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What are the Warning Signs of “Unhealthy” Therapy?


Hi Folks,

In an effort to create a document that will help consumers to be informed about how to know the differences between unhealthy and healthy therapy.  I’m asking for your wisdom.  Here are some of my questions that I’d love to have your input on:

What are the warning signs of unhealthy therapy?

How do you recommend choosing a therapist?

What should you expect from a healthy and effective therapist?

In answering these try to be unspecific about the model of therapy, these should be universals that hold trut regardless of which kind of therapy one is doing.

Thanks for your help,

Noah :)

Noah Rubinstein, LMFT
Founder and CEO


Connect with Noah on Google+

© Copyright 2007 by Noah Rubinstein, LMFT, LMHC, therapist in Olympia, WA. All Rights Reserved.

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  • John Rhead March 24th, 2007 at 12:54 PM #1

    I tell people who are trying to choose a therapist to begin by asking their friends for recommendations based on personal experience, and then to interview more than one prospective therapist to see how it feels to be with him or her. I expect a healthy and effective therapist to truly believe in psychotherapy as a vehicle of transformation and to be willing to talk about his or her own therapy, which should be extensive if not ongoing. He or she should also be in some kind of supervision or consultation group that meets regularly and challenges him or her to confront his or her own blind spots (a.k.a. countertransference issues).

  • Therapist Amsterdam March 24th, 2007 at 12:57 PM #2

    For me is easier to define what is good therapist: By contrast you can think what does a bad therapist mean? right?
    So let’s see:
    Being a good therapist means:
    - Be able to listen carefully
    - Be able to be empathetic
    - Be loving and simple when approching to the people who is coming to ask for help
    - Be able to use a simple lenguage
    - Show ABSOLUT RESPECT when approching to the people who is coming to ask for help
    - You will know inmediately when someone is a good therapist because SOMEONE ELSE will tell you his or her good experience with that therapist!!
    - A good therapist is always willing to understand others point of view and be open to all the possibilities, practicing the humility before others sciences, related with this field.
    I hope with this simple comment I can help other to choose a GOOD THERAPIST!!

  • Murray Kaufman, LMFT March 24th, 2007 at 2:05 PM #3

    I feel that a person interested in Good Therapy can choose a Therapist in the following ways:

    1) The best possible recommendation comes through friends,
    relatives, or your own doctor who may already know of a good therapist from their own personal experience. You will still need to see if that therapist is a good match with you.

    2) Anyone else you may choose due to an Ad, The Good Therapy Site, or anywhere else, the best way in my opinion is to arrange a consultation session. Look at the person’s credentials. Is the person licensed, and have good training? Once you can meet the Therapist, see how you feel.

    a)Do you feel safe and comfortable?
    b)Is it easy to talk with the therapist?
    c)Does the therapist ask pertinent questions?
    d) Do you feel that the therapist is genuine?

    Once you feel initially comfortable with the therapist, it needs to continue. And remember, Therapy isn’t always comfortable, but the trust in your therapist is important. If at any time. you feel uncomfortable with anything the therapist says or does, talk about it with him/her. Finally, don’t forget that You are the one who hired the therapist. Therapy results don’t always occur as fast as we would like. Give the therapist a chance to assist you. Remember, You have the choice to either continue or choose another therapist at any time.
    Hopefully, these strategies will help you choose a good therapist by credentials and experience, but also, the right match for you.

  • Marjorie Rand March 24th, 2007 at 3:27 PM #4

    Some signs of unhealthy therapy are when the therapist talks more than the client, when the therapist shares too much personal material (self disclosure) and other inappropriate boundaries such as going to lunch with the client. Therapy should not include trading sessions, bartering or being in business with the client.
    Sometimes the therapist may appear not to be listening or may seem to be thinking about something else (not present). I think it is unhealthy if a therapist is too confrontive or gives too much advice or tells the client what to do.
    Of course these are just a few warning signs.

  • Derek March 25th, 2007 at 1:08 AM #5

    I would say the warning signs of an unhealthy therapy is a therapy in which a client has become therapy-dependent or therapist-dependent instead of learning techniques and remedies that would support self-support in his/her day-to-day life.

    I would agree with all the previous responses to this post also especially where a therapist is “absent”. I lean very much towards Zen which involves mindfulness and in a therapy session, everything a client says needs to be focused on and taken seriously.

  • Andreea Ionescu March 25th, 2007 at 3:20 AM #6

    I think that it’s important for someone willing to start taking therapy to check:
    - the references about that therapist from other clients, if possible (if he/she was guided there by a friend who was also a client);
    - if the therapist has some training and is certified in psychotherapy, in a well known therapeutical school (I guess a list of these orientations in provided also by this site), and he/she is not working only in his/her way;
    - if the therapist is working under supervision or has a constant intervision group;
    - if the therapist had/has his/her own personal development work with another psychotherpist and has this opening towards going again into own therapy if something shows up in time;
    - if the therapist shows from the beggining empathy, good listening skills (not giving advices, but answering the client’s needs), good acceptance and respect for the client, and is able to present to the client the way he/she works.
    Above all these, I think every client feels what kind of therapist meets his/her needs. Keeping the inner permission to discuss the process first and then to leave therapy if this shows not to be the needed one, it’s the greatest protection a client can provide to himself/herself.

  • Donna Hunter March 25th, 2007 at 5:08 AM #7

    The best sign of a good therapist is when the client and therapist both agree there is a good fit/ connection. After an initial session, a client feeling as though they were heard and have some sense of a plan of action,is in a good situation to begin therapy .
    Unhealthy therapy involves the therapist talking more about themselves/ giving personal examples than the client speaks. Unhealthy therapy has therapists who fall asleep ( I have heard of this more than once), who take personal phone calls during a session, who ask for the clients expertise on a subject. The list can go on.
    I strongly believe in staying away from bartering any services or gifts (tickets to an event etc). I believe that once a client always a client. The therapeutic relationship can be intense and intimate. The therapist must always maintain the boundary of the helping professional not the friend. Therapists are people too. We meet clients with whom we have a great deal in common. But once the therapist client relationship has begun, it cannot transition into a friendship.

  • Karen Carnabucci, MSS, LCSW, TEP March 25th, 2007 at 6:45 AM #8

    You should have the sense that the therapist “gets” who you are and what difficulties you are experiencing.

    The good therapist should be able to offer you hope that your difficulty is able to be addressed and solved — perhaps not immediately but with time and attention.

    A good therapist should be attentive and able to listen well, offer support and validation while also able to be honest with you about your challenges and blind spots.

    He or she should be informed about community resources and able to offer you additional information (books, web sites, other sources within the community) that may be helpful.

    If your problem is outside of the scope of the therapist’s practice, he or she should be able to refer you to a competant therapist who should be able to help you.

  • Darlene Lancer March 25th, 2007 at 3:39 PM #9

    I have heard many stories from clients who were unaware that their therapy was being compromised because of the therapist’s poor boundaries. Many clients come to therapy to learn how to set appropriate boundaries, so it is important that the therapist can model this.

    A therapist can be warm, friendly and work out of their home, but still respect boundaries.

    Warning signs might be if the therapist is initiating hugs or inappropriate touching, frequently giving advice, calling the client, being “friends” with the client, habitually allowing sessions or phone contacts to extend beyond the agreed time, talking about themselves, getting help from the client. Some of the above behaviors feel good. Everyone wants to feel liked and be helpful, but this cam inhibit progress and undermine the therapy. It also may be a warning sign that the therapist has work to do.

    Clients should trust their instincts, and if the therapist is doing or saying something that feels “off.” it should be addressed.

  • Noah March 26th, 2007 at 7:19 PM #10

    Great suggestions about the warning signs of unhealthy therapy and how to choose a counselor or therapist. Please keep the ideas flowing. We will synthesize most of these into the formulation we’ve been working on. Thanks, Noah :)

  • Dennis Thoennes, Ph.D. March 27th, 2007 at 8:07 PM #11

    Warning Signs & Finding a Good Enough therapist:
    Relevant to both of these topics I suggest a prospective client contact the credentialling body for the therapist’s profession in that state. For example in WA the credentialling body is the State Health Dept. Ask that office if the person you’re considering is licensed or certified in the state, is their license/certification in good standing and current? Do they have a record of complaints against the therapist? If so what are the complaints and have they been satisfactorily resolved?
    I encourage the prospective client call the therapist and do a phone interview. Does the therapist sound like he/she is genuinely interested in the caller? Has the therapist done his/her own therapy? Does the therapist have experience working with clients with similiar issues to those of the caller? Another interesting question, “How will I know when it’s time for me to leave, that I’ve finsihed this therapy?”
    Warning signs: Does the therapist scehdule apointments and/or contact outside of normal business hours? Does the therpist mix social or other business activities with the client in therapy? Does the therapist talk about others that are not relevant to the therapy eg, mutual social contacts, politics, friends or colleagues of yours that you haven’t introduced as a significant part of the therapy matter? Does the therapist make special financial arrangements for you, different than are made for other clients? Does the therapist suggest or imply that you shouldn’t talk about your therapy with others, i.e. keep it “secret” or “private”. Does the therapist seem personally offended if you question them, don’t comply with their suggestions or don’t marvel at their wisdom, humor or intellect? Does the therapist “feel” authentic to you?
    Of course each of these could be dabated and in different cases different things are reasonable or within bounds and in others not. A good dose of common sense is likely to be a valued asset in the process of both selecting a therapist and noting warning signs.
    A hair dresser, bartender or grandma can be warm, interested in you and compassionate, and nice to you. In a therapist you want these features sometimes. Also you will benefit if the person is competent, helps you learn, helps you heal and has the capacity and skill to notice and facillitate dealing with your defenses.

  • claire hershman May 27th, 2007 at 8:31 AM #12

    re how do you know if a therapist can help you. accreditation and registration is a very hot issue here in the u.k. at the moment, since the government seems obsessed with standardization.they have even diluted the doctor patient relationship to such a level that doctors are not free to make thier own drug choice to give people, we have standarardized guidelines, which are often a scandel. Anyway, since i work in the national health service some of the time, where counselling is very limited i make a lot of secondary referrals to therapists i know. referral is a real art. what criteria do to use.?apart from the obvious baseline of accreditation and training. its the intangeable…since i know the people i refer to, its something like the aa model, does this person have qualities i value and respect.i could not put my finger on it, but its probably trust. do i feel this preson knows themselves, has some inner peace and has the psychic space to help. i welcome other referres comments.

  • Dennis Buttimer July 21st, 2007 at 10:33 AM #13

    RE: Warning signs of unhealthy therapy, I believe that in its essence, the problem is the therapist meeting their own needs over that of the client. This can exhibit itself in the form of unnecessary therapy (type and/or length), focusing on the financial gain vs. appropriate compensation, boundary concerns around the physical (initiating hugging, etc. too often or with fragile clients not seeking a hug, etc.), as other therapists above have mentioned: too much personal sharing, also accepting inappropriate gifts (e.g. vacation homes, etc.) and more. Thankfully, I see where most of the colleagues I know are quite vigilant about these possible problems and do well in steering clear of these while practicing “good therapy.”

  • Deah Curry PhD July 22nd, 2007 at 11:49 AM #14

    For myself if I were a person seeking help with an emotionally difficult issue, I would consider the following signs of an unhealthy therapist:

    1. s/he is inflexible
    2. s/he doesn’t listen to my feelings
    3. s/he is disrespectful of my perspectives
    4. s/he slams other therapists
    5. s/he ridicules other healing practices
    6. s/he can be talked into doing what I want
    7. s/he diagnoses rather than helps or coaches
    8. s/he shows her irritation with my progress
    9. s/he tries to coerce me into outside activities
    10. s/he tries to sell me her products
    11. s/he hassels me when I cancel or quit
    12. s/he isn’t available for emergencies or questions
    13. s/he doesn’t remember my name or issues from one session to the next

    I would also consider the following to be traits of unhealthy processes during therapy:

    1. focus on thoughts to the exclusion of feelings
    2. denial of the importance of spirituality
    3. sessions that are unsatisfyingly short
    4. lack of therapeutic homework
    5. being asked to do something beyond my boundaries
    6. being allowed to run up a bill
    7. lack of input to a treatment plan
    8. no discussion of therapy goals
    9. no discussion of how to know when therapy can be completed
    10. constant focus on what’s wrong instead of also working on what’s strong and could be stronger

    Dr Deah Curry PhD
    Holistic Counselor
    Therapeutic Coach

  • Therapist Kharkiv December 19th, 2007 at 9:40 PM #15

    Therapists who talk too much.
    Talking should be at least 90% patient talking if not more, 8% therapist asking questions, 2% therapists making observations.
    Therapists who talk too much damage client/therapist trust. It seems that they are talking because they are uncomfortable and need so desperately to help the patient that the therapy focuses on their “solutions” rather than the patient’s issues. This is great to validate themselves as knowledgeable therapists but doesn’t really help as much as listening and asking questions like Why, why did you do that, why do you think they did that, what do you want to do now, etc.

    Therapists who ask questions with the insinuation that there is a “correct” answer they are looking for is also is bad.

  • Lisa February 12th, 2008 at 6:28 PM #16

    I’m just wondering why a therapist would only focus on the negative? I just left a therapist who never even talked about my strengths and only pointed out all my dysfunctions. I wound up feeling worse about myself than ever.

  • Violet July 29th, 2008 at 10:32 PM #17

    My therapist is a lovely woman except she has on numerous occasions started to cry during my sessions (not sobbing! but tears). She is very professional in every other sense although this to me is inappropriate and very unprofessional obviously leaving me feeling very uncomfortable! Would be interested to know if this has happened to anyone else? I have stopped my therapy with her, it got too much.

  • mary October 14th, 2008 at 11:45 AM #18

    “I’m just wondering why a therapist would only focus on the negative? I just left a therapist who never even talked about my strengths and only pointed out all my dysfunctions. I wound up feeling worse about myself than ever.”

    Sadly, this has been my experience too, and finally, why i decided to leave a therapist who was good in many ways.

    The problem is that a client who is new to therapy may be in a difficult position to make judgments about the suitability of a therapist as the new client may be feeling desperate, lacking in confidence, and confused. Also, unless the client has lots of access to money, there may be compromises along the way.

  • Mylene May 2nd, 2010 at 5:21 AM #19

    The signs were there from the start. I asked how was this supposed to work. He said ‘just talk about anything’. Occasionally he’d let slip that ‘other women say that’ or the classic ‘you care too much’. I sometimes felt puzzled when he dismissed my distress as ‘normal’ without ANY explanation. If I wrote something or described dreams they were met with silence. After two years I was scarily aware that had to fill him in on my whole life at the start of each session. His reactions to distress were a slow ‘YESSS’ and ‘there is a lot of emotion there’…(YOU THINK!)No plan, no real continuity except that which I brought with me. The only comments were Hallmark card cliches. The general coldness and distance, I mistook for professionalism. I sometimes sensed that he didn’t like people/women. After each visit I felt I had done the work of two people. As my visits became infrequent due to financial difficulties, this reason was thrown back at me when in a state of deep distress I asked for some sort of diagnosis that would explain my incredible confusion/daily depression. He refused to do that saying any name could be made label one’s state of mind.
    Now with my decision to quit I am shocked to feel a weight off my shoulders. Having briefly seen another therapist, I wonder how human or inexperienced this person was. I am not seeing anyone at the moment but thankfully my faith in therapy has not been destroyed. There’s sticking to ‘rules’ and being a robot in an ivory tower.

  • Vikki January 22nd, 2011 at 2:52 PM #20

    I am currently in therapy with a clinician who insists I see her three times a week. When financial difficulties made this unfeasible she pushed me to borrow money, suggested ways I could pay back the loan, and suggested that my discomfort with asking my parents for money to pay her was an issue we needed to discuss. When I tried to leave therapy she called a psychiatrist who I was supposed to see for the first time and canceled my appointment, saying that I couldn’t see this person without being in therapy with her. When I reminded her that I had not signed a release for her to discuss me with the psychiatrist she said she had been “sloppy”, but had acted in my best interest since this person would have told me I couldn’t be her patient anyway. Now I’m trying to end the relationship but I’m a bit frightened of this person. She calls me and demands I come in when I try to cancel an appointment. I’m afraid that she will call my university of something if I leave and tell them I am “mentally unstable” since she obviously has no issue with sharing my private information….

  • bav May 18th, 2011 at 12:32 PM #21

    I saw a therapist this morning and all I can say is I should have done more research on her. Firstly she openly said she was tired, and then used the F word. Very calming voice yet not all there. Please be very careful to who you open up to, it’s so easy to trust a therapist as they are perceived to be ones to help you however little comments can leave a scar.

    Now in Response to Vikki January 22nd, 2011 at 2:52 PM

    Report her ASAP. She is not right in the head, telling you to borrow money. REPORT HER NOW

  • NoNamePlease January 19th, 2012 at 7:22 AM #22

    I really hate it when the marriage counselor says in front of my husband “you jump around A LOT” and makes a face. (I feel she was diagnosing me.) I also did not like her saying “You would really enjoy being on anti-depressants.” Does anyone enjoy being on that stuff? ALSO, at our first session, after hearing our stories she said “I’m not a miracle worker.” WOW! That was SO negative. We will most likely end up divorced but she really hurt us more than helped us. Absolutely useless counselor on so many levels.

  • Concerned girlfriend April 6th, 2012 at 5:50 AM #23

    My partner has been seeing the same psychotherapist for 6 years to little improvement and I am very concerned about the following behavior as he is rapidly deteriorating in condition I.e mood swings and hysteria.
    - she tried to get him to pay her while away on holiday, despite 6 weeks notice of that holiday, without ever explaining that in terms and conditions, and convincing him at his
    memory was poor. This is despite there being no documentation of billing terms.
    - she then convinced him that he needed therapy on this holiday, despite not recommending it on any other holiday, even when severly distressed or anxious.
    - she called him “a deceitful liar” when he sought a second opinion and has refused to apologize. He is convinced by her that this was an acceptable response that he deserves.
    - he broke down in panic at the fear of telling her he had sought a second opinion
    - she insists that a maternal relationship with her will help resolve his mother issues, while he is becoming increasingly disturbed
    I am very worried for his mental health- is this an appropriate relationship? Can I report her?

    - she convinced him to see her three times a week for a year with no treatment plan or goals
    - she says he is not to discuss his therapy with me, his partner

  • Crushed in Emotions July 14th, 2012 at 2:56 AM #24

    My husband and I went to out first marriage counseling session and our intention is to work through some issues which happened prior to our marriage. So that we may eventually resolve to a stronger love connection and communication system. During the entire session the counselor criticized everything about me, from my being a stay at home wife to me being boring. She stated I was the entire problem. When ever I tried to tell her how I felt about some thing my husband bought into our marriage she dismisses those things before I get a word out and says the first thing we need to do on the next visit is figure out if we want to be together. My husband and I didn’t go in the office to split up or consider it for that matter. We just want some guidance on getting through a couple of rocky issues. I felt completely helpless and abused emotionally in that Drs. office. I felt worse leaving the office than before I went in. I was happy prior to this.

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