What Do You Expect?

One of the most challenging experiences for a therapist is when a client leaves angrily. Fortunately, it is rare. But when it happens, it is hard on both the client and the therapist.

What makes a client suddenly terminate therapy? The reasons tend to be: one, insurance issues and, closely linked to that, financial ones; second, if the therapist says something that the client doesn't like; and, third, if the therapist makes a mistake.

To explain each of them: the insurance issues can be due to the therapist having problems getting paid and turning the unpaid claims over to the client. Or, perhaps, the client has switched to a different insurance or a difference plan, one that the therapist doesn't take and doesn't want to sign up for.

Next, the client may have left because the therapist said something that hurt. Maybe the therapist brought up a touchy topic, such as the client's substance use or temper issues.

Lastly, the therapist could have made a mistake, which triggered the client's leaving. Perhaps the therapist got confused about an appointment time or charged an erroneous fee.

For these types of reasons, a client may leave angrily. But the question is: were the client's expectations realistic in the first place?

Therapists are human. We make mistakes. If the errors are willful, that is a different thing. And if the therapist keeps making mistakes, that would be concerning.

But generally mistakes are due to our imperfect human nature. If, for instance, "Mary" sees her therapist as all-knowing and perfect that would be a set up for disappointment.

Or if Mary views the therapist as a loving and always supportive parent figure, the client's expectations may be dashed before too long. Lastly, if the client takes insurance problems personally, rather than just the down side of using insurance, the client can have hard feelings around it.

One last point: I would encourage folks to go into therapy open to what the therapist thinks, even if it isn't always easy to hear. If a therapist says something that a client doesn't want to hear, talking about it together may be better than just stopping.