“Sorry, I can’t be your therapist. Here’s a referral to another colleague I trust…”
Some people may take for granted that therapists can pick and choose who they see and under what conditions. Not all therapists will see every patient that walks through their office door. There are a variety of reasons a therapist won’t see you, and most of them have to do with professional ethics.
For instance, most therapists seek to avoid “dual relationships” with you or their other patients. A “dual relationship” is one where the therapist isn’t just your therapist, but may also be a friend, lover, business associate, or some other role in your life. Therapists seek to avoid dual relationships, so if they are already your friend, business associate, or whatnot, they will refuse to become your therapist as well (this also works in reverse — your therapist should never offer to become your friend, lover, business associate, etc).
Although this may feel like rejection, you shouldn’t take it personally. Therapists will often avoid seeing certain people for these reasons to ensure the patient is treated with proper respect and dignity. Here are five reasons why your therapist won’t see you now…
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A couple of reactions.
You wrote…
“3. Your therapist is seeing someone else in your family, a close friend, or has a close relationship with one of those people.”
I saw this in action once in an almost-soap-opera fashion, where a therapist had a long-standing psychodynamic therapy underway with client X, much of which had had to do client X’s search for a life-partner. Client X met person Y, and fell deeply in love with him. Person Y, unbeknownst to client X, was a close personal friend of the therapist.
What a mess. All three of them are still sorting it out. All I can say about it is that life happens.
What would you do in that sitch?
As for your last point, #5, it reads like a bundle of rationalizations wrapped in a collection of excuses surrounded by a plethora of justifications. After a gap in time, how can the therapist possibly deduce that s/he can nothing more for the patient without having the patient in his/her office for a good number of new sessions? Life changes, people change. This reason feels presumptive in the strictest sense of the word.
The scheduling thing? Puh-leeze. There are always cancellations and slots that open up at the last minute. You know this, and I know this. It is a reality of the business, even for the analysts. As a practical matter, if the patient is willing to be flexible for a while, the therapist can always fit them in at the last minute. And if the patient can only be flexible in the medium term, waiting a month, six weeks, or eight weeks will almost always result in an opening.
I really think reason #5 is a terrible excuse for not seeing someone. It seems more like, the therapist just doesn’t like the client.
There are always openings eventually. The therapist can be honest and say, “I don’t have many openings, I think it would be best if you see someone else, or you may not get in to see me for a few weeks”, but private therapists always have people canceling and/or dropping out of therapy.
Also, unless the client has an issue that the therapist isn’t trained to deal with or is refusing to do the therapy homework or be engaged in therapy, I think it’s irresponsible for a therapist to just abandon the client. And even then, it should really be the client’s decision if they want to see someone else.
Most people in therapy are very vulnerable and many are suicidal (about 1/4 have suicidal ideation). I think it’s very damaging for a therapist to say “sorry, I don’t want to see you anymore.” Most people will see that as a personal rejection. Plus, if the client already has an established relationship with the therapist, it’ll be easier to keep seeing the same therapist, instead of having to start over with with another therapist.
Honestly, if #5 really is a paraphrase for “the therapist just doesn’t like the client,” that’s a fine reason by me, and phrasing it as a schedule conflict or a professional limitation is a kind way to do it. As the article says, therapists are only human. If any strong personal feeling–positive or negative–is likely to prevent them from maintaining their professional objectivity, especially if it comes up at a point in the therapy where some progress has been made and there’s a natural pause or plateau where a referral for another approach might be helpful, letting go is just the reasonable thing to do. They’re therapists, not life partners.
And seriously, if you honestly feel that a particular therapist would terminate therapy with you (or not make room in their schedule for you to resume therapy with them after a break) for trivial reasons that aren’t in your best interest, why would you want to work with that therapist anyway? Even if they capitulated and “took you back,” if you’re in an emotional state that leaves you vulnerable to taking that kind of professional decision personally, wouldn’t you end up so worried about the possibility of further rejection that you wouldn’t be focusing on your own progress anyway?
I was surprised to read such an unsubstantiated, outdated and inaccurate statement of “a professional therapist will almost always seek to avoid dual relationships — especially where they have a pre-existing relationship with you in a nonprofessional capacity.” Dual relationships are unavoidable in rural and many small communities across the country. They are mandated in the military and forensic settings and unavoidable on college campuses. As my book and many articles at http://www.zurinstitute.com/articles.html#boundaries clearly described, some dual relationships can enhance the therapeutic relationships between therapists and clients, which is the best predictor of positive therapeutic outcome. APA, ACA and many other professional organization have changed their view of dual relationships, which is also reflected in their codes of ethics.
Ofer Zur, Ph.D.
Director, Zur Institute
http://www.zurinstitute.com
My only reaction, and I thank Dr. Grohol for his candor, is that contrary to current popular belief, therapy is not a cure-all. In fact, in my case, I found it to be worthless. Whatever progress I have made has been the result of self-help and hard work, and I didn’t have to pay $150 an hour for it.
I totally agreee with you Athirson. Not by choice, though. I went to counseling for appprox. 6 months. b/c of PTSD from rape, Major anxiety &depressive disorder,and was forced to have a new LISW every 3-4 weeks w/out notice after out-patient then voluntary in-stay in hospital for 5 days. Never completed CBT program in hospital b/c I was not in the hospital ong enough. Just got the booklet and a bunch of handouts. The hospital put me on the floor with suicidal and severely emotionly disturbed people. They should have been there. They neeeded help. Not me. I was not suicidal I just wanted talk therapy and tools to learn how to deal with all the fear, anger, anxiety, etc. The Dr.’s put me on so many anti-depressants that made me feel empty and diagnosed me with bi-polar disorder (ignoring the fact that I was raped and had PTDS. I just ignored what I had to deal, quit counseling,(I obviously got tired of the rotating counselors) took the meds. for 5 years.
Now I’m a mess. I’m off the meds., joined a gym, called a new PhD., she said I had to go back to the hospital!! I said no way. So I guess I’m on my own. I’ll continue to talk to my husband and deal with the denial of my family, try to forgive myself , & starve my fear /anxiety ALL BY MYSELF!
No thanks to the help of the Professionals!
Mouse
Wow, mouse, I feel for you and think your choice is good. The best therapists I ever found were not even therapists, but human. Also much better able to listen, and much more accepting and tolerating of the type of stuff that freaks professionals out. it seems to me that most professional therapists, even here, are unable/unwilling to handle anything, and feel that totally normal issues and feelings can only be handled in a professional, paid for $50 minute hour. They shake, and outright reject anyone who asks them for or about anything over the internet, immediately suggesting someone like ‘you’ needs to be handled in a hospital/office and is otherwise too dangerous to be talked to normally.
etc, etc,…Oh, and in a psychiatric hospital, or on a psychiatric floor, I think the only ones who are really helpful are either the aids, or the other patients.
PS: And social worker? my sincerest condolences!