Therapists and 42 red flags to look out for

Red flags and therapists?

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Therapists and red flags

Have you ever attended therapy, either with the NHS or privately and was it a positive experience? Are you considering therapy? If you’ve never been to see a therapist/counsellor, perhaps you don’t know what to expect, or what to look out for in a therapist? Let me say, if you are thinking of therapy, you might want to read and consider some of the therapists and red flags listed below.

But first — this post came about after a friend (an Occupational Therapist) told me she’d had six sessions of counselling, which she accessed through her work’s Wellbeing programme. While she said there had been an improvement in her mood, she would never go to counselling again! She hated the therapist who allegedly looked bored, was too blunt, always late and talked about herself a lot of the time. “She looked like she should be in counselling,” moaned Hayley.

Getting personal

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NHS provide staff with therapy

We talked about how many other people we knew that had had bad experiences with therapists, and all for various different reasons. I’ve seen 5 different therapists over the years, and although one was excellent and a few were good (ish), the final one was so awful, I didn’t go back after the second session. My first time was arranged via my GP, it lasted over three years and my therapist was fantastic. The other four times were accessed through my NHS Trust’s Wellbeing programme and the difference between these therapists and the first one was like night and day.

In the UK, most NHS Trusts provide workplace counselling as an employee support. The service is usually short term and provides an independent, specialist resource for staff – a free, confidential, workplace counselling service. Sounds great, doesn’t it?

However, during my chat with Hayley, we both thought, how do you tell if a counsellor is any good? Why was one better than the rest for me? In hindsight, I think the problem for me was that these independent therapists tend work on a freelance basis, and although they are all registered and approved by their various governing bodies, they are not vetted by the Trusts themselves.

Then Haley and I thought, what about all those people that have to pay to see a therapist? I’ve since looked online and seen that, in London, you can pay anything upwards of £70 and often way over £100. Although I believe that counselling is a great investment in yourself, if the therapist is ‘no good’, it’s a terrible waste of a lot of money. I’d hate for that to happen to you so I’m going to share some of the red flags you might come across. But first,

Before therapy

Before you go into therapy, you may want to ask your therapist about:

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You must ask questions about your therapist too
  • their background and qualifications
  • the type of therapy they practice. If they have a specialism, as some therapists specialise in working with particular issues like abuse and violence, addictions, LGBTQ, or survivor groups
  • their experience of working with the problem you’re experiencing
  • how long the therapy will last
  • the benefits and any risks involved
  • their confidentiality policy
  • whether they have a waiting list and how long it will take to get an appointment
  • if you have a disability and need reasonable adjustments to make the sessions easier for you to attend.

Let them know if you have any preferences i.e male or female therapist or someone who speaks your first language.

Therapists red flags

In no particular order, and though counsellors and therapist might offer different therapies, I’ll use the word therapist throughout and for ease I’ll say she or they, so, if she

Black and white image young female with head in her hands
Not all my therapists were good
  1. doesn’t talk you through what will happen during counselling, like which type of therapy i.e. CBT and a short explanation about the concept and how long it will last
  2. doesn’t provide you with information about your rights as a client i.e. fees, her policies, or confidentiality
  3. constantly misses, cancels, or shows up late to appointments
  4. looks down on you or treats you as inferior, subtly or not
  5. blames your partner, family, or your friends, or encourages you to blame them
  6. doesn’t have sufficient or specific training to help with your problem and/or she tries to treat problems outside the scope of her specialism
  7. can’t or doesn’t clearly define how she can help you solve whatever problem that brought you to therapy
  8. isn’t interested in the changes you want to make or your goals for therapy, and works from her own agenda
  9. speaks in the language (psychobabble) that confuses you
  10. discloses that she’s never done personal therapy work (maybe she’s only done group work)
  11. gives no explanation of how you will know when your therapy is complete
  12. focuses on diagnosing without also helping you to change
  13. doesn’t ask your permission to use various psychotherapeutic techniques outside of what you’ve discussed already
  14. makes promises like “you’ll be much more confident after this”, she won’t know this for sure
  15. tells you that only her approach i.e. CBT works and ridicules other approaches
  16. acts as though she has all the answers and spends time telling you how to fix things instead of working with you
  17. tries to make decisions for you, tells you what to do, or gives frequent unsolicited advice
  18. focuses on thoughts and cognition at the exclusion of feelings and somatic experience
  19. focuses on feelings and somatic experience at the exclusion of thoughts, cognition and cognitive processing
  20. hijacks your session to get her own emotional needs met, instead of focusing on you and your therapy
  21. talks too much about her own issues and/or self-discloses in a manner that doesn’t help you. Self-disclosure can be used if it’s to help the client
  22. seems too emotional or overwhelmed with your feelings or problems
  23. empathises too much
  24. focuses too soon on helping you appreciate or resolve the underlying causes of an issue when learning coping skills to manage your behaviours or impulses would benefit you more
  25. avoids exploring your emotional or vulnerable feelings or
  26. pushes you into really vulnerable feelings or memories too soon or against your wishes
  27. tries to befriend you
  28. tries to touch you in a way that makes you feel uncomfortable i.e. hugging without your consent or
  29. attempts to have a sexual or romantic relationship with you
  30. tries to enlist your help with something outside of your therapy i.e. you might be a hairdresser and she asks can she come to your salon
  31. is frequently confrontational with you
  32. doesn’t remember your name and doesn’t remember what you discussed or what your issues were from previous sessions
  33. ignores how important your spirituality, religion, faith, or culture is
  34. promotes her own religion, beliefs and tries to push it all onto you
  35. allows/encourages you to become dependent on her
  36. shows no empathy or compassion
  37. is judgmental or critical of your problems, behaviour, or lifestyle choices
  38. discloses your identifying information without authorisation or your consent
  39. talks about and tells you the identities other clients, famous or otherwise
  40. doesn’t accept feedback or admit mistakes
  41. talks too much or doesn’t talk at all, just sits nodding and staring at you — too much eye contact or none at all
  42. tries to keep you in therapy when you think it’s time to stop

What to do if you spot red flags

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Re-evaluate your relationship Pixabay.com

If any of these red flags come up during your first few sessions, you might need to re-evaluate your therapist and your relationship with her.

If you do see of these red flags, the first step would be to discuss your concerns with your therapist, telling her what’s bothering you. Say time-keeping is an issue for you. If she was only late once and had good reason, you could excuse that; she’s human too and sometimes things happen outside our control. However, if she was late for a second time, explain that it’s not acceptable, your time is valuable too, and you don’t appreciate other people being late. A good therapist will listen, understand your concerns, and make any necessary adjustments to their practice.

Most therapists have your well-being and best interests at heart, and they can make small mistakes too. However, some errors can prove more serious, such as touching you or trying to have a sexual relationship with you. If you’ve been in or are in a situation like this, you must report it to their practice manager and their governing body immediately.

Most people in therapy tend to know quite quickly whether the therapist is a good fit and whether or not they think they can work with them. But generally, I’d give it a maximum of three sessions, all being well before I decided if I needed to go elsewhere. However, too many red flags during the first and second sessions would make me hot tail it out the door.

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.

Ryan Howes

There are lots of good therapists out there. Unfortunately, there are lots of charlatans too. They’ll keep taking your money, even when they should have discharged you weeks, months or even years ago. Yes, years! I’ve known a few patients who’d been in therapy for five years plus, and if you ask me, they were more confused and anxious or depressed than when they first started.

Over to you

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Clipart.com

Of course, there may be many more red flags that I don’t know about. Do you know of any that you’d like to share? What’s your experience of therapy/therapists? I’m looking forward to your comments and any questions you might have.

Related: Boundaries in therapy (1) Boundaries and warning signs of a bad therapist (2)

Author: mentalhealth360.uk

Mum to two amazing sons. Following recovery from a lengthy psychotic episode, depression, anxiety and anorexia, I decided to train as a Mental Health Nurse and worked successfully in various settings before becoming a Ward Manager. I am a Mental Health First Aid Instructor and a Mental Health Awareness Trainer, Mental Health First Aid Youth and Mental Health Armed Forces Instructor. Just started my mental health from the other side blog.

39 thoughts on “Therapists and 42 red flags to look out for”

  1. I’ve seen a few therapists over the years, some good, some not so good. Some you gel with an some you don’t.

    All such short term.

    By the time you build up trust, feel comfortable with them and it starts to help, it ends and you are on your own once more. I was reluctant to go down the CBT route again, but that is all they offer for Anxiety in my county. I’m on my 5th round of CBT. Personally I think I need something longer term but can’t afford to go private.

    I have had a wonderful counsellor in the past through my GP, but then the way therapy could be accessed was changed.

    1. Yes, unfortunately if you only have a few sessions (we got 6 through the NHS wellbeing programme) it doesn’t feel right, like you said, you’re just getting comfortable then it’s over, so I get you.

      From what I’ve read, the NHS are pouring money into mental health, particularly talking therapies so they can reduce the amount of admissions. It’s not admission that most people want, particularly for anxiety and depression, so I’m not sure how that will work.

      I still believe that having longer term therapy in the community is more cost effective than admissions. However, the powers that be don’t seem to understand and continue to offer only brief therapy.

  2. As you know going private was great. I still have her number in my phone to text anytime.
    I can also email.

    NHS, ok when I can get it. My issue is accessibility right at the bginning, by referring myself. It all needs to be done by email. They say phone. I tell them email and when they say I am on it, we will arrange assessment at first counselling sessionn, later when I query how long to wait, I am not on it. So they still don’t learn their lessons there. Hence I went private because of being suicidal this time and I will always stick with private.

      1. I would have liked to have complained, but when you are feeling suicidal and have no energy for yourself, or be bothered to do anything for yourself, then complaining is the last thing on your mind. Otherwise, when I did receive counselling some years ago via the NHS the first time round, after the palaver, the counselor was good.
        But after the palaver second time, not being on list when I was supposed to be and feeling suicidal, then private was the only option.

      2. I know what you mean. I always used to let patients know that they could complain if they weren’t happy with some of our staff but they said same as you. They were to tired, p’d off, too unwell to complain. That’s how some of the bad staff get away with their crap!

        I’d probably gone private too. I’m glad we have the NHS but if need be, you can never spend too much on your health.

        Like dentistry, but I won’t get started on the cost of that!

  3. I saw one therapist through my previous employer’s employee assistance program, and on our first meeting, she suggested that I would feel better if I started dating. When I emailed her later to cancel the next appointment, she wanted to know why. When I told her that it was the dating comment, she wondered why that stood out for me. Um, because it’s totally inappropriate, perhaps?

    1. 😂😂😂 sorry to laugh but…….. Oh boy, just when you think you’ve heard it all!

      Oh my word, then she asks you why you cancelled and sounds like she’s decided that this is an issue you need to fix lol.

  4. Wow, this list is brilliant!! Very good!!

    I only took issue with this one: “blames your partner, family, or your friends, or encourages you to blame them” because I would say, since my mom’s a total narcissist, she often deserves to be blamed. Now, on the other hand, I wouldn’t blame her for something she didn’t directly do or cause, and I can see not just throwing all the blame at everyone else; but if I visited my mom and she was horrible to me and it ruined my day, I think she’d deserve to be blamed, ya know? And that the only burden upon myself would be to think twice about visiting her again.

    Elsewise, you have no idea how many of the items I can relate to! Oh my goodness!! Check, check, check….

    1. Thank you Meg. I’m glad you think it’s good. Possibly I didn’t explain myself properly. It’s more a case of accepting responsibility for your own feelings. If that makes sense, otherwise I’ll go off on one – that means me writing a whole other post lol.

      Ah, I just looked back up and you’ve explained it yourself lol.

      Yes, same for me Meg — tick, tick, tick……….

  5. This was fantastic. I’ve had 5-6 therapists. Two were good, One was ok and the others were disappointing to say the least. At my most recent request to resume therapy I was more aware of having someone that would aid my recovery. I’m still on the NHS waiting list.

    1. I think it’s probably similar across the board, people having the same experiences. It doesn’t bode well for our NHS does it? Last time, when I didn’t return, I spoke to her (my therapist) practice manager who appeared to take offence when I said I didn’t think the therapist was qualified or skilled enough to support me because I was a mental health nurse and she seemed to know way less than me.

      She said she’d put me back on the waiting list – I’m still waiting two years later.

      Mind you, I just had a call yesterday from my pain management team who said they would put me on their list. I think it’s CBT for pain so let’s see – when I get an appointment that is.

      1. I’ve been told off the record, newer people are given priority over long term sufferers when it comes to wait lists. Which provides an element of relief knowing, but at the same time raises questions. It’s quite frustrating.

      2. Yes the NHS Improving Access to Psychological Therapies (IAPT) services is said to provide evidence-based psychological therapies to people with anxiety disorders and depression. You can google your postcode to see waiting times, which appear to be around 6-8 weeks at the moment.

        I have two friends who are IAPT trained and work in London, but they’re unaware of accepting newer patients? Perhaps it does happen in particular postcodes?

        Don’t say I told you but if you are desperate and having thoughts of suicide, you’ll be seen quicker.

  6. What I like about your site is that you address your audience.

    I love the engaging questions.

    This is what I aspire to do on my site.

    Keep up the great content! 😄

  7. I think there are just too many therapists out there. They can’t be all that good. As a client I think you also have a responsibility to be well informed. When you’re really ill, that is more difficult of course.
    In my last session, my therapist told me what to do – I can’t stand it – and now I’m very rebellious about it. I have two therapists, the one that I’m seeing for years now is great. The lady who tells me what to do, I feel like she’s through her patience with me.
    I don’t know if she follows a certain protocol but I hope not. ‘I need to dress in real clothes every day’ … and I love my leggings so much!

    1. You’re right there’s too many and most of them are charlatans. They do their 3 year Psychology Degree then perhaps another year of their choice of therapy and weyhey, you’ve got yourself a shabby therapist title!

      And I agree Kacha, when people are unwell and desperate, they might accept the first therapist. And if they’ve never been in therapy before, they don’t know what to expect and go along blindly with whatever the therapist is saying. These con artists just cos so much more damage.

      I’m glad you have at least one good therapist. But the other one sounds like a nightmare! Telling you what to do is an absolute no-no!

  8. Great post. Unfortunately bad therapists far outnumber the good, in my opinion. At least that’s been my experience. Still there are a few really good ones who strive to do the best their patients.

  9. How about telling you all about her personal life and acting annoyed if you aren’t impressed? I had that happen once.

    It is frustrating how hard it can be to find a good therapist, especially considering the cost, but a good one is worth the time and effort of looking.

    1. Wow, I would have reported that one lol.

      It’s never easy finding the right one, first you need to’click’ with her/him. You often know immediately that you don’t gel but you go back a few times, as if to confirm that no, I didn’t like her the first time lol.

  10. This is such a beneficial post. Not a lot of people talk about how important it is to find a therapist that works for you and that is professional. The first therapist I went to didn’t really let me even talk much and kept talking the whole time about themselves and I was just like wow that’s a waste of my time and money.

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