We know how difficult the process of choosing the right professional can be, so we have come to your rescue with a list of ‘red flags’ to look out for during your sessions. However, if you meet a professional who ticks the following red flags, it does not mean that there are no other competent, compatible professionals ready to listen, accept and support you.
It is a Red Flag if your professional:
1. judges you
A large proportion of people report that they do not begin a psychotherapeutic process because of shame, guilt and fear of judgment. A competent therapist will not judge the thoughts and emotions of the client in front of him or her, but will show empathy and unconditional acceptance, for therapists are as human and imperfect as the patient who walks through their doors. [1] They too carry a life story, emotional wounds and suffering, the difference being that they have already been taught and trained to manage their personal and relational difficulties so that they do not interfere professionally. So, before you change your mind about going to a psychologist, psychotherapist or other mental health professional, remember that your therapist is human, just like you.
If during the sessions you feel criticized or judged by the professional in front of you, and you feel that he is imposing his own beliefs, such as: “You should think about having children at your age, not about work!” or “You have not done the right thing here” etc., could be a red flag that this is not a suitable psychotherapist, or even that they are in breach of the profession’s code of ethics. It is important to note, however, that the psychotherapist will at times challenge the client with a complex question that requires confrontation with the self – and this can put the person in difficulty, as it requires effort to find an answer. This type of situation may be interpreted as judgment by some people.
2. discriminates on the basis of age, gender, gender identity, race, ethnicity, culture, origin, religion, sexual orientation, disability, socio-economic status or any other aspect prohibited by law
Closely related to the judgment of clients or patients is discrimination. Any form of discrimination is a violation of human rights and a breach of a psychologist’s code of ethics as a practicing psychologist. How can you tell if the professional is discriminating? He or she may engage in remarks or behavior that are prejudicial to the dignity of others, refuse to provide services to a certain category of the population or a person belonging to a certain social, economic, etc. category. [2]
If we are talking about discrimination based on sexual orientation or gender identity, cues such as invalidating gender identity/sexual orientation, labeling queer feelings as “a phase” can be warning signs that the professional does not respect the integrity and dignity of others. If the therapist minimizes or even denies the importance of being queer, makes certain negative assumptions, refers to your gender identity/sexuality as a disease to be treated, these are warning signs about the competence of the specialist, but also about the respect for his/her clients. [1]
3. does not provide (enough) information about services
A competent professional will always be transparent about their services. Mental health professionals have a long and continuous career path, so it is very important that they inform the client at the beginning of their services about the costs of their sessions, their professional training, their experience in working with other clients, whether they are in a supervision process or not. Supervision takes place when the professional is at the beginning of his/her career as a psychologist/ psychological counselor/ psychotherapist and lasts for at least 2 years. [1]
- Psychological assessment involves the application of psychological tools, such as tests and interviews, to determine the difficulties a client is experiencing, the level of severity, methods of intervention and treatment.
- Psychological counseling involves short-term interventions aimed at optimizing the client’s current behavior so that they get functional (e.g. improving eating behaviors, sleep schedule, managing emotions, personal development, etc.).
- Psychotherapy is a longer-term intervention than counseling and aims to address the root causes of dysfunctional behaviors. At the same time, psychotherapy is a process of self-discovery, acceptance and love of oneself, through the discovery of one’s own resources, uniqueness and the normalization of one’s inner flaws, emotions and experiences. In psychotherapy, the client explores his or her own life experiences, guided by the therapist, in order to understand his or her dysfunctional patterns, i.e. those emotions, behaviors and thoughts that prevent him or her from adapting in a healthy way to his or her relational, professional and family environment. With the help of psychotherapy, the client learns not only to understand these patterns, but also to manage them in order to contribute to the satisfaction of his or her present and future life, outside the sessions and the psychotherapeutic process.
There are many different types of psychotherapy, so each involves different ways and techniques of working, depending on the theoretical foundation on which it is based. We understand that it can be overwhelming to choose the type of psychotherapy that is right for you, so we recommend that you think about what characterizes you and how you like to approach everyday tasks: do you like to be structured and precise or do you rather like spontaneity and expressiveness? Are you willing to commit yourself to a long-term process or do you want to go through a fixed number of sessions over a shorter timeframe? Short-term psychotherapy, with a fixed number of sessions, is often recommended for dealing with specific situations that require rapid and short-term interventions, such as anxiety before an important event, fear of flying, fear of the doctor, phobias, stress, etc., but for more complex situations, and/or another form of long-term psychotherapy is recommended, which works on both the present difficulties and the client’s past events and experiences.
People who feel uncomfortable to talk about their experiences are encouraged to try expressive therapies (to express themselves through the body, movements, colors, symbols), which do not require a direct approach from the therapist, such as “talk” therapy, and some of these are art therapy, experiential psychotherapy, psychodrama, etc.
But this is not a rule and anyone with any personality type and preferences can try any form of psychotherapy. The psychotherapeutic process always allows for withdrawal or dropping out, and remember that you are always entitled to try a different type of therapy!
There is a lot of information about the types of psychotherapy and their effectiveness that can help you to choose the right type of psychotherapy for you, and a competent professional will show flexibility in dealing with the client and adapt their techniques to the client’s needs.
- Psychiatric consultation can only be performed by a psychiatrist, a licensed medical professional. He or she is the only one who can diagnose and prescribe medication (in Romania).
4. offers services outside their area of expertise
Given the areas of expertise of mental health professionals, it is very important that they respect the limits of their competence and their professional training. An essential red flag for a professional is if they are practicing services outside their area of expertise. For example, a psychologist/psychological counselor practicing psychotherapy in the absence of appropriate professional training, or providing drug treatment and making diagnoses outside the specific medical training of a psychiatrist. Also, as mentioned above, keep in mind that a psychiatrist will not be able to practice psychotherapy or counseling in the absence of appropriate training in addition to residency training. To see if a professional is accredited, he or she must be listed by name or unique code in the Unique Register of Psychologists (R.U.P.). If you can’t find him or her there, it would be better to look for someone else.
5. breaches confidentiality
Confidentiality implies that information shared by the client with the professional will not be disclosed unless the client poses a danger to self or others, or if the information will be used in studies or discussions with the supervisor, and will be protected by anonymity. This should also be stated in the contract. Confidentiality should be at the foundation of any therapist-client relationship, and when it is lacking, it can be a major red flag that the practitioner is neither respecting the client before him or her nor the profession he or she is practicing.
So, if the therapy session is recorded, pictures are taken without consent, the therapist discloses client data, brings other people into the room where the session is taking place without the client’s consent, these are some examples of warning signs that the therapist in front of you is violating your confidentiality. The exception is when group therapy is taking place, with the remark that each person involved in the therapeutic process must maintain confidentiality, i.e. a couple or family therapeutic process is taking place, respecting the same conditions of confidentiality.
Confidentiality can also be breached when the professional tells you about other clients in great detail, and even specifies things that could lead to the person’s identification.
In such situations, the client’s trust is eroded and he or she may no longer have the courage to share information about his or her own life, thus affecting the therapeutic process.
6. has multiple relationships
A psychologist/psychotherapist is not allowed to provide mental health services to close persons such as relatives, friends, acquaintances, partners, because in their healing process can intervene the professional’s subjectivity and emotions, as a result of the relationships he or she has outside the professional area.
Given that for many clients the safe space created by the therapist is something new, beneficial and something they have never experienced before, it is possible that they may feel a sense of attraction and attachment to their therapist because he or she offers acceptance and a safe space in which to express themselves. This is also the case when clients want the therapist’s friendship, but it is very important that the boundaries of the professional relationship are respected by both parties.
In this context, we can also talk about a professional who has sexual relations with the client during or after the psychotherapeutic process, as well as about the case when he/she has sexual relations with close persons of his/her clients [3]. This not only renders the counseling/psychotherapeutic process ineffective, but can also worsen the well-being of their clients and may even lead to their exploitation.
Also, extra-professional relationships, such as economic ones (e.g. the psychotherapist proposes to do business together), are a red flag because they lead to conflicts of interest, decreased professionalism and even abuse.
7. does not finish services “correctly”
It is important that a therapist does not terminate sessions without good reason, especially when the patient continues to need and be satisfied with these services. However, if the therapist does not have the necessary skills to deal with the patient, the therapist will refer the patient to another professional. The psychotherapeutic process ends when the client has acquired a number of skills to help him/her in everyday life and is able to manage his/her problems and feelings on his/her own, in order to avoid dependency on the therapist. It can also end when the client feels that he or she no longer wants, can (for financial or emotional reasons) or needs to continue the psychotherapeutic process. In some situations, although the therapist recognizes the client’s progress and the goals they have achieved together, they may suggest continuing the process if they feel that further work is needed on certain issues.
If, however, the client feels that therapy with the professional is not helpful, violates their own values, does not create a safe environment, it is important to remember that they are always entitled to give up and seek someone else.
8. practices pseudosciences (e.g. tarot, astrology, coffee or crystal reading)
We can usually realize that the service that is offered or suggested to us is pseudoscience when we are promised a miraculous cure in a very short period of time, often without our involvement and not based on a scientific basis and studies conducted to establish the effectiveness of these practices.
This includes: numerology, reiki, working with angels, dragons or other entities, manifestation (“healing through manifestation”, “manifest your happiness/ perfect couple life/ perfect health/ perfect career” etc.). I think we have all noticed how an online content creator or public person promotes “miracle” recipes for healing childhood trauma, the inner child, depression, etc. Such people end up facilitating camps, workshops, retreats for a fee. Most of the time these notorious people do not have the necessary professional training to talk about this kind of very vulnerable situations for many of us, to contain and work with the emotional feelings of the group. Of course, sharing our own experiences is welcome because it helps us to realize that we are not the only ones who are suffering or have gone through a traumatic event, but talking about your own experience is not the same as promising a miraculous cure and we need to be very careful about these issues.
Pseudosciences are often based on subjective beliefs and have no exact, tested basis, so they cannot be a cure. Accepting and promoting these practices in therapy may expose clients to risks. They are all the more dangerous because the clients who seek these ‘services’ are vulnerable and have a particular mental condition that may be exacerbated by an inappropriate approach to their distress. To ensure that your psychotherapist is practicing an effective and accepted approach, you can look it up on the APA Division 12 website[4].
9. gives you advice
A competent therapist will never give advice to his or her clients because the therapist’s job is not to tell you what to do and what not to do, but to be there with you and support you in the therapeutic process to help you discover your own inner resources.
The specialist supports and emotionally contains your feelings so as to help you to make your own decisions, in a conscious way, in accordance with your needs and possibilities at the moment. He will not give you miracle cures, the therapeutic process requires efforts on his part as well as yours, you being the main agent in the therapeutic process. While in the case of a physical ailment, medication can be administered to relieve or cure pain, in the case of emotional difficulties, it is necessary to actively and consciously involve the client in their own healing process, as the therapist does not have a magic wand with which to eliminate the client’s problems.
10. manages time inefficiently
A counseling/psychotherapy session usually lasts 50 minutes. During this time, it is important not only to check off the goals set with the client, but also to create a safe space for emotional expression. This can be difficult when the client is not given enough time to process their feelings and is rushed by the therapist to talk and reveal what they are feeling and thinking. Although the time in a session is limited, the discussions between the therapist and client can be resumed or continued in subsequent sessions so that the client is given as much time as they need.
It is also important for the psychotherapist to gently guide the psychotherapeutic process and to help the client to finalize his or her speech when the 50 minutes are coming to an end, so as not to interrupt him or her abruptly and to end with a positive aspect about himself or herself, which will contribute to his or her well-being until the next session.
Given the limited time of a session, a competent psychotherapist knows how to work efficiently, prioritizing the topics discussed and asking for feedback, doing everything possible to make progress in a well-defined time.
11. pushes you and does not respect your limits or needs
Seeking the help of a mental health specialist is difficult, especially in the current context of stigmatization of people’s emotional difficulties. It can be all the more difficult when clients do not feel understood and accepted. Such a case occurs when the specialist does not respect the client’s boundaries and needs, forces the client to talk more than he or she wants to or can, insists with questions even when the client refuses or avoids answering. Also a definite red flag of a mental health professional is invalidating your experiences, emotions, difficulties that might sound something like this: “It’s no big deal!”; “You are too sensitive”; “It is your own fault that…”; “There is nothing to be stressed about”; “You are too young to feel that way”; “There is no way you can be afraid of…/ feeling…/ thinking…”, and the list goes on. This is a form of emotional harassment on the part of the therapist and is in no way acceptable in a practice that is supposed to provide a safe space for expression.
Another form of harassment is sexual harassment, which may involve non-consensual touching, sexual remarks or propositions [5] from the specialist, and this kind of behavior is a serious deviation from the Code of Ethics and Discipline of the Romanian College of Psychologists.
Remember that you are in control in the therapy session and you can always decide what you want/do not want to happen and let the therapist know how you feel and what is uncomfortable for you.
12. talks about their life and emotional difficulties
There are times when some of the psychotherapist’s disclosures help to validate your experiences and shape the therapeutic relationship, and this is done in a controlled and bounded way [6].
There are also situations in which the therapist may identify with the client’s problem, at which point the therapist’s past experiences and emotional states interfere with the client’s. In this situation, an honest therapist will communicate to his or her client that he or she cannot continue services until he or she addresses the difficulties in his or her own psychotherapeutic process with another professional.
If you feel that the session is all about your psychotherapist, you do not feel that you are being paid attention to and you do not feel listened to, this can be an important red flag about your professional and their competence.
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If you encounter one of these red flags, you can make a written complaint to the Ethics and Disciplinary Commission of the Romanian College of Psychologists.Also, in case you have unpleasant experiences that fall under the points discussed here or in others with therapists found on our map, you can write your feedback here.
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Bibliography:
[1] American Psychological Association. (n.d.). Ethical principles of psychologists and code of conduct. https://www.apa.org/ethics/code
[2] Deibler, A. (2021, October 11). 8 red flags to look out for in therapy. Psychology Today. https://www.psychologytoday.com/us/basics/therapy/8-red-flags-watch-in-therapy
[3] Royal Australian and New Zealand College of Psychiatrists. (n.d.). Psychiatrists and psychologists. Your Health in Mind. https://www.yourhealthinmind.org/psychiatry-explained/psychiatrists-and-psychologists
[4] Lilienfeld, S. O., Ammirati, R., & David, M. (2012). Distinguishing science from pseudoscience in school psychology: Science and scientific thinking as safeguards against human error. Journal of School Psychology, 50(1), 7-36. https://doi.org/10.1016/j.jsp.2011.07.001
[5] Dachs, S. (2020, September 14). Sexual relationship between a psychotherapist and a patient. Shayne Dachs. https://shaynedachs.com/newsletters/medical-malpractice/sexual-relationship-between-a-psychotherapist-and-a-patient/
[6] Private Therapy Clinic. (2021, September 6). Is it okay for a therapist to talk about themselves? Private Therapy Clinic. https://theprivatetherapyclinic.co.uk/blog/is-it-okay-for-a-therapists-to-talk-about-themselves/
