Feel your therapy just isn’t working? It could be that your counsellor is ‘drifting’. Here’s how to spot the warning signs, and what to do when it’s time to say goodbye
When you buy a new phone, you know exactly what you’re getting. You can check its features and examine its technical specs. But when you buy a service like counselling, it’s not so simple. You might research the different kinds of therapy available and then choose a counsellor, but how do you know if what happens in the room is actually the therapy you signed up for?
Therapist drift is a term that describes counsellors and therapists failing to deliver the most suitable evidence-based treatment for a client’s symptoms. It happens when, for whatever reason, the therapist drifts away from what the research suggests is effective. Perhaps they will blend together different approaches, or just busk it and do what feels right in the moment. It’s usually well-intentioned, but it might mean that you’re not getting what you asked for, or what you’re paying for.
If you went to a restaurant and had a poor meal, you would not go back. The same goes for therapy. If it's not working, it's time for a change
So what causes therapists to drift? Not all professionals are trained in all approaches. Counselling and psychotherapy are broad professions with many different approaches, from cognitive behavioural therapy (CBT) to person-centred counselling and psychoanalysis. Counsellors will use the approaches they are trained in, and their continuing professional development will reflect their interests and preferences. How they identify themselves and what they value will inform what they do, and don’t do, in the therapy room. It’s well worth checking out their background when choosing someone to work with, and being clear if their approach is recommended for what you are seeking help with.
We all have a unique personality and that is reflected in clinical practice. Past experiences have an effect on how we work. Counsellors tend to use what they perceive to have worked for their clients in the past. The trouble is, we don’t always know. Sometimes the things a counsellor perceives to have been powerful are not the things that made the difference for you.
What a counsellor believes, thinks and feels will come into play in the way they work. Add to this the individual dynamic between you and the counsellor, and there will be a number of factors that influence what happens in the therapy room. Robust clinical supervision is critical to making sure counsellors are doing the right thing by their clients, and are working on their own self-development continually to stay focused.
There are a number of signs to watch out for. At the beginning of therapy, a clear outcome and focus should have been agreed. When the work drifts away from this to something else, it’s a good idea to note it, and if it continues, to challenge it. While sometimes it’s useful to explore something that’s come up because it may be relevant, too many deviations will dilute the benefit you are receiving.
Another sign is when your counsellor starts to back off from working on the difficult things. When a client is distressed, or expressing doubt about their ability to cope with therapy, counsellors can be seduced by this and stop doing the very work asked of them. Therapy can degenerate into a weekly chat where you offload and the counsellors sympathises, but where no clinical work is done related to the goal of exploring deeper patterns, meanings, ways of coping, or behaving. Therapy is not a comfortable process. If it was, it most probably wouldn’t be hitting the spot. It is beneficial to build up coping skills and resilience so that the therapy can stay on track. Also, watch out for no-go areas created by either yourself or the counsellor, as these are not therapeutically helpful.
One more sign of drifting is when the counsellor begins to try to solve your problems. In therapy, it is the client’s role to come up with their own way forward and to discover what fits for themselves. While a counsellor might provide psycho-education and beneficial research, this should be clearly marked out as different to the usual therapeutic process. You set your own goals, priorities, and your plans for change. Your counsellor is there to enable and encourage, but if they are continually offering suggestions and solutions you may start to question whose therapy this is.
To minimise the chances of therapeutic drift, here are some important questions to ask your therapist before you begin:
- Which approaches are you trained in?
- What are these approaches effective for?
- What’s the evidence?
- Which professional associations do you belong to?
- How do you keep up to date on the research for treating my symptoms?
- What have you learned about it recently?
- How does your clinical supervision work?
- What are the recent benefits?
- How do you know your treatment works?
Some of these questions might sound very forward, but an effective counsellor should be open to discussing them with you. Beware the counsellor who tells you that “relationship” is all that matters. Research shows that the relationship between client and counsellor is crucial to the therapy being effective, but this doesn’t mean that anything goes.
Therapy doesn’t always work out. As a client, I’ve twice ended a therapeutic relationship because it wasn’t working. The first time, I just couldn’t relate to them. The second time, the therapy had degenerated and become too cosy – my counsellor was not helping me address what I was asking her to explore with me.
Breaking up with a counsellor is hard. We go to therapy and say things we don’t tell anyone else. That makes it an intimate relationship, and ending it can feel tough. It’s important to remember that however close you may feel to your counsellor, it’s a professional relationship where they are being paid to deliver a service to you. If you went to a restaurant and had a poor meal, you would not go back. The same goes for therapy. If it’s not working, it’s time for a change.
Before ending your therapy, see if you can stand back and see if it’s moving you towards your goal. If you are moving forwards, then it may not be the end. If you can’t see a way through in the medium term, then it’s probably time to move on.
If you are uncomfortable with the therapy, talk to your counsellor. It may be beneficial and help to get the work back on track. Or, it may help you decide you want out, particularly if you are met with defensiveness or an unwillingness to adapt. A counsellor should always be comfortable discussing their approach and how it fits with your symptoms. This is not a power relationship. It is two equals working together on your symptoms, and that’s how it needs to feel.
If you decide to leave therapy, it’s fine to be assertive. Calmly explain what is not working for you and that you have decided to end the work, and then say goodbye. Personally, I found it empowering to take control and move on, which in itself was a moment of growth.
Fe Robinson, MUKCP (Reg), MBACP (Reg) is a psychotherapist and clinical supervisor. Visit counselling-directory.org.uk to find a professional in your area.