Taking the step to begin talking with a mental health therapist can be scary. Just like every person you meet is not your person, every therapist is not going to be the best fit for you. Read on for some red flags you can look for as your starting therapy – these things are good indicators this therapist is not the right one for you. And, be on the lookout for upcoming posts about the yellow flags and green flags of therapy.
No Informed Consent
Therapy is most effective when you (i.e. the client) are on-board with the process and have actively agreed to the plan for working together. This is officially known as informed consent, and generally includes both some documents for you to review and sign as well as ongoing conversation with your therapist.
One aspect of initial informed consent is information about the therapist: their credentials (those letters behind their name), any specific trainings or specialties they may have, and their general approach to therapy. Another aspect of informed consent is confidentiality, ensuring you know how your information is handled and when, if ever, confidentiality may be broken. Informed consent prior to starting therapy will likely also include details about policies and procedures your therapist follows related to: payment, cancellation policies, social media, etc. Since I provide therapy via telehealth, my initial informed consent also includes information related specifically to telehealth to ensure all potential clients have enough information to make an informed decision about attending therapy virtually.
Informed consent should also continue throughout your time in therapy. For example, if my recommendation for how we approach therapy changes during our time working together, it’s important for me to talk with my client about the reason my recommendation has changed, to answer any questions they may have, and to ensure they are in agreement with changing course. Another example comes from my own experience in therapy as a client (I believe all therapists can benefit from being on the other side as well). At the end of a particularly difficult in-person session, my therapist appropriately asked me if I would like a hug – this was related to our discussion in the session and I was able to provide consent based on my comfort level and need/desire at the time.
As a client, you should feel informed about the process of therapy. You should feel that you’re able to ask your therapist quetions and provide feedback. And you should know that your consent is important throughout the context of the therapuetic relationship.
Constant Distraction
Ideally, your therapist cares about you and is able to demonstrate this by being fully present for your sessions. When it comes down to the nitty gritty, you are paying for their time and expertise in supporting you.
I’ve heard far too many folks share their experience with a therapist who constantly looked at their cell phone, or asked questions the client had just answered, or even fell asleep during the session. Now, therapists are human. There are times where we may have family in the hospital and need to keep our phones nearby, or we may have gotten rotten sleep the previous night and are struggling to meet the day’s demands. Hopefully instances such as these will be quite rare, and your therapist will inform you, in a professional manner, of what’s going on.
If you feel like you’re constantly competing for your therapist’s attention, that’s a good indicator this therapuetic relationship is not a match.
Dismissing Your Lived Experience
The first step toward having empathy for someone’s struggle is believing them when they share their experience. Feeling heard and believed are integral to creating safety in your relationship with your therapist.
I’ve had folks tell me how they were dismissed or “corrected” by a provider when they attempted to share their thoughts about the symptoms they were experiencing. Others have shared that their narrative of an experience was met with some version of “Was it really that bad? I’ve never seen that happen.” If you don’t feel that your therapist believes you, can you really build the safe relationship needed for therapy?
Again, I acknowledge that therapists are human. I can personally think of times when a client has shared something about their identity or lived experience that didn’t fit with my own experience. Sometimes I approach this with curiosity and ask if they’re open to sharing more. Other times I make myself a note to do my own research around a topic or idea. And I always try to own that, “hey, I’m not really familiar with that, but I’m open to discussing it more if you’d like or to helping you find another resource/provider if that feels like a better path for you.”
One way to determine how safe you feel in your relationship with a therapist is to take stock of whether you are able to offer feedback or correct them regarding your experience. For example, part of my role as a counselor is to help clients put words to emotions. Sometimes my attempt at labeling the emotion is off-base. I know a client feels safe and connected when they are able to reply with something like, “No, the word disappointment doesn’t quite get to the point. It’s more like a fiery anger.”
Not Respecting Confidentiality
I often joke that I have a “masters degree in secret keeping.” Maintaining confidentiality – ensuring that what you share with your therapist stays with your therapist – is a fundamental aspect of being a licensed professional mental healthcare provider.
There are very few instances when confidentiality can be ethically and legally broken. If a client requests that I share information with someone (a primary care physician, a partner, etc.), confidentiality can be broken. This will generally require a signed form that clearly indicates what details the client would like for me to share. If there is concern for safety – of my client or someone else – I may need to break confidentiality in order to ensure everyone is safe. Once again, I would attempt to share only the necessary information to ensure safety. If there is a court order from a judge related to legal matters, I may have to break confidentiality. This last one is a reason I don’t recommend having your therapist involved in any legal proceedings – being forced to share details from your therapy sessions can break the safe, therapuetic relationship.
If you have concerns about confidentiality, speak with your therapist. If they are hesitant to answer, you may want to find a more forthright therapist. If you have reason to believe they aren’t upholding their ethical obligation to maintain confidentiality, you may want to report them to a supervisor or their licensing board.
How To Handle Red Flags
I truly hope none of these red flags are things you run into on your mental health journey. However, if you do, I want to validate that these may be reasons for ending (or not beginning) a therapuetic relationship with that provider. I also want to remind you that there are lots of amazing therapists out there and you are worth spending the time to find one who is the right fit for you.
If you’re located in NC and are interested in working with me as your therapist, please reach out via the contact form on my website. I’m happy to chat with you and see if we might be a good fit.
Michelle F. Moseley is a licensed clinical mental health counselor providing telehealth services in the state of North Carolina. She specializes in providing support for folks who struggle with feelings of not being enough, which often stem from messages of being “too much.” She works from a trauma-informed perspective, and believes that ALL people deserve respect, compassion, and to feel heard. Learn more about Michelle by visiting www.MichelleFMoseley.com or following her on Instagram – @therapy_with_michelle
