Odds are that one of the reasons you went into therapy was because you connect well with people. You may have been the friend that everyone turned to. Perhaps you have one of those faces that screams, “tell me your life story” and you find it easy to meet and interact with a wide variety of people. The idea that someone may not be able to connect with you or may not want to talk to you could be a very foreign concept to you. If this sounds familiar, you are in good company.
If you are in the therapy game long enough, you will encounter a client who requests a transfer. There can be a variety of reasons that this happens. Not all of these reasons will be things you can learn from. Sometimes people just don’t click, the same can happen in a therapeutic relationship as well.
Let’s unpack some of the reasons that a client may ask for a transfer and how you can tackle these situations.
Your Approach Isn’t the Right Fit
Let’s face it, there are A LOT of approaches and modalities to choose from when it comes to being a therapist. Most of us will say we are “eclectic” when asked, and for good reason. It’s rare that one approach works for everyone– in all honesty, it’s rare one approach works for most! We are all different and approach the world in our own unique way. Therapy is no different.
Even if the modality you gravitate toward is a good fit for a client, your approach may not work for them. It’s like speaking a language: many individuals in the United States speak English, though there are MANY dialects.
This can be difficult. Sometimes a client will request a transfer due to this, or you may feel you need to initiate the transfer due to feeling you aren’t the right fit. Either way, it can be difficult.
What can you do?
First and foremost, don’t blame yourself. It can be VERY hard for a client to tell their therapist they would like to transfer, and they are likely envisioning the situation going poorly. Having a therapist react negatively to their request can make it even harder, but you can make this a therapeutic moment.
I have found myself in this situation and while I had feelings about it (I’m human) you can commend your client for advocating for themselves. It’s hard to ask for help, it’s even harder to ask for different help. Assist your client in finding a therapist who may be a better fit or specializes in an approach you do not. This can further reinforce that advocating for yourself can be a positive experience and that there are folks out there that want the best for us.
Be sure to also process your feelings related to this. While we know clients will ask for transfers from time to time, it can sting. You are allowed to be human. Your approach isn’t wrong if it doesn’t work for every client you meet.
What can you learn?
You could learn a new approach if you find yourself called to it! Let’s say your client wants a therapist who specializes in DBT. You aren’t familiar with this approach but you find yourself wanting to be. Enroll in some continuing education courses, shadow, get additional supervision. The options are endless.
You can also continue to learn that this is par for the course. Clients will ask for transfers and you can bust out your own radical acceptance skills as well. We all have them, but are you using them?
Personality Differences
As I mentioned before, we are all unique. While we focus on being professionals, you are a human and you have a unique personality as well. Your personality may not be everyone’s cup of tea, the same goes for your clients. The harsh reality is that some clients will not like you.
You may find yourself working with a client whose personality does NOT mesh well with yours. They may request a transfer because of this or they may simply stop coming to sessions.
We all know that magical feeling when we are connected with our clients and sessions seem to be going in the right direction. Most of us have also experienced the opposite from time to time. Personality differences can contribute to this. It can be hard not to take this personally, though remember it’s likely that there have been times that you didn’t enjoy others for the same reason. This can go both ways, and unfortunately some clients may not like your personality.
What can you do?
Addressing the potential that you may not be the right fit for every client from the first session can be helpful. It is helpful in all of these proposed areas, but especially when it comes to personality differences. I always let my clients know from the first session that I realize I am not the right therapist for everyone. I give a lot of feedback, I focus a lot on skills, and I’m not good at letting self-defeating behaviors slide. A lot of clients have sought me out because of this, though I realize that there are many clients that would despise working with me for the same reasons. And you know what? That’s okay.
Let clients know that their goals are your goals. You want them to be successful and to work through what is holding them back. If you are not the right therapist for them, that’s alright, you can help them find that therapist.
What can you learn?
You can always learn more about yourself. No matter how much work we do on ourselves we may find there are additional things about ourselves that we would like to explore and improve upon. If you find that there are aspects of your personality that are off-putting to not only clients but others around you, this may be worth looking at.
Only you know if these personality differences are natural and unavoidable or a sign of something more. If these differences aren’t problematic and simply unavoidable, this is also a good place for radical acceptance. Don’t beat yourself up, our personalities will not mesh well with everyone. It can take skills and courage to acknowledge this, put aside our feelings and help our clients find the provider that is right for them.
Conflict of Interest
This one can be a doozie. The hope is that we tease out conflicts of interest before we see a client, but this cannot always be avoided. You may be in the middle of a session with a client and realize that you also see a close family member of theirs.
While this situation may not go against your ethics, it may complicate treatment. For example, you may be able to ethically treat siblings, but due to their unique relationship it could become detrimental.
There are certain conflicts of interest that do require a referral to another therapist, as it would be unethical for you to continue to work with that client. In these cases it can be a little more clear cut as to what you need to do.
What can you do?
It is never a bad idea to consult your liability insurance when it comes to tricky situations. Knowing what you are ethically and legally bound to do is invaluable. Most liability insurances will have lawyers that you can speak with surrounding difficult situations, and conflicts of interests can fall under this.
Documenting what they advise you to do and following that advice is a good idea. They can also help you to figure out the best way to present this to your client without infringing on your other client’s confidentiality. Saying “I can’t see you because I see your roommate and that would be weird” is NOT advisable. Let them help you word it in a way that protects privacy.
What can you learn?
Each situation will present you with different opportunities to learn. You may decide that you want to ask more direct questions when assessing whether a client is a good fit. Maybe you should be asking if they have a friend or family member who has been seen by you. You certainly cannot confirm whether you have seen that client, but this can help to decrease conflicts of interest.
Process the experience afterwards, seek supervision, even ask your liability insurance attorney what you can do to decrease the likelihood of similar situations happening. Use your resources and continue to grow as a practitioner.
You Offended Them
This can be one of the hardest situations to work through and to experience. The reality is that we are not perfect and there is always the potential that we will offend our clients. Sometimes it’s due to their interpretation of what we said, and sometimes it’s simply what we said.
The last thing most of us want to do is offend our clients, however, sometimes things can come out wrong. Feelings can be hurt. Therapy is tough work, we oftentimes have to confront our clients’ behaviors and they may not always like what they hear. Sometimes this can be an opportunity for growth, though sometimes it can be too much for the client to hear.
Situations like these can also be therapeutic moments, modeling how to admit when we said something in a way we didn’t like, validating the other person’s feelings, and rephrasing is a valuable skill. You can model this to your clients and it may actually be very helpful for them. It may not.
What can you do?
As I mentioned, validation can go a long way. If you said something to offend your client and you realize that you would have liked to have said it differently, own up to it. It can be frustrating to talk with someone who will not admit they were wrong, and this can also play out in therapy.
If the client feels that they cannot work through what was said, you can help them to find a therapist to transition to. Some of these situations can lead to progress, and some will lead to transfer.
What can you learn?
A lot! All joking aside, you are not perfect. You will make mistakes, you will offend clients from time to time. If you can work through this and maintain a healthy therapeutic relationship, great. If not, learn from it.
Be careful that you don’t blame the client if you are experiencing a lot of negative emotions regarding this situation. This can be really uncomfortable, and blaming others can relieve that discomfort. Seek additional supervision and process the experience. It’s okay to have feelings about this and be sure to work through them.
To Sum it Up
Some clients will not like you. There is a reason I’ve said that multiple times, it is because it’s true. Whether a client actively fires you or passively fires you by never returning, it will happen. You don’t have to wait until it happens to prepare yourself for how you will approach this.
Addressing this from the first session can create a framework and normalize this potential for clients who feel they may need a different therapist. Many clients will assume that therapy isn’t for them or simply quit if they feel you may not be a good fit for them. You can be part of the solution AND help your clients learn to advocate for themselves.
While this is a reality of being a therapist, it’s okay to have feelings about this. It’s okay to second guess yourself and even feel a little sad. Let yourself feel, and don’t get stuck there. Practice what you preach, my therapist friend. See you next time.
