In the individual psychotherapy process, one of the most decisive elements for the success of the treatment is not only the competence of the professional, but the quality of the therapeutic relationship, also known as therapeutic alliance. Numerous studies confirm this, including an important study conducted by Horvath, Re, Flückiger and Symonds (2011), published in the volume Psychotherapy Relationships That Work. The authors analyzed a large set of empirical data, demonstrating that the alliance between patient and therapist is one of the main predictors of the effectiveness of psychotherapy.
This relationship goes far beyond personal sympathy: it is a shared agreement on the goals of therapy, an active collaboration on therapeutic tasks and an emotional bond based on trust and respect. When one of these elements is missing, it is highly likely that the results of the therapy will be affected. If you see yourself in this situation, it may be time to change therapists.
Here are five clear signs that help you understand when it’s time to end a therapeutic relationship that is no longer working.
You feel belittled or not listened to
A therapist who systematically invalidates your emotions, makes you feel “over the top,” or judges you for your thoughts undermines the very basis of the therapeutic alliance. As Horvath and colleagues (2011) point out, the effectiveness of therapy largely depends on the patient’s perception of acceptance and safety.
Therapy must be a safe space, where even the most irrational thoughts can be expressed without judgment. Otherwise, shame and mistrust are generated, which impede the healing process.
You don’t make any progress after months
If after months of therapy you feel like you’re always stuck in the same place or even getting worse, don’t ignore this sign. The study by Horvath et al. (2011) highlights how a poor therapeutic alliance is closely associated with less effective results, regardless of the technique used.
Although personal commitment is essential, if the bond with the therapist is fragile, shared goals are lacking or you do not feel understood, it is difficult for concrete improvements to occur.
You feel judged instead of understood
During a therapeutic journey, it is normal to fall back into old behavioral patterns. If your therapist reacts judgmentally or makes you feel inadequate, the relationship risks becoming toxic.
As emerged in the research of Horvath and colleagues, trust in the therapist is essential to maintaining motivation to change. Without empathy, it is difficult to feel free to explore your fragilities.
The therapist does not specialize in your disorder
Each psychological disorder requires specific treatment. If, for example, you suffer from OCD, it is essential that your therapist has specific training in this area. A generic approach can not only be ineffective, but even counterproductive.
The study by Horvath et al. suggests that, to strengthen the therapeutic alliance, it is crucial that the patient perceives the therapist as competent and capable of understanding his specific situation. Otherwise, the intervention risks becoming superficial and sterile.
The therapist talks too much about himself
A therapist who excessively shares his or her personal experiences during the session risks shifting the focus onto himself, breaking the balance of the relationship. Even in this case, the implicit agreement that makes the therapy effective is compromised: the one according to which the patient is the center of the therapeutic process.
As demonstrated by Horvath et al. (2011), to obtain concrete results it is essential that the therapist maintains a relational posture centered on the patient, capable of promoting openness, trust and collaboration. If you are denied this space, it’s time to change.
A good therapist can be recognized by the relationship, not just by the CV
Therapeutic work is a human relationship as much as it is a clinical technique. If the therapeutic alliance is fragile, ineffective or compromised by judgments, misunderstandings or lack of empathy, not only is it difficult to progress, but it also risks worsening. The study by Horvath et al. (2011) confirms it: the therapeutic relationship is the heart of psychotherapy. Listen to your body, trust your instincts and don’t be afraid to end a therapeutic relationship that isn’t good for you.
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