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 specialist will not judge the thoughts and emotions of the client in front of them, but will show empathy and unconditional acceptance, for therapists are as human and imperfect as the person 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 criticised or judged by the specialist in front of you, and you feel that they are imposing their own beliefs, such as: “You should be thinking about children at your age, not work!” or “You didn’t do well here” etc., it could be a warning sign that they are not a suitable psychotherapist or even that they are violating the professional code of ethics. It is important to note, however, that the psychotherapist has moments when they will challenge the client with a complex question that requires a confrontation with themselves – and this can put the person in question in difficulty, as they need to make an effort to find an answer. This type of situation can be interpreted as judgment by some people.
2. discriminates based on age, gender, gender identity, race, ethnicity, culture, origin, religion, sexual orientation, disabilities, socioeconomic status or any aspect prohibited by law
Closely related to judging clients or patients is discrimination. Any form of discrimination represents a violation of human rights and a violation of the code of ethics of a psychologist with the right to practice independently. How can you tell if the specialist you have contacted discriminates? They may engage in remarks or behaviours that harm the dignity of others, may refuse to provide services to a certain category of the population or a person belonging to a certain social, economic category, etc. [2]
If we are talking about discrimination based on sexual orientation or gender identity, indicators such as invalidating gender identity/sexual orientation, labelling queer feelings as “a phase” can be signs that the specialist does not respect the integrity and dignity of others. If the therapist minimises or even denies the importance of you being queer, makes certain negative assumptions, refers to your gender identity/sexuality as an illness that needs to be treated, these are red flags regarding the specialist’s competence, as well as their respect for their clients. [1]
3. does not provide (sufficient) information about services
A competent specialist will always be transparent regarding their services. Mental health specialists undergo a long and continuous professional journey, so it is very important that at the start of services they inform the client about the costs of sessions, their professional training, experience working with other clients, and whether or not they are in a supervision process. Supervision takes place when the specialist is at the beginning of their career as a psychologist/psychological counsellor/psychotherapist and lasts for a minimum of 2 years. [1]
- Psychological assessment involves the application of psychological tools, such as tests and interviews, to establish the difficulties a client is experiencing, the level of severity, and intervention and treatment methods.
- Psychological counselling involves short-term interventions aimed at optimising the client’s current behaviour so that they are functional (e.g., improving eating behaviours, sleep schedule, emotion management, personal development, etc.).
- Psychotherapy is a longer-term intervention than counselling and aims to address the causes that led to dysfunctional behaviours. At the same time, psychotherapy is a process of self-knowledge, self-acceptance and self-love, through discovering one’s own resources, each person’s uniqueness and the normalisation of flaws, emotions and inner feelings. Within psychotherapy, the client explores their own life experiences, guided by the therapist, to understand their dysfunctional patterns, i.e., those emotions, behaviours, thoughts that prevent their healthy adaptation to their relational, professional, family environment. With the help of psychotherapy, they learn not only to understand these patterns, but also to manage them to contribute to the satisfaction of their present and future life, outside of sessions and the psychotherapeutic process.
There are several types of psychotherapy, so each of them involves different working methods and techniques, depending on the theoretical foundation they are based on. We understand that it can be overwhelming to choose the right type of psychotherapy for you, so we recommend you think about what characterises you and how you like to approach daily tasks: do you like to be structured and precise or do you prefer spontaneity and expressiveness? Are you willing to engage in a long-term process or do you want to complete a fixed number of sessions over a shorter period? Most often, short-term psychotherapy, with a set number of sessions, is recommended for solving specific situations that require quick and short-term interventions, such as anxiety before an important event, fear of flying, doctors, phobias, stress, etc., but for more complex situations, a different form of long-term psychotherapy is recommended and/or used, which works on both present difficulties and the client’s past events and experiences.
People who feel uncomfortable talking about their experiences are encouraged to try expressive therapies (to express themselves through the body, movements, colours, symbols), which do not involve a direct approach from the therapist, as is the case with “talk therapy”, and some of these include art therapy, experiential psychotherapy, psychodrama, etc.
However, this is not a rule and anyone, with any type of personality and preferences, can try any form of psychotherapy. The psychotherapeutic process always allows for withdrawal or discontinuation, and remember that you are always entitled to try another type of therapy!
There is a lot of information regarding the types of psychotherapy and their effectiveness that can help you choose the right type of psychotherapy for you, and a competent specialist will show flexibility in the relationship with the client and will adapt their working techniques according to their needs.
- Psychiatric consultation can only be performed by a psychiatrist, a licensed medical specialist. They are the only one who can establish diagnoses and prescribe medication.
4. offers services outside their area of expertise
Given the areas of expertise of mental health specialists, it is very important that they respect their limits of competence and the professional training they possess. An essential red flag in the case of a specialist is if they practice services outside their area of expertise. For example, a psychologist/psychological counsellor who practices psychotherapy in the absence of adequate professional training, or who offers medication and establishes diagnoses, outside the specific medical training of a psychiatrist. Also, as mentioned above, remember that a psychiatrist will not be able to practice psychotherapy or counselling in the absence of appropriate, additional training to the residency programme. To see if a specialist is accredited, they must appear by name or by a unique code in the Single Register of Psychologists (R.U.P.). If you don’t find them here, it would be better to look for someone else.
5. violates confidentiality
Confidentiality means that information shared by the client with the specialist will not be disclosed, except in situations where the client poses a danger to themselves or others, or if the information will be used in studies or discussions with the supervisor, and will be protected by anonymity. This must also be mentioned in the contract. Confidentiality should be at the foundation of any therapist-client relationship, and when it is absent, this can represent a major red flag that the specialist respects neither the client in front of them nor the profession they practice.
Thus, if the therapy session is recorded, photos are taken without consent, the therapist discloses client data, brings other people into the room where the session takes place without the client’s consent, these are some examples of warning signs that the specialist in front of you is violating your confidentiality. Exceptions are situations where group therapies take place, with the note that each person involved in the therapeutic process must maintain confidentiality, or a couple/family therapeutic process takes place, respecting the same conditions for maintaining confidentiality.
Also, confidentiality can be violated when the specialist tells you about other clients, with detailed specifics, even mentioning aspects that could lead to the identification of the person.
In such situations, the client’s trust erodes, leading them to no longer have the courage to share information about their own life, thus affecting the therapeutic process.
6. has multiple relationships
A psychologist/psychotherapist is not permitted to provide mental health services to close individuals such as relatives, friends, acquaintances, partners, because in their healing process, the specialist’s subjectivity and their emotional states towards them intervene, as a result of the relationships they have outside the professional area.
Given that for many clients the safe space created by the therapist is something new, beneficial and something they have not experienced before, it is possible for them to feel attraction and attachment to their therapist, because they offer acceptance and a safe environment for expression. This is also the case when clients desire the therapist’s friendship, but it is very important for both parties to respect the boundaries of the professional relationship.
In this context, one can also speak of a specialist who engages in sexual relations with the client during the psychotherapeutic process or after its completion, but also about the case where they engage in sexual relations with people close to their clients [3]. This not only makes the counselling/psychotherapeutic process ineffective but can worsen the well-being of their clients and can even lead to their exploitation.
Also, extra-professional relationships, such as economic ones (for example, the psychotherapist proposes a business to you), are a red flag because they lead to conflicts of interest, decreased professionalism and even abuse.
7. does not terminate services “correctly”
It is important for a therapist not to end sessions without a valid reason, especially when the patient still needs these services and is satisfied with them. However, if the therapist does not have the necessary competencies to deal with the patient, they will refer them to another specialist. The psychotherapeutic process ends when the client has acquired a series of skills to help them in daily life and manages to deal with their problems and feelings on their own, to avoid dependence on the therapist. Also, it can end when the client feels they no longer want, can no longer (for financial or emotional involvement reasons) or no longer need to continue the psychotherapeutic process. In some situations, even if the specialist recognises the client’s progress and the goals they have achieved together, they may suggest continuing the process if they believe further work on certain aspects is necessary.
However, if the client believes that therapy with that specialist is not helpful, violates their own values, or does not create a safe environment, it is important to remember that they are always entitled to quit and look for someone else.
8. practices pseudosciences (e.g., tarot, astrology, coffee cup reading or crystals)
Usually, we can tell that the service offered or suggested to us is pseudoscience when we are promised a miraculous cure, in a very short period of time, most often without our involvement and which is not based on a scientific foundation and conducted studies that 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 a content creator or a public figure online promotes “miracle” recipes for healing childhood traumas, the inner child, depression, and so on. Moreover, such people become facilitators of camps, workshops, retreats, for a fee. Most often, these well-known individuals do not have the necessary professional training to talk about these very vulnerable situations for many of us, to contain and work with the emotional experiences of the group. Of course, sharing one’s own experiences is welcome because it helps us realise that we are not the only ones experiencing suffering or having 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 aspects.
Pseudosciences are often based on subjective beliefs, do not have an exact, tested foundation, and therefore cannot represent a treatment. Accepting and promoting these practices in the field of therapy could expose clients to risks. They are even more dangerous as clients who resort to these “services” are vulnerable and present a certain psychological condition that can worsen as a result of the inappropriate approach to their suffering. To ensure that your psychotherapist practices an effective and accepted approach, you can look it up on the APA Division 12 website.[4]
9. offers you advice
A competent therapist will never offer advice to their clients because the therapist’s job is not to tell you what to do and what not to do, but to be by your side and support you in the therapeutic process to help you discover your own inner resources.
The specialist supports and emotionally contains your experiences to help you make your own decisions, consciously and deliberately, in accordance with your current needs and possibilities. They will not offer you miraculous healing recipes; the therapeutic process involves efforts from both their side and yours, with you being the main agent in the therapeutic process. If in the case of a physical ailment a medicine can be administered to alleviate or cure pain, in the case of emotional difficulties, the client’s active and conscious involvement in their own healing process is necessary, as the therapist does not have a magic wand to eliminate the client’s problems.
10. manages time inefficiently
Usually, a counselling/psychotherapy session lasts 50 minutes. During the allotted time, it is important not only to tick off the objectives established together 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 specialist to speak and reveal what they feel and think. Although the time of a session is limited, discussions between the specialist and the 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 help the client finish their discourse as the 50 minutes draw to a close, so as not to interrupt them abruptly and to end on a positive note about themselves, which will contribute to their well-being until the next session.
Given the limited time of a session, a competent psychotherapist knows how to work efficiently, prioritising discussed topics and asking for feedback, doing their best to achieve progress within a well-defined time.
11. forces you and does not respect your boundaries or needs
Seeking help from a mental health specialist is difficult, especially in the current context of stigmatisation of emotional difficulties people face. This can be even 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 them to talk more than they want or can, insists with questions even when the client refuses or avoids answering. At the same time, a categorical red flag of a mental health specialist is the invalidation of your experiences, emotions, difficulties, which might sound something like this: “It’s no big deal!”; “You’re too sensitive”; “It’s your fault that…”; “You have nothing to be stressed about”; “You’re too young to feel that way”; “There’s no way you can be afraid of…/ feel…/ think…”, and the list goes on. This is a form of emotional harassment from the therapist and is under no circumstances accepted in a practice that is supposed to offer a safe space for expression.
Another form of harassment is sexual harassment, which may involve non-consensual touching, remarks or sexual propositions [5] from the specialist, and these types of behaviours represent a serious deviation from the Code of Ethics and Discipline of the College of Psychologists of Romania.
Remember that you are in control in the therapy session and you can always decide what you want/do not want to happen and communicate to the psychotherapist how you feel and what is uncomfortable for you.
12. talks about their life and emotional difficulties
There are times when some disclosures by the psychotherapist help validate your experiences and form the therapeutic relationship, and this is done in a controlled manner and with well-established boundaries [6].
There are also situations where the therapist may identify with the client’s problem, at which point the specialist’s past experiences and emotional states interfere with those of the client. In this situation, an honest therapist will communicate to their client that they cannot continue services until they address their difficulties in their own psychotherapeutic process with another specialist.
If you feel that the session is only about your psychotherapist, you don’t feel that you are being given attention and you don’t feel heard, this can be an important red flag about your counsellor and their competence.
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If you encounter any of these red flags, you can file a written complaint with the Ethics and Discipline Committee of the College of Psychologists of Romania. Also, if you have unpleasant experiences that fall under the points discussed here or others with therapists found on our map, you can send us your feedback using the form on the map.
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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/
