When to Fire Your Therapist or Counselor
I decided to write this blog when my wife told me about a friend who had derived no benefits from remaining in therapy for over two years with a counselor for whom she had a strong dislike. My comment was: "Why would she do that? The therapist is on the client's payroll, and if one is not satisfied with what he or she is saying or doing, pull the plug." I was informed that she lacked the courage to fire her therapist because she believed that her lack of progress was due to her being a "bad patient." She was told that she had to work much harder and have at least three individual sessions per week. When her insurance ran out, she took out a loan so she could pay for further treatment. Finally, when the situation became financially untenable, she informed the therapist that she had to terminate. Like a bad marriage, too many clients remain in therapy out of guilt or fear.
Here is a questionnaire I developed with a colleague, Allen Fay, M.D. which we and our students have used to good effect for many years.
For each question or statement below (there are a total of 17) use a 0 to 4 point rating (i.e., 0,1,2,3 or 4) where 0 reflects no agreement and 4 reflects total agreement:
1. I feel comfortable with the therapist.
2. The therapist seems comfortable with me.
3. The therapist is casual and informal rather than stiff and formal.
4. The therapist does not treat me as if I am sick or defective, and about to fall apart.
5. The therapist is flexible and open to new ideas rather than pursuing one point of view.
6. The therapist has a good sense of humor and a pleasant disposition.
7. The therapist is willing to tell me how s(he) feels about me.
8. The therapist admits limitations and does not pretend to know things s(he) does not know.
9. The therapist is very willing to acknowledge being wrong and apologizes for making errors, instead of justifying this behavior.
10. The therapist answers direct questions rather than simply asking me what I think.
11. The therapist reveals things about himself or herself either spontaneously or in response to my inquiries (but not bragging and talking incessantly).
12. The therapist encourages the feeling that I am as good as s(he) is.
13. The therapist acts as if s(he) is my consultant rather than the manager of my life.
14. The therapist encourages differences of opinion rather than telling me that I am resisting if I disagree with him or her.
15. The therapist is willing to see people who share my life (family, friends, work associates, or other significant people).
16. The things that the therapist says make sense to me.
17. In general my contacts with the therapist lead to my feeling more hopeful and having better self-acceptance.
HOW TO INTERPRET THE SCORE
It is probably a good idea not to work with a counselor or therapist who you rated below 50 points. It is strongly advisable not to be seen by someone whose score fell below 40 points. Don't feel that you have to stay with someone simply because you have been with the therapist for months or years. It is your time, well-being and money that are at stake.
Copyright by Arnold A. Lazarus, Ph.D.
Remember, think well, act well, feel well, be well!
