I agree that many therapists are not equipped to handle diagnoses beyond the usual suspects of depression, anxiety, etc. Many do not have the clinical background to deal with ADHD, bipolar disorder, schizophrenia, and other specific diagnoses that come with very particular issues that require some detailed knowledge of specific treatments, some of the medical in nature.

It is important to have a psychiatrist who IS knowledgeable in working with these specific diagnoses, who can differentiate comorbid diagnoses symptoms from each other, and who can sort out which diagnosis is at play at a given time and how to deal with it and how they interplay.

It's complicated, and I do believe that kind of complexity is beyond many therapists' knowledge and training.

As someone who was dealing with several comorbid diagnoses, having a therapist with the broader and more clinical background to sort through those complexities was a must.

Yes, therapy IS hard, but is made harder when the therapist is not really equipped to deal with that level of complexity. If the therapist is unable to work with that complexity, then the therapy can also be bad due to the lack of skill and knowledge of the therapist.

Therapists should know when they are in over their head; unfortunately, many either are clueless or refuse to admit they really aren't able to work with a client. Or, they tell the client that they need a different therapist/level of care, and the client refuses to take that professional advise.