Therapy has the potential to be profoundly healing. As you explore your current frustrations, past hurts, and dreams for the future, you can gain insight into your inner conflicts and find the freedom to make more authentic choices.
“A good therapist gives you a safe space where you can talk about things you’ve never talked about before, express deep emotions, and release fears you’ve been keeping locked inside.“
Unfortunately, though, therapy doesn’t always go so well. Sometimes, it just doesn’t work. You might not click with your therapist or form the kind of connection that allows you to open up or make progress. If you’re not ready, you might need to wait and come back when it’s the right time. Or you might need to experiment with different therapists or approaches until you find the one that’s right for you.
In the worst-case scenario, therapy can be destructive. Therapists are human, and while most are well-meaning, some are blind to serious flaws or conflicts of interest, and a few are overtly exploitative and unprincipled.
“Bad therapy is worse than no therapy at all. Careless, negligent, or predatory therapists can do lasting harm.“
Fortunately, getting good therapy isn’t just a matter of luck. You can learn how to spot good therapists and avoid the bad ones. When you know the ethical standards therapists are expected to meet, you can walk into a therapist’s office with the confidence to walk right back out when you can see that things just aren’t right.
A bad therapist can’t help but raise red flags. To avoid the worst of them, watch out for the following warning signs. You can (and should) walk away from a therapist who:
- Makes unwanted physical contact.
The instinct to offer a comforting touch is strong and can be a challenge for therapists to navigate. Client preferences differ and therapists can sometimes assume your comfort level wrongly based on experiences with other clients. Good therapists make mistakes, but they also learn from them.
So, a good therapist might hug you before they think to check whether you’re okay with that. But they should immediately apologize if they see you’re uncomfortable and shouldn’t do it again after that.
Two Major Red Flags
There are gray areas when it comes to figuring out an appropriate level of physical contact with a therapist. For example, some people are fine with hugs and handshakes while others are not. But some things are always wrong. Something isn’t right when a therapist:
- Persists in physical touch after you have asked them to stop.
- Engages in sexual or intimate physical contact with you.
The first flag is lack of consent—ethical therapists won’t persist in anything you ask them to stop doing. The best won’t assume but will ask if it’s okay to share a hug or even a handshake. While an unsolicited handshake isn’t automatically a bad sign, it’s definitely a red flag if a therapist ignores what you tell them and continues doing it after you’ve said it makes you uncomfortable.
The second red flag is when therapists do more than offer a hug or a brief hand on your shoulder. If a therapist asks you to exchange massages or sit in their lap, they’ve wandered far past the gray area. The most severe boundary violation is when a therapist makes sexual advances toward a client.
You should never go back to a therapist who pursues sexual contact.
2. Blurs professional boundaries in other ways.
Sexual relationships put clients at severe risk of emotional harm and exploitation, but they’re not the only kind of harmful dual relationships therapists can have with clients.
It’s unethical for therapists to seek to enlist you in their personal, business, and social projects outside of the office. Not only does the power imbalance easily lead to exploitation, socializing with your therapist can also disrupt or destroy the special relationship you need to have with them for therapy to work.
It’s a sign of a good therapist if you don’t know much about them. Some good therapists practice limited self-disclosure when it illustrates important therapeutic principles like the universality of an experience or the human capacity for growth and recovery. And some good therapists start sessions with a little small talk to break the ice. But good therapists keep their own issues out of the therapy room.
For therapy to work, your therapist has to have a unique relationship with you in which you share a lot and the therapist shares little.
In general, therapists shouldn’t be too “chatty.” They shouldn’t vent to you about personal problems or take up too much of your time talking about themselves.
The safest way to prevent dual relationships is for therapists to refuse to work with clients they know socially outside of the office, like people they see and chat with at parties. It’s usually fine if you go to the same gym or grocery store, but usually isn’t if you go to the same book club or bar. The key is the depth and intimacy of your incidental interactions.
Good therapists don’t make social overtures outside of the office like sending you Facebook friend requests or offering you rides. They avoid conflicts of interest and don’t agree to see clients who have competing interests, like people in legal or custody battles (except when they are explicitly hired as a mediator). They don’t try to get free or discounted services from clients or barter with clients by accepting goods and services in exchange for therapy.
Good therapists keep their personal agendas out of the office. They shouldn’t see their relationship with you as a way to further their social, political, personal, or business interests.
Your therapist shouldn’t be trying to convert you to their religion, talk you out of your political views, or get you to buy something from their Jumia shop.
If you are feeling pressured to support your therapist’s personal agenda, it’s probably time to walk away.
3. Shares your information with other people.
One of the things that makes the therapy room a safe space is your confidence that your therapist won’t share what you tell them with anyone else.
There are a few exceptions to confidentiality. Therapists are legally and ethically obligated to violate confidentiality when they learn that a client is abusing a child or planning to harm or kill someone. In rare cases, they might have to release records in response to a subpoena.
Good therapists seek input from clinical supervisors and colleagues when they’re stuck on a case (though they nearly always disguise or leave out personally identifying information when they do).
Other than in these special circumstances, therapists shouldn’t be sharing your information.
Therapists shouldn’t be writing about you online, telling colleagues your secrets, or telling friends or family, “You won’t believe who I just saw today.”
They shouldn’t indicate in public that they know you unless you approach them and initiate the interaction.
If at any point, you find yourself in a compromised situation because your therapist violated confidentiality, it’s probably time to walk away
4. Keeps vital information from you.
Another ethical standard closely related to your right to privacy and confidentiality is your right to self-determination. You should be able to choose your own goals and the path you want to take to achieve them.
Good therapists know that their role is not to tell you what to do. Instead, they want to help you come to your own realizations. Good therapists won’t try to control or manipulate you to get you to do what they think you should do or what they want you to do.
Good therapists don’t provide care without informed consent. This means they need to make sure you understand what you’re signing up for from the beginning. If a therapist tells you after the fact that they were videotaping you or using you as a guinea pig for an experimental new therapy, it’s a significant violation of informed consent.
Good therapists will spend time explaining their approach and limitations with you. They will tell you if they are about to retire or go on a long sabbatical or vacation that will interrupt your work together for more than a week or two. They will be upfront about fees and won’t charge you more than they said they would. If they raise their rates, they will give you time to prepare (and will usually work something out with you if their new rates create a financial hardship for you).
If your therapist surprises you with information that kept you from making informed choices, they haven’t been acting in your best interest.
5. Offers services they aren’t qualified to provide.
Another important ethical concern for therapists is competence. Good therapists only provide services they are qualified to provide. For example, good therapists don’t agree to work with children if they have no training or experience working with children. They won’t advertise that they specialize in trauma-informed methods just because they read one article about EMDR.
The best therapists take it a step further than refraining from false advertising. They keep up with developments in the field, complete continuing education requirements, and read relevant literature. If they become interested in a therapy method they haven’t used before, they take a class or certification to become proficient in it before offering that new intervention to clients.
Good therapists know there’s always more to learn, so they’re always seeking to improve their existing skills.
It can be discouraging to put effort into finding the right therapist, only to have to walk away because you’ve spotted the signs of a bad therapist. It’s especially disheartening when someone you trusted tries to take advantage of you. But you don’t have to let a bad experience keep you from having a good one.
If you’ve had to go back to the drawing board after an unfortunate encounter with a bad therapist, consider using TherapyRoute to find a new therapist locally or online. If you keep looking, you might just meet someone who can help you discover all the good things that good therapy has to offer.