When to Change Therapists: Making a Difficult Decision
Sometimes therapy is not working because the therapist is not right fit. Knowing when to stay and when to leave can be challenging.
Valid Reasons to Change Therapists
Lack of Progress
After reasonable time (typically 3-6 months), you should see some improvement.
Signs of lack of progress:
- No reduction in symptoms
- Not learning new skills or gaining insights
- Same problems discussed repeatedly without movement
- No change in functioning
- Feeling stuck session after session
- Getting worse rather than better
Important: Discuss lack of progress with therapist first. Good therapist will adjust approach or help you find better match.
Poor Fit
The relationship matters more than technique.
Signs of poor fit:
- Do not feel understood or heard
- Personality clash
- Different values or worldviews causing friction
- Communication styles do not mesh
- Cannot be vulnerable or open up
- Dread going to sessions
- Consistent feeling something is off
Competence Concerns
Not all therapists are equally skilled or experienced.
Concerns about competence:
- Unfamiliar with your condition
- Uses outdated or questionable techniques
- Cannot explain their approach
- No clear treatment plan
- Gives harmful advice
- Does not recognize issues beyond their expertise
- Seems unsure or uncertain
- Chronic disorganization
Boundary Issues
Boundaries protect therapeutic relationship.
Boundary violations:
- Inappropriate self-disclosure
- Seeking personal relationship outside therapy
- Sexual comments or advances
- Financial exploitation
- Asks you for emotional support
- Contacts inappropriately
- Breaks confidentiality
- Dual relationships
Serious violations should be reported to licensing board.
Unprofessional Behavior
- Chronically late or cancels frequently
- Forgets what you told them
- Takes phone calls during session
- Seems distracted or checked out
- Does not return calls or messages
- Poor clinical documentation
- Billing problems or unethical billing
Judgmental or Harmful Attitudes
- Judgmental about your identity (LGBTQ+, race, religion, etc.)
- Pushes their values or beliefs
- Blames you for your problems
- Shames you
- Dismisses your concerns
- Minimizes your experiences
- Makes you feel worse about yourself
Change in Your Needs
Your needs may outgrow current therapist.
- Need more specialized care
- Need different therapeutic approach
- Initial issue resolved, new issue needs different expertise
- Need more or less intensive care
- Ready for deeper work than therapist offers
Practical Reasons
Sometimes logistics make it impossible to continue.
- Moved to new location
- Therapist no longer takes your insurance
- Schedule conflicts
- Cost is unsustainable
- Therapist leaving practice
When Not to Change
Normal Discomfort
These are part of therapy, not reasons to leave:
- Feeling vulnerable or exposed
- Being challenged or confronted
- Temporary increase in symptoms when processing difficult material
- Awkwardness in beginning sessions
- Frustration with pace of progress
- Difficulty opening up (if therapist is patient and supportive)
Avoidance
Sometimes urge to leave is about avoiding difficult work.
- Therapist touched on something painful
- You are being asked to change behaviors you are attached to
- Getting close to breakthrough and feeling scared
- Pattern of leaving relationships when they get real
Discuss these feelings with therapist. Working through them is part of therapy.
How to Decide
Reflect Honestly
Ask yourself:
- What specifically is not working?
- Is this poor fit or am I avoiding difficult work?
- Have I given therapy enough time?
- Have I been honest with my therapist?
- Have I communicated my concerns to them?
- What would need to change for this to work?
- Is that change possible?
Talk to Your Therapist First
Before deciding to leave, discuss concerns with therapist.
A good therapist will:
- Listen non-defensively
- Thank you for bringing it up
- Explore what is not working
- Adjust approach if appropriate
- Acknowledge if they are not right fit
- Help you find better match if needed
A poor response tells you it is time to leave.
Red flags in their response:
- Defensive or angry
- Blames you
- Dismisses concerns
- Makes you feel bad for bringing it up
- Refuses to adjust approach
Get Second Opinion
If uncertain, consider:
- Consultation with another therapist
- Talk to trusted friend or family member
- Check in with your instinct
Trust Your Gut
If something consistently feels wrong, trust that.
Your intuition about therapeutic relationship is important data.
How to Leave
You Have the Right to Leave
You do not need permission. You do not owe continued sessions.
You can leave therapy at any time for any reason.
Options for Ending
Option 1: Direct conversation (recommended when safe)
- Schedule session to discuss ending
- Explain your reasons (as much as you are comfortable)
- Process ending together
- Get referrals if helpful
- Say goodbye
Example: I have decided to end our work together. I appreciate the time we have spent, but I do not feel this is the right fit for me. Can you provide referrals?
Option 2: Written message
- Email or portal message
- Brief explanation
- Request for records if needed
- Thank them for their time
Option 3: Do not schedule next appointment
- Simply do not return
- Therapist will reach out once or twice
- You can respond or not
- They will eventually close your case
When to use option 3:
- Boundary violations or harmful behavior
- Do not feel safe having conversation
- Extremely poor fit
- Therapist has been unprofessional
What to Say
Keep it simple and honest:
- I have decided to end our work together
- I do not feel we are the right fit
- I am going to try a different approach
- I have found a therapist who specializes in [your issue]
- I am taking a break from therapy right now
- This is not working for me
You do not owe detailed explanation, especially if leaving due to their behavior.
Feelings About Leaving
You might feel:
- Guilty
- Like you are disappointing them
- Worried about their feelings
- Afraid of their reaction
- Like you failed
- Relief
- Sadness
- Anger
All normal. Remember: This is YOUR therapy. Your wellbeing comes first.
Finding Your Next Therapist
Learn From Experience
Reflect on what did not work:
- What approach did not fit?
- What personality traits clashed?
- What did you need that you did not get?
- What would you want different?
Be More Specific in Search
- Specify approach you want
- Specify areas of expertise needed
- Specify personality or style preferences
- Ask detailed questions in consultation
- Trust your gut earlier
Ask Different Questions
In consultation with new therapist:
- I previously worked with someone who [issue]. How would you handle that?
- Can you tell me about your approach to [concern you have]?
- How do you typically work with someone with my presentation?
- How do you measure progress?
- How do you handle it if therapy is not working?
Consider Different Type of Therapist
- Different credential (LCSW vs. psychologist vs. LPC)
- Different theoretical orientation
- Different specialization
- Different demographic (sometimes helpful to work with someone who shares your identity)
- Different setting (group vs. individual, clinic vs. private practice)
Transferring Care
Requesting Records
You have right to your records.
- Request in writing
- May be small fee for copying
- Therapist has 30 days to provide (varies by state)
- Can have sent directly to new therapist
What to Share With New Therapist
- Previous diagnosis
- What you worked on
- What was helpful
- What was not helpful
- Why you left
- What you are looking for now
Be honest. It helps new therapist understand your needs.
Do Not Give Up on Therapy
One Bad Experience Does Not Mean Therapy Does Not Work
- Fit matters enormously
- Most people try few therapists before finding right one
- Each attempt teaches you more about what you need
- Right therapist is out there
Therapy Works When
- Good therapeutic relationship
- Evidence-based approach
- Competent, ethical therapist
- Client engagement and openness
Keep searching until you find someone who provides those conditions.
What If This Keeps Happening?
Pattern of Leaving Therapists
If you have left multiple therapists:
- Reflect on common themes
- Is there pattern in what causes you to leave?
- Are you avoiding intimacy or commitment?
- Are you leaving when things get difficult?
- Do you have unrealistic expectations?
- Is this about attachment issues?
Consider discussing this pattern with next therapist. It may be something to work on.
High Standards vs. Avoidance
- High standards: Seeking competent, ethical therapist who is good fit
- Avoidance: Finding reasons to leave whenever therapy gets challenging
Honest self-reflection helps you distinguish.
Bottom Line
Changing therapists is common and sometimes necessary. The right therapeutic relationship makes all the difference.
Do not settle for therapy that is not working. You deserve someone who is good fit, competent, and helps you make real progress.
Keep looking until you find that person.