To think she was a bit rude/not empathetic?

[UndertheCedartree]

I can't quite put my finger on it so said rude/not empathetic but could be something else.

I had a first appointment with a therapist today. Been in this position many times and know the first appointment is just an introduction/talk about practicalities/see if we can work together - it doesn't always work out which I find hard as well as I struggle with new people.

So I asked my support worker (PA) to come with me to this appointment. She has supported clients with therapy many times before so it was no problem.

Therapist comes into waiting room and calls me by the wrong first name...I corrected her and introduced her to my support worker. She then addressed the support worker and told her 'stay here, I'll take her in'. It made me feel uncomfortable that she didn't speak to me and made me feel like an object with 'I'll take her in'. So I said 'I would like SW to come in with me.' Therapist ummed and ahhed over it. I told her I was within my rights to have my SW with me. Eventually she let us leave the waiting room and go into a private room. There she called me by the same incorrect name and when I corrected her just told me she sees a lot of people.

She then proceeds to talk to my SW about why she shouldn't be there. That therapy isn't a 3 way thing. Questions the dynamic between us etc. My SW explains her role to the therapist and that I'd asked her for support in this sutation and that it was a situation she was very familiar with. I make some comments but the therapist ignores me in favour of talking to my SW!

I try to explain to the therapist why I have asked for support for this session and explain going forwards I will mainly seek support from her after our sessions and possibly for her to support me to go to the session and be with me for 5 minutes at the beginning until I start to feel comfortable with the therapist. I may therefore ask her to wait for me in reception for a couple of sessions. My SW asked if we could agree that if I wanted her with me for 5 minutes at the beginning of the next session that, that was ok (to try to prevent such an awkward start next time.) She wouldn't agree to this.

She spoke in so much jargon. She didn't have to think about something she had to 'have a thought.' She was constantly 'curious' about things. I was 'holding on' to the idea of therapy = I wanted therapy. Just so much it was hard to understand her. I explained to her how I felt and she just kept asking again and again and I had to repeat myself 3 times. She then left a massive pause and asked if I felt sad...which was not what I had said at all! She didn't understand my use of 'in the community' (I.e not in hospital) when that is a completey normal turn of phrase!

She was then 'curious' as to how I could cope with therapy if my SW was in the waiting room. I just replied the same as anyone. And then I asked what would happen if at the end of the timescale she had given me we hadn't finished the work necessary and her reply was we would have to 'have a thought' about it.

It felt like she was highly anxious. She obviously had a problem with me having my SW with me, but if she hadn't been with me I would have walked out because tbh the therapist was really pissing me off!

This is part rant and part - do you think that this sounded a bit 'off'?I want to go into the next session knowing how to make this work better and how to deal with these kind of difficult situations.

Establishing that relationship takes time. It doesn't happen at the first meeting. It makes no odds if my SW has come with me to the first appointment. At the end of the day if I'm too anxious to come to the first appointment without support then she's never going to get to build a relationship! Whatever happens now, the relationship will take longer to establish due to how uncomfortable she made me feel. And if she wants to build a relationship with me, maybe she should speak to me rather than my SW who was trying to direct her to speak to me!

This really is nonsense and a misunderstanding of how therapy works. A therapeutic relationship is one-on-one. Anyone else being there, support worker or not, will undermine it.

My plan was only to have my SW with me for the introductory meeting not for the actual therapy. But she made me feel so uncomfortable I feel like I want my SW to come with me just for 5 minutes.

Having worked in fields with ‘complex’ (not a fan of the phrasing so apologies) adults would never dream of saying such things. Id always double check with the person “are you okay with them coming in” but direct everything towards the individual. Maybe make a goal of them coming in 1:1 to the room when theyre ready with the support worker, family member, social worker or whoever it was waiting outside but put no timeline on that. Make a phone call in between face to face sessions to build a rapport so they can feel more comfortable coming in etc.
my first round of therapies my community mh nurse came to my first few appointments and it helped massively then after 3 sessions she waited in the waiting room.
you could raise it within the service and talk about that experience so it can be raised and addressed and that therapist or as a wider office they can be given additional training on how to deal with those types of situations.

Thank you 🩵

Yes, I know. This is NHS though and I've waited 4.5 years so I want to try and make it work if possible. But I am wondering if it doesn't get better next week if I could speak to her manager to explain why it's not working and if I could see someone else?

Its so clear that the SW was there for the initial meeting only, partly because OP finds starting with someone new difficult.

There's a huge difference between explaining that it's fine for SW to be there today but going forward (if OP is happy) it should be 1-2-1, and being openly hostile and making the atmosphere awkward.

I don't know - it's NHS. Yes, I will try again next time. My SW said let's give her the benefit of the doubt this time and try and start a fresh next time and take it from there.

That's absolutely not clear; the OP was talking about having her there at the beginning of sessions for five minutes, debriefing with her afterwards, waiting for her in reception - that is absolutely an undermining of the relationship and no decent therapist would agree to work like that.

I agree. It sounds like a therapist is worried about her therapy sessions being observed by another professional.

Thank you for your reply.

With regard to the 'I'm curious'...it just didn't feel authentic and was repeated countless times. I don't think using the occasional genuine 'I'm curious' is a problem...just with her it was over used and came across as just jargon from a training manual!

I completely understand where you are coming from about me being free to talk/an agenda etc. But the confusing thing was it was the therapist who made it all about my support worker. My support worker was trying to direct her to talk to me saying 'pretend I'm not here' type of thing. And I explained I didn't plan on her attending the actual therapy but I felt so freaked out by her hence me saying I might want my SW to just come in for 5 minutes at the beginning. If I felt comfortable with the therapist I would have just asked SW to meet me afterwards next time.

If OP needs support until she is comfortable with a therapist, the therapist should accommodate that and try and wean her off the need to have the SW there. There's nothing wrong with easing OP into therapy and building trust over time.

It does all smack of the therapist doing a sloppy job and thinking it's fine because the patients won't feel able to speak up. Having someone there as a support only highlights how shit she's being. Getting a patient's name wrong repeatedly is appalling, and to use your phrasing, totally undermines the relationship, and trust, and OP won't make any progress at all if she feels the therapist is too disinterested to even get her name right.

Sorry posted too soon. I did actually tell her she made me feel very uncomfortable. I hope she will reflect on that. I will give her the benefit of the doubt.

Thank you for the validation, though. I am a bit of a validation seeker! And I'd love to have a therapist like you who has been a patient too, it gives you an understanding that few have ☺️ Not that I'm saying you can't be a good therapist without that experience.

Thank you for explaining that.

That certainly sounds a much better approach to me.

I have to say there certainly felt an edge of that. It appeared to make her very nervous there being someone else with us.

That's a good idea, thank you.

Well, the therapist certainly undermined the chance of a good relationship.

Other therapists don't have an issue with it though. I certainly had support workers with me in sessions with my Psychologist in the past, not an eyelid batted.

Not the right therapist for you!

I worked with Headway for a few years. Almost all of our clients had a SW or PA present for therapy so that the team could learn the relevant strategies to support clients with. It totally depends on the context of the therapy and the client's goals.

Thank you, that makes so much sense. This therapist seemed very inflexible but I wonder if she is new and just doesn't realise yet that she will come across this situation.

Definitely find a different therapist. She sounds really unprofessional.

That question shows a total lack of understanding of complex mental health issues