50 Warning Signs of Questionable Therapy and Counseling
February 12th, 2008
The items listed below are significant red flags and important information for anyone in therapy or considering therapy. If any of the following red flags appear during the course of your counseling, it may be time to reevaluate your counselor or therapist. Should you recognize one of these red flags, the first step, in most cases, is to discuss your concern with your counselor. Try talking candidly about what’s bothering you. A good therapist should be open and willing to understand your concerns. If your counselor doesn’t take your concerns seriously or is unwilling to accept feedback, then it’s probably in your best interest to consult with another therapist about it. Most therapists mean well and are willing to take accountability for their own “stuff.” So, it’s also important to give your therapist the benefit of the doubt…all people make minor mistakes. And sometimes what people think is their therapist’s issue is actually their own. These “blind spots” can be the most difficult to see and are well worth talking about with your therapist.
It’s also important to note that the following red flags have varying degrees of significance. Some of them are very serious violations of ethical standards, such as a therapist attempting to have a sexual relationship with a client. There is no exception to this rule, and if you find yourself in such a situation, you are advised to report to the state professional licensing board and consult with other professionals. However, a number of the red flags listed below do have “exceptions to the rule” and depend partly on the context. For example, it’s generally unacceptable for therapists to have dual relationships with their clients. So if a counselor is treating the neighborhood barber for his depression, the counselor goes to a different barber to avoid confusing the “client-therapist” relationship. However, in small communities it can be impossible to avoid certain dual relationships. Ethical guidelines are flexible enough to take this, and some other exceptions, into account.
In no particular order, it is a red flag if you find that your:
1. Counselor does not have sufficient and specific training to address your issues and/or attempts to treat problems outside the scope of the practice.
2. Therapist is not interested in the changes you want to make and your goals for therapy.
3. Counselor cannot or does not clearly define how he or she can help you to solve whatever issue or concern has brought you to therapy.
4. Therapist provides no explanation of how you will know when your therapy is complete.
5. Counselor does not seek consultation with other therapists.
6. Therapist makes guarantees and/or promises.
7. Therapist has unresolved complaints filed with their licensing board.
8. Therapist does not provide you with information about your rights as a client, confidentiality, office policies, and fees so you can fairly consent to your treatment. Note: The information provided to new clients by therapists differs by state and licensure requirements.
9. Counselor is judgmental or critical of your behavior, lifestyle, or problems.
10. Therapist “looks down” at you or treats you as inferior in subtle or not so subtle ways.
11. Counselor blames your family, friends, or partner.
12. Counselor encourages you to blame your family, friends, or partner.
13. Therapist knowingly or unknowingly gets his or her own psychological needs meet at the expense of focusing on you and your therapy.
14. Counselor tries to be your friend.
15. Therapist initiates touch (i.e., hugs) without your consent.
16. Counselor attempts to have a sexual or romantic relationship with you.
17. Therapist talks excessively about him- or herself and/or self-discloses often without any therapeutic purpose.
18. Counselor tries to enlist your help with something not related to your therapy.
19. Therapist discloses your identifying information without authorization or mandate.
20. Counselor tells you the identities of his or her other clients.
21. Therapist discloses that he or she has never been in his or her own therapy.
22. Counselor cannot accept feedback or admit mistakes.
23. Therapist focuses extensively on diagnosing without also helping you to change.
24. Counselor talks too much.
25. Therapist does not talk at all.
26. Counselor often speaks in complex “psychobabble” that leaves you confused.
27. Therapist focuses on thoughts and cognition at the exclusion of feelings and somatic experience.
28. Counselor focuses on feelings and somatic experience at the exclusion of thoughts, insight, and cognitive processing.
29. Therapist acts as if she or he has the answers or solutions to everything and spends time telling you how to best fix or change things.
30. Counselor tells you what to do, makes decisions for you, or gives frequent unsolicited advice.
31. Therapist encourages your dependency by allowing you to get your emotional needs meet from the therapist. Therapist “feeds you fish, rather than helping you to fish for yourself.”
32. Counselor tries to keep you in therapy against your will.
33. Therapist believes that only her or his counseling approach works and ridicules other approaches to therapy.
34. Therapist is contentious with you or frequently confrontational.
35. Counselor doesn’t remember your name and/or doesn’t remember your issues from one session to the next.
36. Therapist does not pay attention or demonstrate he or she is listening and understanding you.
37. Counselor answers the phone during your session.
38. Therapist is not sensitive to your culture or religion.
39. Counselor denies or ignores the importance of your spirituality.
40. Therapist tries to push spirituality or religion on to you.
41. Counselor does not empathize.
42. Therapist empathizes too much.
43. Counselor seems overwhelmed with your problems.
44. Therapist seems overly emotional, affected, or triggered by your feelings or issues.
45. Counselor pushes you into highly vulnerable feelings or memories.
46. Therapist avoids going near any emotional or vulnerable feelings.
47. Counselor does not ask your permission to use various psychotherapeutic techniques.
48. Therapist tries to get you to exert overt control over your impulses, compulsions, or addictions without helping you to appreciate and resolve the underlying causes.
49. Counselor prematurely and/or exclusively focuses on helping you to appreciate and resolve the underlying causes of an issue or compulsion when you would instead benefit more from learning coping skills to manage your impulses.
50. Your counselor habitually misses, cancels, or shows up late to appointments.
If there are other warning signs or red flags you’d like to add to this list, feel free to make a comment and we’ll consider adding it to the list.