By Arielle Cohen, Families for Depression Awareness Programs Manager

Have you or your loved one ever been unhappy with something your therapist did or said? Maybe the therapist made a joke that didn’t sit right, focused on an area you didn’t want to in that session, or, like my therapist, repeatedly started sessions late.

It can feel difficult and uncomfortable to tell your therapist you didn’t like what happened. When we are not honest with our therapists (or ourselves, or anyone else for that matter), we can begin to harbor resentment. By not advocating for our needs, we often bubble beneath the surface until we just can’t take any more … and explode. This can be detrimental to a healthy therapeutic (or any) relationship.

Believe it or not, therapists are human. Like all of us, they make mistakes and unintentionally cross boundaries. It’s on us not to hold on to things that bother us and instead advocate for what we need. For anyone wanting to improve their self-advocacy, starting with a therapist is a safe place to begin. If your therapist is a good one, they’ll be open to hearing your feedback.

To put this theory into action, I’ll share my experience with you.

It’s story time!*

*Spoiler alert! I had resentment, it bubbled up, and I didn’t handle advocating for myself exactly how I wanted. Second spoiler alert! It worked out.

My therapist was always late. It really bothered me that my sessions were not starting promptly, but I never said anything to her directly. (My friends and colleagues heard about it, though!) I could forgive a five-minute window, but starting 15 to 20 minutes late felt disrespectful. After two years of my appointments continuously getting pushed later and later, I walked into her office, and here’s how it went.

Without making eye contact, I said something like, “What’s going on? My sessions always start late and I don’t like what’s happening.” My therapist responded saying she knows sessions have been going late, and asked if we could push my time still later. I began to respond and she cut me off mid-sentence.

I interrupted her, “Please let me finish what I’m trying to say. I’ve been very tolerant of starting late. But when we first started meeting my sessions began at 3:15pm. You were late and pushed me to 3:30pm. You kept arriving late and pushed me again to 3:45pm. Now I see you’re meeting with a client during my original timeslot and it feels like you’re pushing my appointments later than I am comfortable.” I noticed after I spoke that my tone was firm, I was shaking, my heart rate had become faster, and my breath was a little more rapid. My body was definitely having a stress response, I felt really uncomfortable, but I was relieved to finally talk to her about my concern.

She acknowledged how I was feeling and said she did not know that starting on time was important to me. (I mean, isn’t it important to most people?! I digress.) She was right, I had let this behavior go on for a long time and didn’t speak up. At the end of the discussion, she promised to start within a five-minute window of my scheduled appointment and she’s been keeping to that promise. Let’s break down what happened.

So, what’s the lesson? The world didn’t end when I spoke up for myself. In fact, my therapist and I have a stronger relationship and I feel more comfortable telling her when I’m not happy with something.

Tips for advocating with a therapist

  • Pay attention to boundaries. Boundaries are clear limits that separate you from others. They express the kinds of behaviors and actions we accept in order to feel safe in the world. Clearly, being punctual is a limit that matters to me. Tune in to when you reach your limits and make a mental or physical note that this area needs attention.
  • Be honest, even when it’s uncomfortable. If you are hiding things from your therapist, you’re not making the most of your therapeutic relationship. I’m so grateful to have learned this hard truth. I was ashamed to talk about many things, but being able to share them with my therapist has helped me heal. Encourage yourself or your loved one to talk about difficult issues and work through the emotions that arise.
  • Plan ahead. If you or your loved one feel nervous about conflict, practice how the conversation might go. Try a scenario where the therapist is understanding and one where they are defensive. If you’re not sure where to start, you could journal what you want to say and even read what you write to the therapist.
  • Don’t aim for perfection. Even if I had been in a calmer state or practiced with friends, I likely wouldn’t have handled it exactly as I imagine in an ideal world. Focus on the victories you had and continue to refine the areas that you want to improve over time. Hey, now that you were direct with your therapist, maybe they can help you work on communication!
  • Celebrate successes. Take time to reflect after advocating for yourself or supporting your loved one. Far too often we run right to the next task and don’t leave time to pat ourselves on the back. You did something difficult and that’s worth celebrating.
  • Make sure this is the right therapist. If you’ve advocated for change and the therapist doesn’t rise to the occasion, it may be time to find a new provider. This can be a hard and lengthy process, but it’s important to find someone you or your loved one trust.

Check in with yourself and your loved one periodically to make sure that the therapeutic relationship is supporting wellness and healing.


Additional Resources