Sometimes, therapy can feel uncomfortable. In therapy, we address difficult feelings or moments of trauma so that we can examine them and heal. However, the discomfort of processing difficult feelings or memories is different from the experience of ineffective therapy.
Even during the uncomfortable times, you should feel connected and safe with your therapist. That trust is essential to your wellbeing and growth in therapy. The most successful outcomes from therapy are a result of developing a deep, trusting relationship. Sometimes, your therapist may not be a fit for you, even if they are dedicated, caring and highly trained.
When you are suffering, it can feel extra difficult to also take on advocating for yourself. A bad therapy experience can be extremely discouraging. However it is always better to be clear and compassionate about what you need to find the right care.
Red Flags
Sometimes your hesitations about your therapist may come from the discomfort of therapy, or even the simple recognition that your therapist is not the right fit for you. However, sometimes these hesitations may signal that a therapist is acting unethically or against the standards of their profession. While exceptionally rare, if your therapist is doing one of the actions listed as a Red Flag, you should seek a second opinion and / or terminate the relationship immediately.
1. Violating Confidentiality
If your therapist shares something detailed about you to a family member or names another client to you, this is a violation of confidentiality. Sometimes, therapists may be legally required to break confidentiality, such as if a client threatens to hurt someone, but they should not be sharing details and identities about other clients with you.
2. Violating Licensure
If you discover that your therapist is not registered or licensed with your state’s licensing board, discontinue seeing them immediately. You can check their licensure in your state board of therapists’ public database, the same one we use before letting a therapist join Mental Health Match.
3. Violating A Boundary
Strong boundaries are the cornerstone of a positive, healthy therapeutic relationship. Sometimes, it can almost feel awkward to practice these boundaries, which include:
- -Having a person who knows so much about you engage with you only in the context of therapy.
- -Not knowing many or any personal details about your therapist.
- -Being intimate and vulnerable while keeping a professional distance with very little, if any, physical touching. Some therapists may feel comfortable engaging in handshakes and short hugs with clients, while others do not. The therapeutic relationship should NEVER include anything more than that.
A therapist should never do something without your consent. This includes physical touch or coming into your personal space. It also includes repeatedly asking about or bringing up issues that you have asked to not talk about. While an effective therapist may challenge you or invite you to think about a certain experience, they should never make you feel like they’ve violated a boundary you shared with them.
4. Erratic or Manipulative Behavior
A therapist who often shows up very late, acts distracted, forgets sessions, or changes session times often and repeatedly is a major issue. One example of this is a therapist who is doing something else, like cleaning or cooking, during their session with you. Another example of this might be dramatically changing the fees you agreed upon and then pressuring you to pay. (Note, most therapists do fairly raise their fees occasionally, and when they do they are required by ethics to give lengthy advance warnings.) Therapy is supposed to be a steady and safe place. It will be impossible to build trust if you feel unsure that your therapist will be present, consistent or fair.
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Yellow Flags
If you feel your therapist’s behavior falls under one of the yellow flags below, the first step is to speak with them about it directly. If you feel heard and are able to resolve your concern, then the interaction can be a positive one that builds more trust. If you still feel as though something is off, a second professional opinion or a deeper examination of your experience is a good idea.
1. Revealing Personal Details
Some therapists reveal no personal details in therapy as a part of their treatment approach, while others reveal pieces of information about themselves at different moments to build connection and trust. However, these kinds of details can be a yellow flag if they make you change what you bring up or talk about in therapy, such as if a disclosure about religious beliefs makes a queer person hide part of themselves to their therapist. It is also always an issue if your therapist spends more time talking about themselves than listening to you.
2. Lack of Experience
Just like doctors, therapists can develop specialties. Many therapists are flexible, and can tailor their support to your needs and your relationship as it grows. However if you are seeing a therapist for something specific like infertility or neurodivergence and your therapist doesn’t seem to understand the process or experience, it could feel as though you aren’t seen and limit your progress. Know that you can always ask your therapist for more information about their training and career.
3. Pushy Advice or Making Judgments
Repeatedly pushing you to do something that makes you feel uncomfortable, from ending a relationship even to reading a specific self-help book, is giving directions, not providing therapy. While suggestions or insights around how you might handle a situation or person is okay, doing it in a way that makes you feel judged or controlled is not. Therapists should ask questions and help you clarify your own opinions, not give you theirs.
Making Sense Of It All
The overwhelmingly majority of therapists are competent and thoughtful professionals who care deeply for their clients. However, there are therapists who are unable to hold and implement the best practices of their profession. A violation of ethics by your therapist, or even simply a bad fit can mean that your experience in therapy risks hurting rather than helping.
Advocating for your own needs and care is an okay and important thing to do. It’s often one of the most important skills you’ll hone in therapy. This is why Mental Health Match exists as a resource and a supportive starting point. Always remember you can listen to your gut in a therapy relationship – or any relationship.
If you’re struggling to know if your therapist is the right one for you, more research or trying out a different practitioner can help give you the context, information and support you need to make the choice that’s right for you.
Finally, if you have been particularly harmed by a therapist or are concerned about their potentially harming other clients in their practice, each state licensing board has a grievance procedure you can follow to report your experience or concerns.