February 12, 2021

What a Therapist Should Not Do: 24 Red Flags to Watch For

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18
min read

Everyone’s heard of a funny or horrible therapist story at some point in their life. Either through the movies, someone else’s experience, or another medium, your view of a therapist may have been formed by something similar to the following:

  • The tales of strange behavior, like a therapist removing their socks during a session
  • The belabored cliché question, “How does that make you feel?” 
  • The stereotype of therapists’ condescending attitudes toward their clients
  • The feeling that something is wrong with you just because you’re seeing a therapist

All jokes aside, these are poor indicators and false depictions of what therapy is really like. We must focus on the things we really need to watch for.

Curious about what a therapist should not do?

If you’re new to therapy or considering starting it for the first time, it’s natural to ask yourself, “How will I know if what my therapist is doing is right?” There’s no easy answer, but here are 24 examples of what a therapist should not do.

1. Skip building trust or rapport

Trust is the foundation of any relationship between a licensed therapist and their client. But if they jump into the details of your life before you’re comfortable sharing, it can be very awkward for you.

Instead, a therapist should start with basic details that are easy to talk about. After that, they can gradually move into the deeper layers of what you’re experiencing.

2. Lack empathy

It’s critical that you’re honest and open with your therapist, but that’s hard to do if they don’t show empathy. Based on a study by Dr. Robin DiMatteo, physicians who showed empathy and genuine concern saw a 19% increase in patient adherence. 

A good therapist should be compassionate and understanding in order to better connect with you, make you feel comfortable, provide you with the right guidance, and let you know that you’re in a safe place.

3. Act unprofessionally

Unprofessional red flags include: 

  • Dressing inappropriately
  • Poor hygiene
  • Talking too casually or informally
  • Having a messy office

It can be hard for you to focus with these distractions. On the other hand, even if you find comfort in a therapist’s office, it’s still a professional work environment. A good licensed therapist knows that the way they present themselves as a mental health professional says a lot about them and how they work.

4. Be judgmental or critical

It’s a therapist’s job to look at your situation without their own opinions and biases. If you feel judged, it can hinder progress and make it difficult for you to open up. No one should have to experience this, especially from someone whose role is to help you.

5. Do anything other than practice therapy 

Here are some non-therapy things a mental health professional should never do in your session: 

  • Ask you for favors
  • Talk about things not related to why you’re there
  • Make sexual comments or advances
  • Touch you inappropriately
  • Make plans with you outside the session that don’t relate to your mental health

This is a professional relationship between you and your therapist. They should know that anything that happens during these sessions is strictly about your mental health and nothing more.

6. Lack confidence

A therapist should not appear nervous, shy, or unconfident because it can raise doubt for you as the client. It can be natural for new therapists to experience this, but how can you trust the guidance of someone who doesn’t have conviction in what they say? A licensed therapist has much knowledge (backed by a lot of training and graduate degrees) and should be confident about their approach to psychotherapy.

7. Talk too much or not at all

If you find your therapist is doing most of the talking in your sessions or you’re the only one talking, that’s another red flag. The focus should be on you — the client. All licensed mental health professionals are trained in communication. That means they should know when to switch topics, how to read body language, how to guide you through tough situations, and when to talk, or not.

8. Give unsolicited advice

Contrary to popular belief, a good therapist will never tell you how you should live your life. They won’t tell you how to treat your family members, to break up with a toxic spouse, or what hobbies to take up.

No matter how long it takes or how hard it is, a therapist’s job is to guide you to make your own decisions and build awareness of your thoughts and emotions.

9. Share confidential information

Client confidentiality isn’t just something a good therapist does — it’s the law. Many federal and state laws, such as the Health Insurance Portability and Accountability Act (HIPAA), make it a top priority to protect a client’s privacy. Unless it involves saving someone’s life, no clinician should share the details of your therapy sessions with anyone. Nor should they share confidential information about other clients with you!

10. Seem bored or uninterested

If you have goals you want to achieve during therapy or changes you want to make, it can be discouraging if your therapist doesn’t show that they share your interests. It can be even more disheartening if they show any of these other clear signs of boredom or lack of interest: 

  • Drawing on their notepads
  • Yawning all the time
  • Being easily distracted by something else
  • Not focusing or concentrating
  • Being late to sessions
  • Doing anything other than talking or listening to you

Your therapist doesn’t need to share your interests, but they should take them into account so that they line up with your mental health plan. To do this effectively, they should also be completely engaged and focused on you. 

11. Avoid admitting mistakes or accepting feedback

It can be difficult to make progress in your therapy sessions if your therapist takes things personally or if they can’t admit fault. They should be able to own up to mistakes or respond to constructive feedback without negativity. No therapist is perfect, but a good one will respond to your input with maturity and calmness.

12. Talk in technical or academic language

Clinical psychologists are highly trained and educated people. But that doesn’t matter if you don’t know what they’re talking about. A therapist shouldn’t speak in psychobabble, or psychology jargon. Instead, therapists should ensure that what they’re saying to you is crystal clear, without making you feel dumb.

13. End your sessions without action items

Talking through problems or difficult issues, especially during your first sessions, is one of the most effective ways to treat a mental health condition. But if talking is all your therapist does, how can you take action in real life when you’re not around them? 

During sessions, a good therapist will give you the tools you need and actions to take home with you. This will help you build independence and handle difficult situations on your own.

14. Fail to explain when therapy is no longer needed

If you keep seeing your therapist without a clear understanding of what the end goal is, not only will you not know when therapy is done, but you won’t have a standard to measure against your progress.

As for deciding whether to continue or stop therapy, there isn’t one answer. But a therapist should guide you toward goals that are attainable and ones that work best for you throughout your sessions.

15. Make promises or guarantees

There’s no way of knowing what type of therapy will work early on, especially if it’s your first time. And that’s not a bad thing. However, a therapist should not predict your progress, as it may set up unrealistic expectations. This may cause further pain or discouragement down the road. 

Despite the uncertainty, a good therapist will be honest with you, and they’ll reassure you that you’re not alone in this journey.

16. Answer phone calls

Just like you wouldn’t like someone answering their phone in the middle of an important conversation with you, the same goes for your therapist. Instead, they should leave all forms of communication from the outside world for before or after your sessions.

17. Show insensitivity to your culture, religion, orientation, race, age, etc.

The need for therapists to be sensitive to personal, cultural, and religious backgrounds is  important. If a therapist isn’t able to respect your traditional customs, it can damage your trust and hinder your progress.

However, this isn’t solely for the sake of being sensitive. As Dr. Kenneth Pargament said in an interview with the American Psychological Association, many healing actions — such as forgiveness, meditation, and kindness — “have deep roots in Eastern and Western religious traditions and philosophies.” A good therapist should know this and be able to incorporate your traditions and background with your treatment.

18. Use different psychotherapeutic methods without your permission

Trying different treatments isn’t a red flag, but a therapist shouldn’t use them without your consent. There are many types of therapy, such as cognitive behavioral therapy (CBT), humanistic therapy, psychodynamic therapy, and mindfulness-based cognitive therapy (MBCT). 

The dynamic process of finding the right treatment isn’t easy, and it may involve trying out different ones over time. But before jumping into one, your therapist should explain to you what it is they’d like to use and why they would like to use it. It also shows that they respect your boundaries.

19. Seem overwhelmed

Not everyone’s mental health condition is the same, and therapists work with many different techniques, backgrounds, and diagnoses. But if a therapist shows signs of overwhelm, it may mean that they are not present. Some body language cues showing this might include hands on their forehead, a blank expression, or not making eye contact. Their dialogue can also be a giveaway — being negative, having a cold tone of voice, or talking too fast or slow. This can be incredibly uncomfortable for you and make you feel like nobody can help you or you’re not worth a therapist’s time.

Compassion fatigue is a real thing that mental health professionals encounter, but they should have a good balance between commitment and detachment with each of their clients’ cases in order to be most effective.

20. Forget basic details

Constantly mixing up the basic details of your mental health treatment is another red flag and something a therapist should not do. It’s usually OK if it happens in the first session or two, but a therapist’s job is to take good notes on you — their client. This includes the names of family members, what you’re comfortable talking about, what psychotherapeutic techniques are being used, and the goals you want to reach.

A good therapist does this not only to ensure you get the best help, but it also shows that they care and that they’re genuinely involved.

21. Support the wrong decisions

In your journey for well-being, things won’t go perfectly. For example, if you’ve been diagnosed with bipolar disorder and lash out at someone, or if you’ve been diagnosed with an eating disorder and you haven’t eaten in days, it’s OK. Setbacks may happen. They’re part of the healing process.

However, a therapist should not support or praise behavior that doesn’t help you. That’s not to say that they should condemn you (see point number four). They just shouldn't reinforce behavior that will harm you or others. On the other hand, a good therapist should always acknowledge or praise your successes and milestones.

22. Rush a diagnosis

In “A Charlie Brown Christmas,” Lucy tries to diagnose Charlie Brown with different phobias as a way to treat him, but it only makes him feel worse. 

Just like Charlie Brown, receiving a rushed diagnosis can make you feel like the therapist is lumping you into a bucket. The same is true if you're overdiagnosed. A therapist should not do this because it can make you feel like something is wrong with you.

Establishing a diagnosis isn’t easy, and it takes time. The American Psychological Association lists the many things a clinician needs to take into account before making this decision. It’s very important because much of a client’s mental health plan is based on their diagnosis.

This can be a slow process, but a therapist should ensure they’ve taken everything into account before making this critical decision in your life.

23. Fall asleep

You can usually tell your therapist fell asleep if they respond awkwardly (after being awoken) or if they flat out start snoring. It doesn’t mean that your therapist isn’t interested in what you’re saying. They’re probably just tired. Many licensed therapists run their own practice, and they can sometimes work long hours to keep it running. 

However, it’s a therapist’s responsibility to manage their own well-being, get rest, and stay alert for each of their sessions.

24. Keep telling you they’re right for you

Whether your therapist has the title of clinician, licensed clinical social worker (LCSW), or psychotherapist, they shouldn’t try to convince you about their credentials or methods. Doing that can make you feel like they’re actually not qualified.

Aside from a professional relationship, you also have a therapeutic relationship with your therapist. This means that if you’re not getting the healing that you need, then perhaps they should refer you to someone else that may work better for you. If a therapist feels that you would benefit more from another service, then that’s something they should be honest about.

Make this list work for you

Here are some overall takeaways that capture the essence of what a therapist should not do:

  • Be muddy or unclear in their communication
  • Lack kindness, empathy, or respect
  • Make your sessions about anything other than you and your mental health treatment

If you’re new to therapy or if you’ve just started your first few sessions, use this list as a go-to resource to avoid an ineffective therapist.

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