Changing Therapists (If the First Therapist Isn't a Good Fit)

Changing therapists means that a child or adolescent ends their ongoing psychotherapy with one professional and continues with another. The most common reason is a lack of rapport. This means that no trust develops between the child and the therapist, even though both are trying.

The therapeutic relationship is crucial to the success of psychotherapy. Professionals also refer to it as the therapeutic alliance. If a child withdraws when talking, experiences each session as a chore, or feels that the therapist is a stranger, treatment can stall. In such cases, switching therapists is expressly permitted and happens more often than many parents realize.

Especially with children and adolescents, building this trust sometimes takes more time. A child must first feel safe with the therapist before they can talk about fears, conflicts, or traumatic experiences. If this sense of safety does not develop over several weeks, it is a serious warning sign.

Not every crisis in therapy means you’ve chosen the wrong therapist. Many treatments go through phases where a child resists because they’re dealing with uncomfortable topics. This can even be a good sign. Parents should be on the lookout for other signals:

• The child still refuses any contact after the third or fourth session and seems more upset after each session.
• The therapist does not take the parents’ observations seriously or never explains his or her approach.
• Agreements are repeatedly broken, and appointments are constantly rescheduled.
• The child feels uncomfortable and can express this in their own words.

A difficult phase usually looks different. In that case, while the child may not want to go to therapy, they still participate during the session and show small improvements over the course of weeks. Two to three weeks of observation and an open conversation with the therapist can help distinguish between the two.

Patients with public health insurance are allowed to change therapists. Even before the actual treatment begins, there are trial sessions—that is, introductory sessions to get to know each other. Health insurance covers up to six of these sessions for children and adolescents, and up to four for adults. During this time, the child, parents, and therapist assess whether a viable therapeutic relationship is possible.

If it becomes clear during the trial sessions that it’s not a good fit, these sessions can be used again at a different practice. It’s also possible to switch practices during ongoing treatment. The new therapist may then schedule new trial sessions. It is important to inform the health insurance provider about the change and to clarify with them whether a new application is necessary.

No referral is required for the consultation or the trial sessions. Parents may inquire at multiple practices and choose the one that’s right for them. Changing providers does not result in any disadvantages with the health insurance company and does not require justification.

Switching therapists can be arranged in just a few steps. This includes a calm final session with your current therapist, during which you should ask for a brief report for the new practice. Then the search begins.

• Find available slots through the appointment service at 116117 or use the State Chamber’s psychotherapist search tool.
• During your initial contact, ask whether the practice has experience with children of that age and what approaches they offer, such as behavioral therapy or depth psychology-based psychotherapy.
• Use the new trial sessions as an opportunity to get to know each other and pay attention to the child’s gut feeling.

A new search may involve a waiting period for a therapy spot. During this gap, it helps to maintain stability in daily life and have key contacts—such as the pediatrician—readily available.

Children can sense when their parents are unsure. That’s why a simple, honest explanation—appropriate for the child’s age—helps.

• State objectively that another professional is likely to be a better fit for the child.
• Don’t blame the child, and don’t speak ill of the previous therapist.
• Let an older child have a say in the decision.
• Make it clear that the support will continue—only the location is changing.

This way, the child maintains a sense of security, and the change feels less like a stressful interruption of therapy. For younger children, a short sentence is often enough—explaining that they’ll now be seeing someone new who will help them sort through their feelings.

A change should not be delayed for months if a child has been suffering for weeks and no progress is evident. In acute crises, such as self-harm or statements about wanting to end one’s life, immediate help is essential. Points of contact include the local child and youth emergency service, the “Nummer gegen Kummer” helpline, and the nearest child and adolescent psychiatry clinic.

Rückenwind We support parents during this time with coaching and guidance. Whether a diagnosis or a specific treatment is necessary, and whether a change in care seems clinically appropriate, can only be assessed by a medical or psychotherapeutic specialist or a child and adolescent psychiatry clinic.