I recently saw an ad on social media by one of the big online therapy directories. In it, two women are discussing therapy. One says that she is trying it, but she isn’t sure she likes the therapist. Still, she feels like she needs to stick it out.
“Why?” says the other. “You aren’t married to them!”
The message is, there may be someone out there that is better for you, so why put up with someone with whom you feel “meh”?
Pick the Right Therapist for Your Current Concerns
And this may, in fact, be true. Not every therapist is the best fit for every client or every issue. And ethically, a client has the right to self-determination. You have the right to choose who you see and are not obligated to stick with someone you don’t feel is helping you.
As a therapist, I work with individual adults and focus on high-functioning women over 30 with ADHD who are dealing with overwhelm. I also work with adults who have suffered from a traumatic incident or series of incidents.
I love what I do. There is little that is more rewarding than helping someone heal from their hurt.
At the same time, some people love working with me, and some, not so much. And some just aren’t sure when we begin. I understand. It’s tough to feel “raw”, vulnerable, and seek out someone you don’t know.
And nowadays in and near most urban centers, you often have a choice of seeing someone who specializes in what you need. This can be a double-edged sword. Lots of choices give possibilities along with feeling overwhelmed. Why not pick a few therapists and see where it goes?
That may be a good place to start. But long-term, is more better? Here are some ways to think about that.
Seeing Multiple Therapists
Seeing more than one therapist or treatment specialist at a time may be helpful in the following scenarios:
- You just started the process and are still shopping around. You may have gotten a few names and done a few appointments with one or more therapists and are still figuring out who you will stick with. In that case, it may help to see a few folks for multiple weeks before deciding.
- Or, these therapists (or healers) complement each other’s work in helping you. For example, a psychiatrist sees you for medication management, while you see a talk therapist to work through, say, your anxiety about a life change, or parenting issues. Or, you do acupuncture for chronic pain, but do psychotherapy with your therapist. These combinations usually run smoothly, because the practitioners are helping you in different areas of concern.
When is Seeing Multiple Therapists Good?
Another example would be that you see one therapist with your spouse for couples’ counseling, while you see another for your individual issues of parenting, anxiety. This may be complementary, but, depending on the issue, it can occasionally get a bit sticky.
For example, you are working through sexuality issues with your spouse, and at the same time, you started working through the memory of a sexual assault with your own therapist. At the same time, the couples therapist wants to work on, a method to increase physical connection, and that really feels hard for you that particular week or set of weeks, given what’s been coming up with your individual work.
Rather than stop one therapy or the other, here is a “best practice” recommendation. It may be helpful to inform both therapists that you are working with the other and the basics of what you are doing. Not as an unlimited running report, but just to give the basics, especially if they seem to be working on conflicting goals.
If you feel comfortable allowing your individual and couples therapists to speak to each other, you can sign a release for them to speak. Ethically, they would not reveal any more than is needed to help coordinate your treatment well. This would help so that you are not getting contradictory or confusing directives or feedback.
You don’t have to do this, but both your therapies are likely to benefit if they are more informed about the other issue you are working on. Overall, this can still function well, because you are seeing these therapists to work on different things. One is, yourself. The other is, your relationship.
When Can Seeing Multiple Therapists Get Sticky?
Consider the following scenario. If you are seeing two different therapists to work on the same issue for a long-term period, you may want to be more careful.
For some reason, this “many therapists for the same issue” strategy, longer than the “shopping around” period, is something I’m seeing more of these days with some people. Is it an attempt to maximize repair faster? Is it too scary to pick one and feel like you might be “missing out” on what the other offers? I don’t know.
Whatever the reason, sometimes each therapist a client works with may not even be aware of the other’s involvement in this person’s treatment. This could introduce a few complications. In these cases, I believe that more is not always better.
This may especially be true if you are seeing someone for trauma recovery using an exposure method, like EMDR or TIR (the latter is the treatment protocol that I work in). At the same time, you start seeing someone who uses a different treatment modality, such as Cognitive Restructuring, to work on your trauma. And you decide you like both treatments, you like both therapists, so you keep going to both. Be aware of potential pitfalls.
If you do this, you are getting different treatments for the same issue: For instance, your anxiety. It’s not that one treatment is better or worse; it’s that they may counteract each other. One mainly engages the hippocampus part of your brain (the Cognitive treatments), while the other (EMDR/TIR) mainly engages the amygdala. Both are effective. And you may like both therapists.
But if you “talk about” your trauma in the same weeks that you work through it with these treatments, it can actually inhibit or interrupt the reprocessing that your brain needs to do with the Exposure therapy. * A good analogy is training in football and gymnastics at the same time – you get an overall body workout, but you may build up muscles that are working in different ways and could counteract each other.
When you do two different therapies at once, the same thing could happen. At best, you feel a bit better, but you don’t know which treatment had the effect. At worst, you have diluted both treatments for twice the money.
Be Honest with Your Therapists
So in my work, I encourage the following as a best practice. Allow yourself some weeks to shop around and decide where you want to start. Be honest with the person you see about what you want. This is for you, after all. If someone tells me they want strategies for, say, managing their upset, I will take a few sessions to do this. I try to validate and handle client concerns. If that gives them what they need, that’s great. But if there is more going on, I encourage that we look a bit deeper at their issues (or “charge”, in the TIR terminology.)
Do one therapy first, with one practitioner, and if you feel it is benefitting you, allow yourself time to continue with them. A good rule of thumb is at least six sessions to decide if it is helping you. You can work with the therapist on determining the length and course of treatment. If you feel like you need it, seek the other treatment after you have finished the first.
Whatever you do, it is a good idea to inform each therapist that you are working with the other so they can proceed with good knowledge. This is the same principle behind the protocol that pharmacists need to be informed of all the medications you are taking, so you do not get prescribed something that counteracts something else. If you are comfortable allowing these practitioners to speak to each other, you can sign a release for them to do so. Ideally, they can consult and decide either to coordinate treatment, or make recommendations on how to proceed.
A collaborative approach, where you and your therapist are working together, keeps everyone on the same page. If you have concerns about these folks communicating, I encourage you to talk about this with them. That can be another opportunity to connect on what is important to you.
You or even other therapists may have a different opinion. I encourage you to think about what you want out of therapy, and ultimately, it is your therapy. At the same time, consider these points I’ve made as you start and continue your therapy journey. All the best to you for your process!
The GoodTherapy registry might be helpful to you. We have thousands of therapists listed with us who would love to walk with you on your journey. Find the support you need today.
* http://www.appliedmetapsychology.org/research-publications/articles/mygdala-hippocampus-and-traumatic-memories/
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