50 Warning Signs of Questionable Therapy & Counseling
February 12th, 2008 | Email this to your FriendsThe 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 taking 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 her 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 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 himself 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 other clients.
21.Therapist discloses that she has never been in 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” which 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 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 their 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’s 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 over-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.
February 20th, 2008 at 11:38 am
This is a good, comprehensive list. Thanks for taking the time to write these down!
February 20th, 2008 at 11:39 am
It is a great list, I agree. And, I think it is useful for both client and therapist. Sometimes as therapists we do need to be kept on our toes. I think I’ll post this list in my waiting room for my clients and in my office for my own reminders.
February 20th, 2008 at 11:40 am
My daughter goes to a therapist, and I am glad to see that this therapist seems to follow this list very well. She has made a huge difference in my daughter’s life and I am very, very grateful for her. Some of the items on the list I actually laughed at, such as answering the phone during a session. But, I am sure that if it made the list, someone somewhere has done it. But, I’m glad I haven’t had personal experience with this item-that would be very frustrating and maybe even embarrassing.
March 5th, 2008 at 9:46 am
I would be concerned if a therapist’s degree proved to be from a non-accredited institution, or if his or her only training relevant to the problem being treated was through workshops outside of a degree program. I would also be concerned if the person presented as credentials “diplomates” or other certifications offered by self-credentialing membership associations rather than by national professional organizations, or claimed board certifications other than those managed by national professional associations.
March 19th, 2008 at 5:23 am
A therapist who sees a remarried couple when one of the partners was in counseling with the same therapist with their former spouse.
April 1st, 2008 at 7:11 am
Should a good therapist in the beginning stages of the therapy request a historical summary of the client in order to provide good counseling? I have a friend in counseling and the therapist did not ask for historical family information. This friend comes from alcoholic family…..Should we be concerned?
April 21st, 2008 at 1:38 pm
Not necessarily. Actually there is no research evidence to suggest this is important, although it is common and the norm in therapy practice. Many excellent therapists will skip this information in order to use the time to simply get started solving problems. Often problems can be solved without the history.
It is important to track if therapy is helping and if the client feels understood. If either of these things is not happening by the third session, research indicates a good outcome of therapy is considerably less likely.
If your friend feels it is important to tell his/her story and social history, it is worth while to speak up about that. The therapist should be able to adjust.
April 21st, 2008 at 1:39 pm
Not necessarily. Actually there is no research evidence to suggest this is important, although it is common and the norm in therapy practice. Many excellent therapists will skip this information in order to use the time to simply get started solving problems. Often problems can be solved without the history.
It is important to track if therapy is helping and if the client feels understood. If either of these things is not happening by the third session, research indicates a good outcome of therapy is considerably less likely.
If your friend feels it is important to tell his/her story and social history, it is worth while to speak up about that. The therapist should be able to adjust.
April 21st, 2008 at 11:07 pm
If a person is from an alcoholic family and the therapist does not know addictions, I suggest they refer to a qualified clinician! That individual is an Adult Child Of Alcoholic (ACOA) and that is huge! That brings a host of other issues that must not be over looked!!!!
May 5th, 2008 at 7:50 am
I would be wary of a therapist who is limited to one type of theraputic approach. For example, the therapist may say, “I’m a cognitive therapist,” goes to cognitive therapy conventions, is an active member of various cognitive therapy associations, etc. etc. Or Transactional Analysis, or Cognitive-Behavioral, or what have you.
Not to sound condescending, but some therapists are overdependent on specific methods to compensate for their lack of skill in other methods, and end up steering the therapy to fit their method, instead of vice-versa.
The really skilled, successful therapists I’ve seen have been eclectic, and are able to provide whatever approach or approaches are effective with their clients. So for me, if a therapist says, “I’m a whoopeekipperedherring therapist,” that’s a major red flag.
June 3rd, 2008 at 1:23 am
Therapist makes sweeping statements of fact using words like “Never”, “Everyone”, ‘Always”;’ “You behavior would bother anyone”
Therapist takes sides in couple therapy using personal point of view; “Your behavior would bother me too”
June 28th, 2008 at 1:21 pm
I was checking to see if it’s right that your Therapist tell’s you on the phone that she can’t se you any longer cause it’s to hard and she is not going to do abuse Therapy after 7 years leaves you flat with no referals nada nothing. She told me she was going to write me a letter and send me a referal and has a gift ect…it’s been 25 days and again nothing. I want my case notes from her and I have written 2 times a letter requesting them and nothing. I need some advice.
Thank you
June 28th, 2008 at 1:23 pm
I was checking to see if it’s right that your Therapist tell’s you on the phone that she can’t see you any longer it’s to hard and she is not doing abuse Therapy after 7 yearsand no warning. She left me flat with no referals nothing. She told me she was going to write me a letter and send me a referal and has a gift ect…it’s been 25 days and again nothing. I want my case notes from her and I have written 2 times a letter requesting them and nothing. I need some advice.
Thank you
June 29th, 2008 at 11:21 am
Under HIPAA, you have a right to your treatment records, and I think it’s supposed to be within 2 weeks.
You might not want a referral from someone who behaves like this.
July 2nd, 2008 at 6:34 am
I am very sorry to hear of your experience of therapeutic abandonment, considered to be one of the most egregious problems in field of psychotherapy. If you feel you have been abandoned by your therapist or are in any other way being treated unethically or unprofessionally, you can report your grievance the therapist’s licensing board. This should be fairly easy to find online be searching for “your state” and “the therapist’s specific license or title” and the word “board.” There are thousands of great therapists out there; be sure to shop around and follow the guidelines on this site and others in selecting your next counselor or therapist. I hope you will not be too discouraged by this experience which is unusual and fairly rare I would say and that you will find another therapist very soon.