Most therapists want to believe that they are a good fit for their clients. I remember the first time a client fired me as their therapist. I wanted to find some external reason to describe why the client stopped attending, mostly because I didn't want to face the possibility that there was something that they didn't like about me. In these situations, clients usually just disappear after the first or second session, or if its later in the treatment process, they rarely provide an explanation as to why they are no longer attending therapy.
Over the years, I have been taught by my clients that the client / therapist relationship is the most crucial aspect of success in therapy. Some of these lessons have been difficult, yet necessary in my ability to understand what its like for clients to meet with me, and invite me into some of the most protected and vulnerable experiences of their lives.
When I first meet with a client, I want to provide them with a teaspoon taste of who I am as a therapist, and as a person. This helps them evaluate if they want to work with me, and helps me evaluate if they are responding to me well or not. I have learned that its extremely respectful of the client if I disclose sooner than later in the first session if I think its not a good fit. I will then explore what other therapist might be a better fit, and make the referral if necessary. This also gives the client an opportunity to make it about me, and not about their reluctance to become vulnerable in therapy for the sake of seeking relief when it might feel unsafe because they don't feel as though we have access to the kind of therapeutic relationship they are expecting or needing.
I believe its the therapists responsibility to pay attention to the therapeutic relationship, and take the initiative to have conversations with clients when we suspect there might be a disruption or limitation in the therapeutic relationship. This doesn't always mean that we have to terminate therapy, however, it does open dialogue for us to explore what's not working, and what we can do about it. I have had some of the most engaging, safe, and self-disclosing experiences with clients when I have initatiate these types of conversations. Some have led to referrals to other therapists, while others have led to the most amazing changes in my clients.
Even after 18 years of doing therapy, its still an honor and privilege to be invited into individuals, couples, and families lives where they are experiencing hurt, pain, fear, sorrow, and hopelessness. It is my hope that if you are in need of outpatient services, that you will reach out for help. If you find that you do not sense an initial fit with your therapist, that you identify this with them, and ask them for help to either adjust their approach with you, or to have them help you find someone who might be the kind of fit you need in order to engage in your work of healing and change.
Anthony T. Alonzo, DMFT, LMFT, CFLE
