The world of therapy is not easy to navigate. There are literally hundreds of different styles (or types of training), and many practitioners now integrate more than a couple in their approach. Some are built on principles of speed and quick results, others require many months, if not years of regular sessions. Some therapists say very little, some are directive.
No wonder so many people think it’s hard to find the right therapist – and that’s why, 12 years ago, I launched therapist-matching platform Welldoing. On Welldoing, or similar places like Counselling Directory and Psychology Today, you will find therapists who meet a high standard. They are members of organisations such as the BACP, UKCP and NCPS and will have completed the recommended years of training and clinical hours, are having regular supervision and continuing professional development (CPD). This should mean that you are in good hands. But that doesn’t mean there aren’t potential risks.
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Therapy is an unregulated industry and recent press stories have highlighted examples of bad practice, particularly with young, vulnerable people.
In one extreme example, a client was awarded more than £200,000 in damages in a high court ruling after suing her therapist over alleged sexual assaults when she was in her mid-20s.
To protect yourself and to mitigate against harm, it’s important to go into the process of therapy with eyes wide open, looking out for any warning signs of behaviour that exceeds the usual safe practice of psychotherapy. But, before that, you do need to understand what therapy is, and what it is not.
“Therapy is a nuanced and varied process that is fundamentally about building a constructive and trusting relationship in which clients can address and alleviate past and present distress,” says Alice McGurran, a gestalt therapist (a person-centred practice that focuses on the here and now).
“Any suitably trained therapist will have had years of training, personal therapy and supervision, all of which should equip them to manage the serious responsibilities of that relationship.”
Simply starting to see a professional won’t always progress as imagined. “It can seem to take a long time for anything much to happen, and you may feel that you are endlessly telling the same story, without getting the solution you had imagined you were aiming for.”
The majority of people have a good experience with their therapist – but here are are 11 red flags that should raise concern. If these issues become frequent, raise them with the therapist or consider stopping therapy sessions with them.
The therapeutic relationship is bound by a certain formality, so your therapist should not invite you to meet up outside sessions, talk too openly about their lives, or disclose information that isn’t relevant to your sessions together.
2. They offer unexpected physical contact
In general, therapists shouldn’t touch you and the body is out of bounds. It may be appropriate if you’re seeing a body psychotherapist or a practitioner who combines massage with talking therapy, for example. But it should be clear from the outset of your work that this may be a component of the work.
Therapists should not be repeatedly late or forget booked sessions. Yours is a professional relationship, so it’s also bad practice if they frequently run over time, or in any way imply you are getting special treatment.
4. They breach confidentiality
Most, though not all, therapists will send you a contract, outlining their terms and conditions. Therapists shouldn’t break confidentiality unless under extreme or legal circumstances that they will share with you in advance.
Clients are often prescribed drugs like antidepressants or anti-anxiety medication by GPs at the same time as having therapy. But therapists must work within their own competence or training. For example, it is unethical for a therapist to diagnose a client with a condition such as ADHD. This can only be done by a psychologist or doctor.
6. They don’t listen to your feedback
McGurran adds, “While your relationship with your therapist will ideally feel secure, therapy doesn’t always feel comfortable. It may make you feel anxious; it may involve challenge. On top of this, therapists are human and will naturally make mistakes. I’d encourage clients, if they feel able, to raise any concerns and offer feedback to their therapists, especially if there has been a rupture. How your therapist responds to that feedback is key and the chance to work through relationship obstacles can be therapeutic in itself.”
Therapists should be open about their training, and style of working. At the beginning of therapy, it’s a good idea to bring up anything that you think a therapist might not be comfortable or familiar with.
Therapists will often write on their profile that they are affirmative in certain areas, so that clients in that group (the LGBTQ+ community, for example) will know they are a safe place for them. They also should not be dismissive or defensive if you raise something you don’t like about working with them.
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square VEGETABLESRead More8. They encourage you to isolate yourself from loved ones
If you are considering breaking contact with close friends or family members, therapists should be thoughtful and measured. They should want to know the full story. Therapists are there to help you come to decisions, not to urge you to go ahead with everything that comes through your mind.
Breaking contact with family members is a major move, and sometimes if therapists are promoting that it could be to put themselves into a primary position with you. This should be discouraged.
Therapists shouldn’t often comment on the way you look, present yourself, and definitely not your sexual appeal. Due to the intimate nature of the relationship, things may be construed as flirting that aren’t, and it’s not uncommon for people to develop feelings on some level for their therapist – but it is important that the therapist keeps the boundary in place.
10. They pressure you to continue sessions
You shouldn’t be pressured into staying in therapy if you have made up your mind to leave. Therapy can range from 6 sessions to hundreds. It’s a good thing if you discuss how long you think you want to see someone for at the outset. But keep in mind that therapy is necessarily a slow, unpeeling process.
11. They also treat someone you’re close to
Therapists should try to avoid seeing a client who is in some way connected to another client of theirs. In some communities this may be harder to realistically achieve than others, but it is important that a therapist is mindful of any risks of one client coming up in another’s therapy. Generally, if you see a couples therapist and also want to see a therapist for your self, it would be two separate therapists.
Working with a therapist can be life-changing. At Welldoing I hear that every day. But it can also be harmful in the wrong hands, so please, don’t sweep concerns under the carpet. It’s your mental health, you need to protect it.
Louise Chunn is the founder of therapist-matching platform Welldoing.
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