A guide to when and how to change your therapist

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The spotlight turns to the essential yet often overlooked aspect of the therapeutic journey: finding the right therapist. While therapy is a cornerstone of mental well-being, a successful therapeutic relationship is paramount for progress. "While all kinds of therapists are ultimately looking to help, therapeutic relationship can be hampered if you just don't feel comfortable with their approach. For example, a lot of therapists use silence as a tool, but if they're not using it in a way that feels okay for you, it may not be a good fit," shares Divya Tiwari, clinical psychologist and head of therapy at MindPeers.

Recognising the signs of a mismatched therapeutic connection and making the decision to change therapists can be daunting, but it's a crucial step towards optimal mental health, as per Mehezabin Dordi, clinical psychologist at Sir HN Reliance Foundation Hospital, Mumbai.

On this day, mental health experts will delve into the complexities of the therapist-client relationship. They will answer pressing questions and provide invaluable insights into identifying when a therapeutic partnership is no longer beneficial, offering practical guidance on how to navigate this challenging process. Moreover, they will outline the essential qualities to look for in a new therapist and effective strategies for finding a mental health professional who truly understands and supports their needs.

How can I tell if the therapeutic relationship is no longer beneficial?

Tiwari: Some ways you can tell if a therapeutic relationship is no longer beneficial:

1. Feeling like most of your goals have been achieved

2. Therapist not able to help you achieve your long-term goals

3. Wondering about whether you should even continue

4. Not feeling better when they validate or empathise

5. Not feeling motivated about therapy

If you're feeling like the relationship is not beneficial anymore, you can certainly discuss this with your therapist. Most of them are aware of when this starts happening, but if they aren't it can help them tailor the intervention accordingly.

What are the signs of a lack of trust or connection with my therapist?

Tiwari: One can look for the following signs as an indication of a lack of trust:

1. Restraining yourself from saying things in the session

2. Feeling anger or frustration about something the therapist says

3. Not being able to do suggested activities/techniques

4. Missing sessions/not scheduling as regularly as you used to

5. Weighing what you say in the session and holding things back

Feeling like you can't trust your therapist can lead to a breakdown in rapport, which is the main thing that brings about change. If you've been seeing the therapist for some time, feel free to discuss anything that makes you uncomfortable. If it's a new therapist, you can try to look for someone who may be more trustworthy for you.

How can I determine if my therapist's personality or approach is a poor fit for me?

Tiwari: To understand if the therapist's personality or approach is a good or poor fit for you, you can pay attention to some of the following:

1. Their humour or conversational style.

2. Their cultural background and how it fits with yours

3. Whether they are taking into account your factors like community, social life/status, limitations and beliefs.

4. If they rely a lot on out-of-session activities (called Homework) when you would like more in-session work (or vice versa)

5. Aspects of their personality like talking too much/too little, casual/restrained, formal/informal.

Is it normal to experience plateaus in therapy, or does it indicate a need for a change?

Tiwari: Yes, it is perfectly normal to feel like therapy is plateauing. This happens frequently when you've been going to a therapist for a while, and your initial distressing emotional and cognitive state no longer exists. It may indicate a need for change, or that therapy is not needed anymore at this point. At MindPeers, we firmly believe that whatever the reason, it is important to address this with your therapist, so they can explore what the reason might be, and help you take the right steps to resolve the plateau. Some introspection can also help, along with paying attention to how you're doing outside of sessions.

How does one search for a new therapist?

Dordi: When you decide to find a new therapist, it can seem overwhelming, but breaking it down into manageable steps can make the process smoother. Here are several strategies to help you:

Referrals: Start by seeking recommendations from trusted sources. This could include your current therapist, who might have colleagues to suggest, or friends and family who have had positive experiences with their own therapists. Additionally, your primary care doctor can be a valuable resource for referrals, as they often have connections within the healthcare community.

Directories: Utilise online directories to find mental health professionals. Websites such as Practo, 1mg, BetterLyf, and others provide comprehensive listings of therapists. These platforms often include reviews and ratings from other patients, which can give you a sense of the therapist's reputation and effectiveness. Also, consider looking at local hospitals which may have their own directories of mental health professionals.

Professional organisations: Professional organisations, such as the Indian Psychiatric Society (IPS), maintain directories of accredited professionals. These organisations ensure that their members meet specific standards of practice, giving you confidence in the quality of care you will receive.

Local clinics: Reach out to local mental health clinics, hospitals, or community health centres. These institutions often have mental health professionals on staff or can recommend someone who fits your needs.

Specialty searches: If you have specific concerns or need a therapist with particular expertise, look for professionals who specialise in those areas. For example, if you are dealing with trauma, addiction, or LGBTQIA+ issues, finding a therapist with experience in these areas can be particularly beneficial.

What factors should be considered when choosing a new therapist?

Dordi: Selecting the right therapist involves careful consideration of several factors to ensure that you find someone who is well-suited to your needs:

Credentials and experience: Verify that the therapist is properly qualified and has sufficient experience, particularly with the issues you are facing. This ensures that they are equipped with the knowledge and skills to help you effectively.

Therapeutic approach: Different therapists employ various methods, such as cognitive-behavioural therapy (CBT), psychodynamic therapy, or humanistic therapy. Research these approaches to determine which one aligns best with your preferences and what you believe will be most helpful for you.

Compatibility: A strong therapeutic relationship is crucial for effective therapy. Look for a therapist with whom you feel comfortable and understood. Initial consultations can be a good way to gauge this compatibility.

Look at the logistics: Practical considerations such as the therapist's location, availability, and fees are important. Ensure that their schedule aligns with yours and that their services are within your budget. If you have insurance, check whether they accept it to avoid unexpected costs.

Specialisations: If you have specific needs, such as dealing with trauma, addiction, or gender identity issues, seek out therapists who specialise in these areas. Specialised knowledge can make a significant difference in the effectiveness of your therapy.

Reviews and feedback: Reading reviews and testimonials from other clients can provide insight into the therapist's effectiveness and approach. Positive feedback from others can give you confidence in your choice.

How does one ease the transition from one therapist to the other?

Dordi: Once you have chosen a new therapist, transitioning smoothly is key to maintaining continuity in your care:

Discuss with your current therapist: Open communication with your current therapist about your decision to change is important. They can provide referrals and help facilitate a smooth transition, ensuring that you continue to receive the support you need.

Request records: Ask your current therapist for your treatment records. Sharing these with your new therapist can provide continuity in your care, giving them a clear understanding of your treatment history and current needs.

Prepare for the first session: Be ready to discuss your treatment history and current concerns with your new therapist. Having a summary of your previous therapy can help them understand your background and tailor their approach to your needs.

Give yourself time: It may take a few sessions to adjust to your new therapist and build a rapport. Be patient with the process, as developing a comfortable and trusting relationship is essential for effective therapy.

Evaluate the fit: After a few sessions, take time to assess how you feel about the new therapist. It's important to feel understood, and supported, and that the therapist's approach aligns with your goals and needs.

Transitioning to a new therapist is a significant step in your mental health journey. By following these steps, you can help ensure that it is a positive and beneficial change, leading you to the support and care you need for your well-being.

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