As I embark on my new adventure of starting my own private practice, I am thinking of what it takes to be a great and effective therapist. Although many of us mental health professionals take specialized training and spend countless hours honing our skills, many of us still experience premature therapy drop-outs. Why is this I wonder? Premature drop-out is something that each therapist dreads and antagonizes about, especially when it occurs early in therapy before the relationship has had a chance to develop.

Clients affect us more than we like to admit, and more than you know. What clients don’t see is the work we do behind the scenes, after the session. When we write our notes, we are often occupied with trying to match interventions with client goals and symptoms, researching best treatment practices, etc. We often seek consultation with our colleagues and wonder if we are doing enough to help. So when I client leaves therapy prematurely and without causes known to us, it can impact us deeply. We find ourselves asking, what could I have done differently? without actually being able to answer it or make the required changes for the next client.

As such, it is important that both therapist and client understand that the therapeutic relationship is all about best match. Yes, while it is important that your therapist have the proper skill and knowledge for your presenting issue, it is also important that you feel comfortable in their presence. You must be able to connect and are safe enough confiding and being vulnerable with them Healing cannot occur unless you are willing to travel outside of your comfort zone and this this can only happen if you feel safe enough with your therapist. Trust is such a vital ingredient in therapy and if you do not feel it even in the first session it is ok to tell your therapist or seek another one that you do feel that way about.

Another important thing to consider is that therapists are just human beings, not much different than yourself. As humans, we often make mistakes. This means, we may not always say the right thing or we may not interpret what you say correctly 100% of the time; after all, most of us cannot read minds! (although it would help a lot if we could). It is normal for your therapist to blunder from time-to-time. In addition, sometimes…or rather often, change is difficult. This means that your therapist may say or suggest something you either won’t agree with or will feel uncomfortable with.

So…how will you know if these feelings mean it’s not a good match or if they are simply part the change process? If uncomfortable feelings come up for you in therapy, it is important that you explore these. One good strategy is to ask yourself if those feelings lead to self-reflection on aspects of yourself you have never dared to questioned before, perhaps on things that are longer serving you? Do these reflections lead to lasting change? If so, perhaps your therapist is being effective and working with you towards your goals. However, if you find that your therapist is consistently not “getting you”, they have made completely offensive remarks, they cannot support your perspective (which does not mean agree!), or you just get an “off” or an unexplainable uncomfortable feeling from them, it may be time to move on.

It is beneficial to have this conversation with your therapist for several different reasons. First, it will help you assert yourself, which is extremely therapeutic and helps you develop interpersonal communication skills. Second, it also helpful for the therapist. Informing your therapist that they offended or hurt you will allow both of you the opportunity to repair the relationship. They will get the chance to explain their side of the story, after all you may have interpreted what the therapist said in a way they did not intend, going back to our shared humanity. Even if you end up leaving the relationship, this will allow you to leave on good terms. Last, when your therapist understands what went wrong in a client-therapist rupture, it allows them to learn and grow and do differently in future client/therapist relationships. Although it may hurt the therapist temporarily, an effective therapist will truly appreciate the wisdom you imparted in them and thank you for your honesty – after all we cannot all be a great match!

– Wanda @ ReDiscover