Picking a therapist can seem like a daunting and time-consuming task. As clinical psychologist Christina G. Hibbert, Psy.D, said, “It’s hard enough to get yourself to therapy when you need it, but to have to then ‘shop around’ for the right therapist can make many people either quit or settle for the first one they find, even if it’s not a right fit.”
But it’s vital to keep looking until you feel a sense of connection and trust with your therapist, said John Duffy, Ph.D, a clinical psychologist and author of the book The Available Parent: Radical Optimism for Raising Teens and Tweens. If you don’t, find “someone else to work with. Period,” he said.
Hibbert also underscored the importance of believing your therapist can help you. But these signs aren’t necessarily that obvious. In fact, knowing when a potential therapist might not be helpful is just as useful.
That’s why in this month’s “Therapists Spill” series, we asked clinicians to shed light on when a therapist isn’t right for you. Below, they share 11 warning signs that it’s time to find another clinician.
1. They behave unethically.
According to clinical psychologist Ryan Howes, Ph.D, “Any signs that therapy is moving from a professional and empathic relationship to a romantic one should be considered a bright red flag.” (He recommended reading this page for more information.)
But unethical behavior isn’t just sexual advances. It also includes “violations of confidentiality or financial wrongdoings” and offensive comments, said Joyce Marter, LCPC, a therapist and owner of the counseling practice Urban Balance. For instance, a friend of Marter’s had an already-pricey therapist who charged his clients while he was on vacation. In graduate school, Marter had an initial consult with a therapist who made a racist remark. She never went back.
2. They ignore confidentiality and emergency protocol.
Therapists should have you complete an intake form to provide information in case of an emergency, said Jeffrey Sumber, M.A., a psychotherapist, author and teacher. Similarly, every therapist should discuss your rights with you, including the times when they are required by law to break confidentiality, Sumber said. (You’ll also need to sign the confidentiality agreement.)
3. They don’t specialize in your issue.
Hibbert, an expert in postpartum mental health, regularly sees the devastating results from lack of expertise. For instance, she’s seen new moms hospitalized for a month because their clinicians believed they were psychotic. In actuality, they had postpartum obsessive-compulsive disorder, which is nonthreatening and treatable with therapy and medication, she said.
Find clinicians who are trained in what you’re struggling with, she said. Some therapists may simply have exposure in a particular disorder, instead of expertise, said Deborah Serani, Psy.D, a clinical psychologist and author of the book Living with Depression.
She suggested asking specific questions about certificates, diplomas and experience. For instance, when you ask “How many clients have you treated with depression?” you don’t want to hear ‘a handful,’ you want to hear ‘dozens or hundreds,’” she said.
Because she doesn’t have training in substance abuse or eating disorders, Serani refers individuals with these issues to colleagues who do. “Good therapists always know the limits of their expertise,” Serani said. Even if you are seeing an expert in the field, don’t be afraid to seek a second opinion, Hibbert added.
4. Their recommendations go against your beliefs.
Hibbert works with members of her church and has heard of clinicians making suggestions that conflict with their beliefs and values. “A good therapist should work within your own value system,” she said.
5. They dodge your questions.
“Therapists don’t answer every question,” said Howes, who also authors the blog “In Therapy.” That’s because the focus is on you. However, they should answer reasonable questions clearly and directly, he said. These questions can be “general get-to-know-you questions to anything pertaining to treatment.”
Howes gave these examples: “Where are you from? What interested you [to] this line of work? Did you have a nice vacation? How long have you been in practice? Do you have experience with my issue? What do you recommend we do to treat this problem? How do you think therapy is going? How do you feel about our relationship?”
6. They over-share.
On the other hand, Howes said, “some therapists share too much about their own life, drawing attention to themselves and potentially pulling you in to take care of them.” He noted that every disclosure a clinician makes should benefit you in some way. (“You’re always welcome to ask how their story helps you,” he added.)
“A good therapist knows boundaries, keeps personal issues tucked away and always strives to make the session treatment productive for their client,” Serani said.
7. You feel worse after your session – regularly.
“This might happen on occasion, even with a therapist that you love, but if it’s happening all the time, then something is not right,” Hibbert said.
8. You feel judged, shamed or emotionally unsafe.
According to Marter, this includes anything a therapist might say or do, such as rolling their eyes. Marter stopped seeing a therapist because of a similar experience.
I saw a therapist for a few months who came highly recommended but seemed to hold a magnifying glass to all of my issues. I felt worse. I talked with her about it and felt even more pathologized. I was confused about whether she was just helping me see my “stuff” and I was being defensive, but made the choice to tell her I needed to end our work together. It turns out, this was the beginning of me setting healthy boundaries for myself and also led to my finding a therapist with whom I feel completely safe and positively regarded, even when we are processing my less than desirable aspects of self.
9. They’re a lousy listener.
While a therapist might not remember minute details, they should remember key facts about you and your concerns. According to Howes:
Not every therapist will remember your dog’s name, where you went to high school, and your favorite breakfast cereal every week. But they should recall your name and what brought you to therapy in the first place. If you feel like you’re constantly replaying your first session to help them help you better, you may want to take your business elsewhere.
10. They disrupt the session.
This includes answering phone calls — unless there’s an emergency — texting or even falling asleep. As Serani said, “A good therapist makes you the only focus.”
11. You just don’t feel “right.”
Howes and Hibbert stressed the importance of trusting your gut. “Sometimes there is no obvious reason — you just don’t feel it’s right,” Hibbert said. According to Howes:
If you feel like something isn’t right in your first phone call or initial session, this may be a bad sign. Some discomfort is a normal part of therapy, just as seeing a personal trainer isn’t always comfortable, but if you feel uncomfortable to the point of dreading or avoiding sessions, you may want to keep looking.
As Duffy said, “you should also feel comfortable in the atmosphere, physically, spiritually and emotionally, that your therapist provides.”
Of course, therapists may make mistakes. They’re only human. Marter shared a story about a friend’s beloved therapist forgetting their appointment. The therapist walked into the waiting room — in her home office — wearing a robe and slippers 15 minutes after their session was supposed to start. The therapist was surprised to see her client, but she was extremely apologetic. “Such human mistakes should be processed directly and can be opportunities for growth,” Marter said.
Finding a good therapist with the expertise you need isn’t easy. But paying attention to these red flags can give you some guidance on when to walk away, and continue looking for a therapist who is right for you.
Tartakovsky, M. (2013). Therapists Spill: Red Flags A Clinician Isn’t Right For You. Psych Central. Retrieved on May 19, 2013, from http://psychcentral.com/lib/2013/therapists-spill-red-flags-a-clinician-isnt-right-for-you/
Last reviewed: By John M. Grohol, Psy.D. on 15 Feb 2013
Published on PsychCentral.com. All rights reserved.