Whether you’re on session one or 100, it could still be time to make the switch.
Most of us have had the unfortunate experience of sitting through a physical exam with a doctor we can’t stand. But while our doctor’s bad attitude (hopefully) won’t change the outcome of our physical, a rocky relationship with your child’s counsellor could significantly reduce the progress your child makes in therapy. Research has repeatedly found that a positive relationship between a clinician and a client is the most important factor in symptom improvement—even more important than the type of therapy being practised.
But how do you know if it’s time to make the switch? Here are five red flags that it may be time for your child to change counsellors.
1. You Can’t be Honest with Your Child’s Counselor
If you or your child find yourself frequently withholding relevant information from your child’s counsellor for fear of judgment, criticism or retaliation, then it may be time to change clinicians. These feelings are, of course, natural in your child’s first few months of counselling—it takes time to get used to a setting as non-judgmental and accepting as therapy—but after a few months, you and your child should feel comfortable sharing the good, the bad, and the embarrassing with your clinician.
Before you change counsellors for this reason, though, ask yourself (or your child) if this is an issue that you would experience no matter who was in the room, or if this counsellor, in particular, seems to be the problem. For example, if your child is generally fearful of others’ criticism, a change in clinicians is unlikely to help him or her share more openly. However, if you have difficulty discussing your child’s behaviour because the therapist reminds you of a harsh and critical boss you once had, switching therapists may put you more at ease.
2. Your Child’s Counselor is Rude or Unprofessional
If your child’s therapist is outright disrespectful to you or your child, it is probably time to find another clinician. It may be worth discussing the behaviour or comments that bother you with your child’s therapist first—there may be a seemingly offensive company policy, clinical term, or therapeutic technique that simply needs some explanation—but if you don’t feel comfortable having this conversation, it is much better to switch clinicians than to avoid the issue by discontinuing therapy altogether.
Behaviour that seems to cross the line to unprofessional or inappropriate should be reported through that agency’s grievance procedures (usually a paper form available at the front desk or a hotline) or by contacting your state’s licensing board for mental health counsellors.
3. Your Child Won’t Participate
A positive working relationship between a child and their therapist is the foundation of effective therapy. And while many therapeutic relationships develop without difficulty, there are some cases in which a child and a counsellor simply don’t click. This rocky relationship often manifests itself in a child who refuses to participate in therapy, whether by remaining silent for a full hour, making continuous jokes to divert the conversation, talking incessantly about unrelated topics, or throwing a temper tantrum.
Most children demonstrate some kind of resistance to therapy—often, they’re trying to avoid embarrassment, thinking about unpleasant events, or getting in trouble. But once they develop a positive relationship with their counsellor, they usually become more comfortable with participating in therapeutic activities and discussions. Although it could take longer for children with a history of trauma or significant developmental delays, if your child has been in therapy for several months and has not made progress toward participating in their sessions, it’s time to consider changing clinicians.
Refusing to participate in sessions could mean that your child is not ready for therapy—but until you try different counsellors and different types of therapy, it is difficult to tell if a child is resistant toward the therapy process in general, or the therapeutic style of a particular clinician.
4. Your Child’s Counselor Won’t Stop Talking
In our culture, avoiding long silences is a basic social instinct, and sometimes when a child is very quiet, his or her therapist will try to fill this silence by talking. In other cases, a therapist will try to make a child feel more comfortable discussing a particular topic by sharing personal experiences. And in some cases, a therapist is simply a “Chatty Cathy.” Whatever the reason, some clinicians do spend the majority of their sessions talking, and this can make it challenging for your child to express him- or herself openly.
It should be noted that some types of therapy are heavily educational, and it, of course, makes sense for your child’s counsellor to be speaking more than your child while they are teaching a specific skill. But every session should include time for your child to freely discuss recent events and their feelings, and during this time your child should feel listened to and unrushed.
If your child attends therapy alone, talking to your child’s therapist, either on the phone or in person, can give you a sense of what your child experiences in session. If you find yourself waiting to get a word in edgewise on the phone, it may be time to change clinicians. You can also ask your child if they feel that their counsellor is listening to them and if they are able to discuss everything they want to in session.
5. Your Child is Not Making Progress After a Year
Mental health counselling is a progressive process that often moves more slowly than parents would like. But however glacial the pace, therapy should still be moving your child toward their treatment goals. If your child has been in therapy for a year and has not made any progress toward their treatment goals, it is time to consider changing therapists.
Keep in mind that progress is incremental, and no amount of therapy is going to result in a “perfect” child. If your child was hitting his classmates twice a day when therapy began and is now only hitting them once a day, that is enormous progress (even if it does not seem like he is improving because you’re still getting daily calls from the school).
When assessing your child’s progress, you should be mindful of what goals are realistic for your child, and if any significant life events may have impeded their progress toward improvement. Many children experience a regression in their most recently developed skills when a major life event occurs, such a move, change in family structure or traumatic experience.
Making the Switch
If you have decided to change clinicians, discuss your decision with your child, who may have developed a significant relationship with their therapist. Be sure that your choice is not worded in a way that blames your child for the change. For example, instead of saying, “We’re not going to see Mr Smith anymore because you’re still getting in trouble at school,” try something like, “We’re going to see if Mrs Doe has some new ideas for how to help you at school.” Most children are used to changing teachers each year and cope well with switching clinicians.
In most situations, changing counsellors is as easy as making a phone call to the agency or practice your child receives counselling from. If you choose another clinician within the same organization, all of your child’s treatment records will move with you, and you will not need to complete a second intake assessment. If you book an appointment at a new agency, however, you will have to complete a new intake assessment, but you can bring a copy of your child’s treatment file from your previous practice to shorten this process significantly.
Whether you decide to continue with your child’s current counsellor or find a new one, it is important that you maintain a positive attitude about your child’s therapy and therapist in front of your child, and help your child attend sessions consistently. Many parents stop bringing their children to therapy if they dislike the counsellor, but changing clinicians is usually a better solution to ideological or personality clashes.
Remember: There is a reason you brought your child to counselling in the first place, and you and your child are the ones who miss out the most when you stop attending therapy.
(This story originally appeared on psychologytoday)