As a friend or family member, I’ve helped people find good therapists on several occasions.
I’ve also seen some shocking violations of ethics and common sense among therapists. The education and licensing system are designed to support expertise and ethical behavior in the mental health industry.
When it comes down to it, however, the system isn’t perfect and people are just people. Sometimes therapists make mistakes. Sometimes they are just incompetent.
So, while your therapist is supposed to have training and expertise that you may not have, you shouldn’t assume too much or give away your power. A good counselor would never expect that.
Your therapist works for you. Whether or not you are paying directly for services, you are the one in charge. You have choices among therapists and it’s fair to have healthy expectations of your therapeutic relationship.
If therapists do any one or more of the following, fire them and find a replacement.
1. Diagnosing your friends, family or others from a distance
I once sat in a therapist’s office with my daughter on a first appointment. We were looking for someone with an objective opinion for her during a rough patch. When hearing a short story about one of my daughter’s friends, the therapist replied, “Oh, she’s bipolar. It’s classic.”
“Are you sure”? I asked. “It’s not that much to go on. I wouldn’t want my daughter to have that in her mind when we have no idea whether or not it’s true.”
She responded, “Oh, you’d be shocked at how many “bipolars” there are running around. Yeah, this is definitely one of them.”
Fired on the spot. We left right then, in shock. Don’t pay therapists who toy with diagnoses based on little to no information, confidently filling your head with half-baked ideas that affect important relationships.
Interestingly, as much as I understand the criteria for bipolar disorder, I still can’t figure out how this therapist reached that conclusion even when I give her a huge benefit of the doubt. The story my daughter told had so many other possible explanations.
2. Making romantic advances
During my eight years working as a counselor in an agency, two therapists were fired for such misconduct. One actually had an affair with a female client who was apparently in therapy because her husband was having an affair. Taking advantage of clients is illegal. Therapists cannot have romantic relationships with their clients. If your therapist is attracted to you and it shows, don’t fall for it.
Therapists are certainly capable of being attracted to a client. When this is the case, it’s incumbent upon the therapist to closely manage the situation or recuse himself or herself from the relationship. It is never appropriate for a therapist to act on the attraction. A very small percentage of therapists do, however.
3. Becoming too opinionated about your life
Therapists are people, too, and may have personal opinions about their clients’ lives. Good therapists manage boundaries and, when expressing a personal opinion, make it clear that it’s an opinion. You have a right to disagree. A skilled therapist might even work in a personal opinion at the right time in order to give you a chance to disagree in a safe environment if avoiding conflict is an issue for you.
Sometimes, however, therapists can get annoyed or even angry and condescending when you don’t agree with them or don’t follow through with their recommendations. Over time, the relationship becomes too familiar and you end up bantering like siblings. This is no longer therapy. It’s time to move on.
There are different kinds of therapy and differing reasons to seek therapy. Some clients are seeking direct intervention and practical results. Others are seeking a safe place to express themselves and someone they trust to listen. Whatever your goals for therapy, you are paying someone to do a job. Are they good at the job?
If not, you should find someone who does meet your realistic expectations. Of course, if your expectations are impossible, you’ll end up firing every therapist, but the issue of incompetence on the therapist’s part should factor in. There’s a reason this is important.
One client of mine, years ago, had spent $40,000 total with a previous therapist and claimed to have gotten ‘no results.’ She suffered from a few distinct and troublesome memories that she couldn’t get past. Her therapist had a habit of engaging in detailed explanations how the mind processes painful memories. If the client processed them correctly, freedom from the past would result.
When asked how to process these memories, the therapist would reply, “Take a deep breath and just let them go.”
Not surprisingly, this never worked for my client. When I asked why she kept going to the therapist for so long even when the methods were inadequate and didn’t match the therapist’s explanations, my client replied, “I thought it was me. I just thought I was doing something wrong, so I kept trying.”
Sometimes therapists are incompetent.
5. Financial conflicts of interest
One client of mine was getting involved in a local investment that sounded opportune. It didn’t have anything to do with why he was seeing me in counseling. As I thought about it, I really wanted to take advantage of the opportunity to ask him some questions about the investment for reasons of my own. Should I step over that line and say hey, “You know that such and such opportunity, what if I were to get in on that?”
I chided myself for even being tempted to create a conflict of interest with a client, putting him in an awkward situation. I let it go without disclosing my interest and just considered it one of those things. The law is the law. You can’t rob a bank because you need money. A therapist cannot have a dual relationship with a client for any reason.
If your therapist moves on any interest in a relationship with you outside of therapy, it’s time to end the relationship.
Important: These are my personal thoughts, blogger style. They don’t represent, by any stretch, a list of ethics violations therapists might commit. Consult your state’s therapy board for the rules and regulations that apply to therapists in your area. As far as therapeutic efficacy, there is no law (that I know of) against a qualified therapist who is incompetent; that’s a judgment call you will have to make.