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Have you ever had a therapist or are you currently seeing one? How do you feel about him or her? Would you ever be able to “live without” your therapist? If not, this article is for you.

I have been in the field of counseling and psychotherapy for over 7 years and although I am still quite youthful, I have seen a lot take place in my field that has negatively impacted clients. Clients and mental health professionals develop a relationship, over a period of time, that allows for the comfortable and caring flow of conversation, reciprocation of feelings and thoughts, and development of tools or better behaviors and thinking patterns. Sadly, this emotionally and psychologically comforting relationship can be interrupted or stopped by a variety of barriers that are hardly ever visible to the client.

This article will explore 8 factors that can negatively impact clients who are in (or who are) seeking therapy services.

If you lost your therapist could you handle it? What if that therapist disappeared one day with no explanation of where they were or why they were no longer working with you? I have been on both sides of the coin. I have been on the side where colleagues have left an agency or business and I was able to observe just how difficult this was for the client. I have also been on the side of the coin where I have resigned from positions and heard that clients were negatively impacted by my resignation, no matter how ethically sound my resignation was.

Because of this, I found it necessary to discuss this topic with you. I have listed a few things that could happen to a therapist in any clinical setting such as:

  1. Termination of relationship due to lack of experience: For many beginning mental health therapists, it can be very intimidating stepping out, sometimes for the first time, doing therapy and becoming a weekly support for a client. Most clients, whether they believe they do or not, depend on the opinions and experiences of the therapist. Because of this it can be very difficult for a beginning therapist to work with clients with severe mental health or personality challenges such as psychosis or schizophrenia, delusions or paranoia, borderline personality disorder, narcissism, extreme child or adolescent behavioral challenges, etc. As a result, a therapist may refer the client to another more experiences mental health professional for treatment. Sadly, doing this results in an immediate ending to the client-therapist relationship. This can be very traumatic for clients who have begun to like, trust, and respect the therapist. Another scenario would be a therapist who is experienced but is not experienced with a particular issue that is brought to therapy such as couples counseling, delusions or hallucinations, conduct disorder, etc. In such cases, a therapist may refer the client to someone else.
  2. Budget Cuts or company politics: Company politics is likely to occur in almost every public agency or work-site there is. However, company politics can be more prominent and detrimental to a therapist in certain settings as opposed to in others. It  is likely that a therapist will be laid-off or even controlled and pressured (in some companies) to a point where the therapist decides to leave the agency or business. Would you stay in a job that felt overbearing, burdensome, or imprisoning? For some therapists, company politics can be so overwhelming that they decide leaving is better than staying. In other cases, budget cuts to a particular program can result in the loss of therapists or other workers.
  3. Colleague envy or betrayal: Sadly, envy and betrayal can exist in the field of counseling and psychotherapy among colleagues. Not all therapists or mental health professionals are unprofessional to a point of envying or betraying someone else. However, there are situations in which mental health professionals do not and cannot get along, for whatever reason. If a therapist is envied, betrayed, or treated in a fashion that makes him or her feel oppressed, depressed, or stressed, the therapist is likely to leave where they are working. Sometimes it’s best to walk away as opposed to being right. Many clients remain in the dark about these things until they become so unbearable that the therapist is no longer working in the agency or business. This can also be traumatizing to a client who has developed a bond with the therapist.
  4. Safety: There are safety concerns in some mental health agencies or businesses. For example, mental health professionals may leave a hospital setting or residential treatment setting where “chemical restrains” or physical restraints occur. I have worked alongside mental health aids who walk away from physical encounters with clients badly injured. Other mental health aids may find themselves accused of things that did not happen, emotionally drained and stressed, or even sued. In cases like these, the mental health professional may leave the agency or business to protect themselves and their name, reputation, and identity.
  5. Career advancement: In most cases, therapists or mental health professionals will often advance their careers by changing jobs, moving, or taking on new responsibility within an agency or business that precludes them from being able to provide therapy. For example, some mental health therapists leave their agency jobs to pursue private practice and become their own boss. Some mental health professionals leave their job as aids, return to school for a higher degree, and then re-enter the field as a licensed therapist or clinical supervisor among many other titles. Even more, some therapists or mental health professionals may leave a job and go to another job for professional or personal reasons. Whatever the reason for advancing may be, it can be extremely difficult for clients to handle. In many cases, clients engaging in therapy in agencies, hospitals, or residential treatment facilities may experience losing multiple therapists.
  6. Job termination: In cases where office politics and clashing personalities occur, therapists or mental health professionals may find themselves terminated from their job or terminating the job themselves (i.e., resignation). Some terminations are warranted while others are not. Some terminations are done with class and professionalism while others are not. Some terminations, if done by the therapist, require advance notice (2 weeks, 30 days, 3 months, etc.) so that clients can be transitioned to another therapist. Unfortunately, in some cases, therapists or mental health professionals are immediately terminated or asked to leave sooner than their notice for whatever reason. Other reasons for termination may include unethical practices, unsafe behaviors with clients, unhealthy behaviors, fraud, unfair bartering (i.e., having clients perform a duty in exchange for therapy services), etc. Job termination can severely impact clients, especially those clients who have developed a strong bond or relationship with a therapist or mental health professional.
  7. Personal health or life changes: Therapists and other mental health professionals are human too and need time off to recover from an illness, heal from a medical procedure, or enjoy changes in their lives. But for some clients, a therapist taking too much time off can make them feel either abandoned or forgotten. In some cases, clients with borderline personality disorder (BPD) struggle with feelings of abandonment if a therapist or mental health professional is away for too long. However, for other clients not suffering from BPD, feelings of abandonment can still be difficult to deal with.
  8. Retirement: Therapists or other mental health professionals get tired, age, and need time off. Older therapists in their late 60’s, 70’s, or even 80’s must consider retirement and ending or transitioning their relationship with clients. Older therapists may find their work becoming more difficult as they age. They may also have health conditions or medical challenges that prevent them from engaging in their work. For example, individuals suffering from early stages of Alzheimer’s Disease may have a difficult time remembering things. Other older therapists may find it difficult to keep up with changing laws or standards in the field and resort to retirement. Whatever the reason, some clients truly struggle with this.
  9. Vacation or maternity leave: I have worked alongside therapist and other mental health professionals who took a month’s vacation to either prepare for a new baby coming or an upcoming wedding or graduation. I have been in the position of taking over a colleagues client base while they were gone. I found that most clients struggled with the temporary transition or decided not to see someone else while their therapist was out. For most clients, a vacation or any kind of temporary leave of absence can emotionally and psychological impact them.

What has been your experience with these barriers? How did you manage your emotions or thoughts and feelings?

It is always best if a therapist or mental health professional warns a client way ahead of time that they may be leaving an agency or business (or taking a long vacation) to help that person grieve, work on some goals, and/or transition to another therapist or mental health professional. However, continuity of care is not always as easy as we all think it should be. As you can see, there are many barriers to continuing a relationship with a therapist or mental health profession.

 

Stay tuned for my article next week which will discuss how to cope with changes when a therapist leaves or the relationship ends.

As always, looking forward to connecting with you.

All the best