When to find a new therapist?

[budgie1979]

How do you know it's time to find a new therapist? I've been seeing mine (CBT) since 2010, and she recently reduced me from monthly to "as needed" which is working out to about once a quarter. I really feel comfortable with her, but my anxiety has flared up terribly since she cut me back, and even the "as needed" sessions aren't all that helpful. It seems like we don't do any real "work" anymore--it's just a 45 minute chat session with maybe a thought record about my most pressing worry.

Right now, I'm wondering if I need to find someone else. When I started with this therapist, my issues were more of the GAD type along with depression, but I've since developed crippling health anxiety and it seems like maybe she is not as well-versed in treating that. I've also asked several times about medication, and she has just advised asking my GP (who won't prescribe it for me).

Complicating the issue is the fact that I may have to relocate to another state some time in the next year. Wondering if I want to go through all the trouble of finding someone new now when I'll have to do it all over again in a few months. Just don't really know what to do right now, but I know I need more help than I'm getting.

[lior]

Well done you for recognising you need more help right now. That's excellent self care.

Therapists seem to have a lot of training in how to handle therapist-client relationships. Have you talked to your therapist about it?

It seems like these are your choices:

1. Continue with the 45 min quarterly meetings until you move states
2. Ask for more meetings with her, in line with what you need
3. Find a therapist that can help with health anxiety specifically, and end the 45 min sessions with your current therapist

1 doesn't sound like it's enough for you.
2 could be a good option - what are the points against this?
3 would involve a bit of work to find a new therapist, but it could make a big difference to your quality of life over the next few months before you move states. Maybe it's worth the work? It's your call to make.

Can you think of any other options?

[MyNameIsTerry]

Is the therapist a member of any professional associations (mandatory or voluntary)? The ethical policies of such associations normally stipulate that a member should be willing to help a client change therapist rather than just terminate the relationship of either or both parties think it would be helpful. Just something that might help if there are any issues.

That's a long time to be having CBT. CBT can address HA whether using such as ERP components or more intensive work as it certainly addressed OCD. Maybe the therapist lacks experience with OCD type disorders so looking for someone with experience could be a good thing but it's worth talking to them about this as I'm sure they will be honest about it with you.

One thig to consider is whether there are better forms of therapy that CBT. It comes in various forms of it's own anyway and a review of whether there is something better, given the long time frame, seems worth it.

[budgie1979]

Well done you for recognising you need more help right now. That's excellent self care.

Therapists seem to have a lot of training in how to handle therapist-client relationships. Have you talked to your therapist about it?

It seems like these are your choices:

1. Continue with the 45 min quarterly meetings until you move states
2. Ask for more meetings with her, in line with what you need
3. Find a therapist that can help with health anxiety specifically, and end the 45 min sessions with your current therapist

1 doesn't sound like it's enough for you.
2 could be a good option - what are the points against this?
3 would involve a bit of work to find a new therapist, but it could make a big difference to your quality of life over the next few months before you move states. Maybe it's worth the work? It's your call to make.

Can you think of any other options?

Thanks, yes those are pretty much the options I've come up with. I agree that the quarterly sessions are not enough. As to more meetings with the current therapist, the only drawbacks are:

• Cost--$200 per session, since she doesn't take insurance; however, I was doing well with once a month appointments, and I can manage that cost
• Time--she is 40 minutes away, which means each session takes 2+ hours of my time
• Effectiveness--I think if I continue with her, I will need to be frank about my feeling that we need to do more "work" on my underlying issues and less "damage control" on whatever single thing is causing my anxiety at the moment. Basically, I know how to do the CBT stuff to get myself out of each episode of anxiety, but I would love to find a way reduce my overall anxiety so that I'm not in a constant low level state of anxiety.

I think probably the best thing to do is make an appointment in the near future and talk this over in session to come up with a plan. I'm also looking into other therapists in my area who might take my insurance (there aren't many, sadly). That way, if we do decide that I might be better served by another therapist, I will have a list of options.

[swgrl09]

I would agree with speaking to your current therapist about it. Usually therapists will either change their current plan of action with your input or explain why they made the decision to reduce. He/she should be more than willing to help refer you to another provider if you decide that is the best choice.

[lior]

Good work.

I found that my CBT therapist was not trained to do work on underlying issues. CBT focuses on management techniques. This is exactly why I went on to psychotherapy. That's how I've been tackling the underlying issues. Psychotherapy is a very, very long process, and can be expensive. But the effects are lasting.