What is Therapeutic Fit?

If you’ve ever had a therapist, you might be familiar with the term “therapeutic relationship,” referring to your connection to your therapist. What you might not realize is that your feeling of trust and connection to your therapist is actually the most important piece of your treatment, more than your therapist’s specific qualifications (beyond basic competency) and more than your therapist’s preferred modality.

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When I say “therapeutic fit,” I am talking about that relationship with your therapist. Not everyone will be a good fit for you, and that will not be your fault – or your therapist’s fault! I did a quick Google search as I wrote this blog, and it said that there are 7.8 billion humans in the world. Odds are, you aren’t going to like some of them.

Therapists are humans. We have mannerisms, personalities, and interaction styles that some people might find off-putting. If you have a first appointment and find that you just do not like the therapist, it’s possible that you need to take time to get to know them and get comfortable in that environment. But it’s also possible that that therapist just is not a good fit for you. (Of course, if the therapist acts in a way that is unprofessional, inappropriate, or unethical, this is another story – you have the right to report unethical behavior! But I’m referring to disliking someone for reasons you might not be able to articulate.)

It’s okay to request another therapist. Every therapist I know who has been practicing for more than a few months has had clients request another provider because of fit – it has happened to me! If I am being completely honest, I don’t love hearing that someone requested another therapist, but I am happy to hear that they felt empowered to seek the best provider to help them, even if that isn’t me.

Reasons I have heard that someone asked to change therapists include:

  1. The client wanted a therapist who understood their specific cultural experience
  2. The therapist shared physical attributes with the client’s former abuser, which was triggering for the client
  3. The therapist fidgeted in a way that the client found distracting
  4. The therapist had a very serious personality, and the client preferred to work with someone who had a more friendly demeanor
  5. The client wasn’t sure why, but they just did not feel they could open up to the therapist

You can request a new therapist for a specific reason or for no reason at all! If your first therapist isn’t a good fit, I hope you can make a change and find the right person to help you.

Published by Amy Marschall, Psy.D.

Dr. Amy Marschall received her Psy.D. from the University of Hartford in September 2015. Her clinical interests are varied and include child and adolescent therapy, TF-CBT, rural psychology, telemental health, sexual and domestic violence, psychological assessment, and mental illness prevention. Dr. Marschall presently works in the Child and Adolescent Therapy Clinic at Sioux Falls Psychological Services in Sioux Falls, South Dakota, where she provides individual and family therapy and psychological assessment to children, adolescents, and college students. She also facilitates an art therapy group for adolescents and college students with anxiety and depression. Dr. Amy Marschall is certified in Trauma-Focused Cognitive Behavioral Therapy and Telemental Health.

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