Do you (or someone you know) have a therapist? Are they ethical? Do they follow the rules of their profession and engage with client(s) and staff with integrity and patience? If not, you might want to look a bit closer. If you begin to question the behaviors and words of the therapist because your intuition says something is off, looking closer is in your best interest.
Sadly, unethical therapists can not only worsen the symptoms of a person seeking help, but create new problems. Dr. Viktor Frankl, Logotherapist and author of Man’s Search For Meaning, coined the term “iatrogenic neurosis” to describe an illness “caused” or made worse by someone who provides healthcare services. It is hard to imagine that a health care provider, specifically a mental health professional, could make an illness worse.
It’s often difficult for people to distinguish a good therapist from a bad therapist until something unethical happens. This article will discuss some things you should look for.
It is often much easier to spot a good therapist than it is to spot a bad therapist. We all look for kind, loving, compassionate, and caring people to connect with, especially when that person will be your therapist. Yet, for a variety of reasons, we can struggle to pinpoint when a professional may be taking advantage of us. The reason may have something to do with who we are and how we have been molded in society – and even in our families – to think about “professionals.” The first few nonverbal signs we look for when meeting someone new is a genuine smiling, eye contact, and maybe a touch (a touch on the arm or hand) to convey friendliness, and a positive tone of voice. When we do not see these things, we often do one of two things:
- Ignore the behavior: Because the therapist may offer cheap rates, may be close to home, or offers other incentives.
- Make excuses: “Maybe she/he is having a bad day,” or “maybe he/she just doesn’t like me.” “Maybe he/she needs time to warm up to me!”
The act of ignoring concerning behaviors is referred to, in psychology, as cognitive dissonance. Cognitive dissonance refers to a situation that makes us uncomfortable due to our conflicting thoughts, beliefs, or feelings about it. It occurs when we hold two conflicting thoughts in mind. For example, if you find a therapist who has 20+ years of experience and has been published in multiple journals but doe not seem to be genuine or even helpful, you may begin to experience cognitive dissonance. You would struggle with the thought of this therapist being a poor therapist because of the many credentials and ears of experience they may have.
When seeking help from someone who will be diagnosing you, giving recommendations, referrals, and offering insight, you really need to be picky. I encourage you to do a little of your own research before the first meeting. I also recommend that if meeting with a therapist for the first time, especially youngsters, someone else should go with them.
If you find yourself questioning the ethical behavior of the therapist, try to categorize the behaviors in the following to categories:
- Boundary crossing: A boundary crossing involves behaviors that are not likely to harm or exploit the client but could still be regarded as compromised boundaries. For example, a therapist who visits a client in the hospital or at home while they are on bed-rest. It could also include a therapist who may hug a particular client or share self-disclosure to help a client’s therapy move forward.
- Boundary violation: A boundary violation involves behaviors that could harm the client and undermine the therapeutic relationship. For example, a sexual relationship, inappropriate touching or sexual comments, stalking by the professional, asking very personal questions, or violating the space and privacy of the client.
Even more, I often recommend to my clients that they watch carefully for subliminal behaviors that may be hard to identify during a first, second, or even third session. These behaviors may include:
- Answering the telephone while you’re in session: There is a thin line between having to take a call because it is important and taking a call because the person feels too important to give you their undivided time. Life is life and sometimes emergencies happen. When this occurs, a good therapist will apologize and make an effort to do better next time. If they don’t, I encourage you to move on.
- Eating while speaking with you: Believe it or not, some therapists have very bad manners. If you are on the phone or meeting in-person with your therapist and they are eating, you might want to consider their ultimate goal of working with you. Some therapists have medical conditions or take medication and must eat during a certain time of the day. Other therapists will eat along with their child or adolescent clients while in session, especially in residential centers. So be fair here, but if you find that eating while speaking to you is constant, you may want to look elsewhere.
- Talking too much about themselves: Some therapists are so self-centered that they enjoy speaking about their accomplishments, their dilemmas, their jobs, articles, families, etc. Be keen to this and fair because some therapists attempt to find a common ground with their clients and use their own lives to teach. But other therapists just like bragging.
- Doesn’t answer your calls in a reasonable time: Life is hard for all of us. Even a therapist has trouble making calls, returning calls, and answering them. I can attest to this! Sometimes therapists have more than 25 messages on their machine in a given day. So we must be fair. But if your therapist ignores you and doesn’t attempt to call you back, answer your calls, or even call you to reschedule or change something, move on. What if an emergency comes and you need your therapist?
- Crosses all boundaries: Some therapists flirt with their clients, make sexual comments, or touch them without permission. Even if the therapist is held strictly to professional ethics and the policies of their agency/company, some will still cross barriers. Watch for subliminal behaviors, yet be careful not to assume all behaviors are “flirty.” Some therapists just have an appealing personality and charm. Be sure you can differentiate.
All the best to you
Editor’s note: This article was originally published October 30, 2013 and then updated on 11/11/2015. However, this article has been updated as of 1/25/2017 to reflect comprehensiveness and accuracy.