the fit with a counsellor can change over time, even if things started out really well." 

Certain signs could indicate it is time to consider switching therapists. They include feeling like there is no progress, that the sessions are not as helpful or relevant, and that the goals you hope to achieve through therapy have changed.

"You might notice that you’re holding back or feeling less comfortable sharing, even if it wasn’t that way before," Ms Shin added.

"Overall, therapy should feel like it’s moving you forward and if it doesn’t, it might be a good idea to check with your counsellor about it or explore other options." 

Dr Karen Pooh, a clinical psychologist at Alliance Counselling, said that another reason to switch therapists is to find another professional to address an underlying issue uncovered during the course of therapy.

“For instance, many of my clients start attending therapy due to stressors in their present circumstances.

"As they delve into matters during therapy, they may realise that it is connected to deeper issues such as adverse childhood experiences and may then choose a treatment that addresses that.”

Clinical psychologist Geraldine Tan, from mental well-being centre The Therapy Room, said that clients might be ready to switch therapists as well when they are moving on to different stages in life.

One of her clients, who had depression, found himself managing better. 

"One day, he said he did not want to continue (our sessions) anymore. I told him there's no offence because us clinicians understand. That was when he said, 'You are associated with a dark period in my life, and I feel ready to walk away'," Dr Tan recalled.

"He agreed that he would see a counsellor in his university and continue getting support from those around him. He had moved into a different stage in his life and wanted to have a new beginning."

CAN YOU AVOID CHANGING YOUR THERAPIST?

Even if the signs indicate that it may be time for a client to seek a new therapist, some might hesitate to make the move considering the trust built up with their current therapist.

Ms Shin said that before deciding to tap out, people could first have an open conversation on the matter with their therapist.

This may allow the therapists to adjust their approach and focus to better suit their clients. If this works, the sessions may continue more productively.

"Another thing to try is to clarify your current goals together to ensure that sessions align with what you want to achieve," she added.

"If you’ve tried discussing your concerns with them and nothing’s improved, that might also be a sign that it’s time to move on."

Some people might also have "therapy fatigue" – where they feel therapy no longer works due to overexposure. In such cases, taking a short break away from therapy sessions may allow people to have a "renewed focus" when they resume with their existing therapist.

However, sometimes a change in therapists might be the only option, Dr Tan said.

For one thing, some clinicians might use only certain frameworks in their approach, such as cognitive behavioural therapy – a type of "talking therapy" designed to alter the way clients think and behave.

However, should the client require grief counselling, for example, and their clinician is not equipped to offer this, a referral would be necessary, Dr Tan added.

"I always tell my clients that if they feel the need for another therapist, they should not be embarrassed to say that. After all, I don't know everything and I can't fit every personality." 

HOW DO YOU CHANGE YOUR THERAPIST?

For those who have decided to make the switch, how may they go about the seemingly daunting and awkward conversation with their current therapist?

"When it comes to how to approach the conversation, being open and direct is usually best," Ms Shin said. "Many therapists understand that fit is important and will respect your decision."

Dr Tan said that sometimes, having this conversation might be too awkward, so some clients might choose to "ghost" their therapist instead. This means they would stop meeting their therapist without a word of explanation.

There can be various reasons for this, such as when clients are conflict-avoidant or are not ready to talk about such a decision. However, Dr Tan said that there are no hard feelings when someone does this.

Still, there are some good reasons for discussing a decision to leave with the current therapist.

The experts said that when clients communicate a decision to move on, the therapist can provide "closing sessions" to reflect on the therapy sessions they have held with the client.

They may also help provide some closure for clients and help them get into the right mind space as they seek other therapists.

Beyond that, there are other ways to make the transition smoother, such as the sharing of clinical notes between therapists.

"We do not hand (clinical notes) over to our clients directly because it can be interpreted wrongly. These notes we write are for us to recall details, facilitate sessions and organise thoughts. We have our own templates and own lingos," Dr Tan said of her own practice.

She sometimes hands her case notes to her client's new therapist if her client consents to it.

Another thing that therapists may do is to make referrals to other experts who might suit their clients, Ms Shin said.

Ultimately, Dr Pooh from Alliance Counselling said, trusting your own sense of growth and self-awareness is “essential” in the process of switching therapists.

“It is totally okay to ‘break up’ with your current therapist to find a new one. A professional therapist will not be offended and in fact, will be happy for you if you do find the right therapist,” she added.