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34 Counseling Mistakes That Therapists Should Avoid

Things Therapists Should Not DoCounseling has been used to guide individuals toward new insights and coping mechanisms since the beginning of the 20th century.

With its widespread use, it is imperative that counseling is performed based on research-supported methods that promote positive client adjustment.

Researchers have identified some key behaviors that should be avoided for counselors to be effective in their therapeutic roles, and this article consolidates the biggest mistakes and how to prevent them.

By avoiding these common counseling pitfalls, therapists will be in a better position to empower, guide, and support their clients toward greater emotional fulfillment and wellbeing.

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General Counseling: 12 Mistakes

The following mistakes are of general importance across counseling types.

1. Confidentiality

As maintaining confidentiality is paramount to the ethical implementation of mental health treatments, violating confidentiality represents a significant clinical mistake. Unless the client has provided permission OR there is a sufficient reason to break confidentiality (e.g., the client poses a danger to themself or others), counselors are bound by specific confidentiality regulations (Hodgson, Mendenhall, & Lamson, 2013).

Not only is protecting privacy and confidentiality the client’s right, but it also provides legal protection for the therapist. There are several ways in which mental health professionals are required to protect a client’s privacy. For example, it is the counselor’s responsibility to maintain secure paper and electronic files and to only discuss a patient’s information with those for whom legal access is permitted.

Along with understanding confidentiality requirements, counselors must also ensure that the counseling office space affords adequate client privacy (Hodgson et al., 2013). Therefore, the waiting room should have proper seating and space, and counseling offices need to be private and soundproof.

Similarly, all counseling staff must understand the importance of confidentiality and avoid exposing client information to others in the waiting room. Not only is maintaining confidentiality the law, but it is the professional counselor’s ethical imperative. Moreover, it is essential for achieving counselor–client trust and enhancing the likelihood that a client will be open and responsive to treatment.

When delivering counseling in an online environment, extra attention should be paid to confidentiality. There are various steps e-therapists must take to maintain compliance with the privacy and security requirements outlined in the Health Insurance Portability and Accountability Act of 1996 (HIPAA) (ASPE, 1996).

These include but are not limited to:

  • Obtaining written informed consent from clients before commencing treatment (Recupero & Rainey, 2018)
  • Using HIPAA-compliant online therapy platforms to ensure that clients’ electronic health records are encrypted (Lustgarten et al., 2020)
  • Establishing procedures for reviewing and maintaining strict security, such as regularly updating passwords and auditing which users have access to clients’ protected health information (PHI) (Moore & Frye, 2019).

Further considerations for counselors to consider include ensuring that clients have access to a quiet, distraction-free space for online therapy sessions and the importance of using technology that reduces potential disruptions (Navarro et al., 2020).

2. Rapport building

Undergoing counseling is a difficult experience for most people, as it often involves sharing deeply personal and distressing information. It takes time for a client to feel safe enough to open up, particularly when they have trust issues to begin with.

Quality counseling means that the therapist does not make the mistake of jumping in too quickly, but instead, builds rapport early on, taking adequate time to establish trust.

While the exact process of building rapport is dependent on the individuals involved, skilled counselors can gauge each client’s degree of responsiveness at the beginning of treatment. Building rapport in ways that serve the unique needs of clients is essential, as it enhances the client’s motivation to work with the therapist toward achieving their treatment goals (Tahan & Sminkey, 2012).

3. Fit between client and counselor

Just as there is a wide range of physician specialties, mental health professionals are also diverse in terms of academic training and treatment focus. Therefore, mental health counselors also need to be matched with their clients’ needs, presenting problems, and expectations.

Individuals seeking counseling will benefit from doing their homework regarding differing counseling styles. The therapist’s transparency aids this in terms of their background, training, and professional manner.

Along with providing clients with easy access to such information, a discussion regarding the counselor’s background and treatment approach should occur before initiating therapy. By taking these steps, the counselor is in a better position to avoid the mistake of poor client–counselor fit.

A typical example of a mismatch between counseling approaches and client needs occurs when clients expect more direction than is offered. For example, a counselor trained in client-centered therapy might be less inclined to provide specific guidance to clients, but rather, may guide them toward discovering their own solutions (Rogers, 1945).

On the other hand, a therapist trained in a directive approach would be more inclined to actively advise, teach, and support clients in ways to deal with their issues (e.g., Rational Emotive Behavior Therapy; Ellis, 1996).

Stated more simply, a client who sits through silent sessions wishing for the counselor to say something, is not likely to benefit from or continue with such treatment.

Of course, few people are educated concerning counselor training philosophies, but they likely have an idea of what they generally expect from a therapist. If the counseling approach does not seem to fit with the client’s needs, it is essential for the counselor to check in with the client to ensure that their expectations are being met.

Therapy may also be undermined due to a poor client–counselor fit in terms of demographic qualities such as age or gender. For example, a female client with a violent history with men may be best supported by a female counselor. In sum, research supports the importance of a compatible therapist–client match as a predictor of therapeutic success (Bernier & Dozier, 2002).

4. Empathy

In the words of noted psychologist Alfred Adler (goodreads.com):

We learn in friendship to look with the eyes of another person, to listen with her ears, and to feel with her heart.

Adler is referring to a quality that is fundamental to good therapy: empathy. Making the mistake of conveying a non-empathetic attitude may result in a resentful, unmotivated client, while also obscuring the therapist’s ability to truly understand the client’s situation.

Of course, counselors are human and thus may be emotionally affected by a client’s problems and behaviors. Nonetheless, professional counselors need to “develop an understanding of how their clients feel and must be able to respect those feelings even when they appear to be making the counselor’s job difficult” (Vacc & Loesch, 2000, p. 22).

The construct of empathy plays such a key role in the therapeutic relationship that empathetic listening skills have been suggested as an essential component of evidence-based counselor training (Moyers & Miller, 2013).

5. Professionalism

professionalismUnprofessional therapist behavior represents a grave mistake with the potential to undermine the goals of therapy.

In many ways, professionalism in the therapeutic setting is much the same as that in other types of jobs.

For example, counselors are expected to be on time, well groomed, and appropriately dressed. Showing up late is a significant error for therapists, as it sends a message that the client’s time is not important. Such a message is, of course, contradictory to the counseling objective of promoting a client’s self-esteem and positive wellbeing.

Additionally, counseling sessions are typically brief and expensive, so tardiness has other costs for clients.

Clients also are put off by counselors who fail to respond to their phone calls, act distracted during sessions (e.g., glancing at the clock), or talk either too much or about themselves. The client is there to receive attention focused on their problems and is likely irritated by a counselor who doesn’t listen or comes across as self-interested.

The office setting also needs to project a professional climate, as a disorganized office does not inspire confidence. Additionally, disorganized files may elicit privacy-related concerns for the client. Professional therapists also engage in adequate preparation for each counseling session.

For example, when counselors fail to remember important client information from week to week, clients are unlikely to feel that they are being heard. While many examples of professional counseling behaviors are common sense, more detailed and specific guidelines regarding ethical and professional counseling practices are also available to readers (e.g., Francis & Dugger, 2014).

6. Skill, knowledge, and confidence

Counselors are expected to be skilled communicators who are “knowledgeable of those aspects of mental health that relate to the development, relief, and solution of an individual’s emotional and other concerns which are associated with quality of life” (Vacc & Loesch, 2000, p. 18).

Making the mistake of administering treatment without adequate skill, knowledge, or confidence diminishes the client’s trust in the guidance being provided. Similarly, if a counselor comes across as nervous and lacking self-confidence, they have personal work to do before seeing clients.

A good counselor also has acquired adequate substantive knowledge and is confident about their theoretical approach. Losing sight of one’s theory is problematic as it may result in advice that is not scientifically based.

Skilled counselors also understand timing and can avoid the negative consequences of prescribing a particular intervention before the client is ready (Methven, Odell, & Weeks, 2005).

Performing as a competent therapist is an ongoing process. It means that counselors are informed about evidence-based practices and that they stay abreast of new developments. As such, it is through continued growth and education that counselors can provide the best available treatment for their clients.

7. Boundaries

things therapists should not doThe client–counselor relationship is not like those that occur in other aspects of life.

It is bound by specific constraints for a good reason, as it is a professional relationship and not a friendship.

Making the mistake of blurring client–therapist boundaries leads to several issues related to trust, as well as a misunderstanding regarding the roles and responsibilities of both parties.

For example, pursuing a client relationship outside of therapy is a major boundary violation that diminishes the therapist’s professional role. Being emotionally reactive to or overprotective of clients also represent additional ways in which a counselor may blur therapeutic boundaries and increase the likelihood of making poor treatment choices (Methven et al., 2005).

Therapists also violate boundaries by allowing sessions to go long and oversharing personal information. Failing to attend to nonverbal cues is another area related to boundaries, as clients have reported a therapist’s body language as important for early therapeutic alliance building (Bedi, 2006).

Generally speaking, some boundary violations are pretty obvious, and others depend upon the individuals involved. The important point is that both the therapist and the client are comfortable and in agreement with the parameters established during the counseling process.

8. Assumptions

Clients often continue to attend treatment despite a lack of satisfaction with the process. However, as clients will not always raise these issues, it is a mistake for therapists to make assumptions regarding the client’s satisfaction with the nature and progression of treatment.

For example, if a client would prefer that the counselor offer more directive guidance, they may not have the confidence to make such a request. Moreover, the client may not even realize that the counselor has the flexibility to alter their approach.

By checking in regularly with the client, the counselor is better able to avoid making assumptions and thus to develop a counseling strategy that is consistent with the client’s needs and expectations.

This is why consistent monitoring of a client’s responses to counseling is encouraged by the Task Force on Empirically Supported Relationships (Ackerman et al., 2001).

9. Optimism

A client seeking mental health treatment needs to feel that the practitioner has hope in their ability to get better. After all, if the counselor isn’t optimistic about the client’s future, then why should the client have confidence in the treatment?

This notion is supported by research indicating that an optimistic and confident attitude among counselors is vital for positive patient outcomes during short-term therapy (Heinonen, Lindfors, Laaksonen, & Knekt, 2012).

Along these lines, competent counselors express genuineness, courage, and positive skepticism toward their clients (Vacc & Loesch, 2000).

Failing to convey a generally optimistic attitude represents a significant counseling mistake, as it is the role of the counselor to instill a sense of encouragement, as well as to inspire and motivate. Moreover, by identifying and encouraging specific goals along the way, the counselor sets up a hopeful trajectory that inspires the client’s confidence in the therapeutic process.

10. Multicultural competence

accept multiculturalismCounselors always need to be sensitive to each client’s cultural background.

The mistake of failing to understand and convey multicultural competence represents such a vital counseling mistake that multicultural competence in counseling is among the ethical guidelines established by both the American Psychological Association and the National Association of School Psychologists (Prout & Brown, 2007).

Trust is diminished when therapists are unable to relate to or empathize with a client’s acculturation challenges. While it may be optimal for clients to be matched with counselors in terms of ethnic background, this is not always feasible. However, counselors convey respect by educating themselves in terms of the history and culture of their clients and using methods that enhance multicultural sensitivity.

The importance of multicultural competence is indeed supported by academic literature. For example, cultural competency training has been associated with increased client satisfaction with the counseling process (Way, Stone, Schwager, Wagoner, & Bassman, 2002). Additionally, cross-cultural sensitivity has been reported as an essential counseling component across various racial and ethnic groups.

For example, in her work with Muslim refugees, Eltaiba (2014) found rapport building to be an essential aspect of culturally sensitive therapy. Similarly, in a study examining cross-cultural counseling with Asian clients, miscommunications and unintended insensitivities were diminished when therapists understood important language and cultural differences between themselves and their clients (Eum Kim, 2004).

Generally speaking, a counselor’s beliefs, background, sexual orientation, prejudices, and racial or cultural identity may come into play during therapy, mainly when working clients with backgrounds different from their own (Prout & Brown, 2007).

The counselor’s ability to be introspective and understand the potential impact of their personal beliefs and attributes on the therapeutic process is essential for achieving sensitive, unbiased therapy. Included in this understanding is the counselor’s examination of their degree of privilege (Arredondo, Tovar-Blank, & Parham, 2008) and the potential for abuse of power.

Additionally, a multiculturally competent therapist is better able to select culturally appropriate therapy intervention approaches for clients (Prout & Brown, 2007).

11. Self-compassion

Mental health professionals are often compassionate people by nature. However, being a therapist is not easy, as listening to others’ problems on a day-to-day basis can take an emotional toll. As such, failing to practice self-compassion is a mistake that increases the risk of burnout among therapists (Patsiopoulos & Buchanan, 2011).

There are a variety of effective ways for counselors to exercise self-care (e.g., regular breaks, relaxation exercises, eating well, exercising, etc.); the choice of approaches depends upon your unique interests and needs.

For example, engaging in meditation is a self-care method that has been associated with reduced burnout among professional counselors (Ringenbach, 2009). Overall, by identifying and practicing self-compassion, therapists will be in a far better position to enjoy a fulfilling career in which they support the emotional needs of their clients.

12. Homework

Studies show that recommending activities for clients to complete between sessions can encourage positive psychotherapy outcomes (Kazantzis et al., 2004; Mausbach et al., 2010).

For a range of reasons, however, research suggests that counselors often fail to provide out-of-session homework as often as they could (Kelly & Deane, 2009).

Because regular homework assignments can help clients set clear goals and objectives for their next session, prioritizing such between-session activities can have an important beneficial impact on their treatment overall.

There are several potential reasons why counselors may struggle to administer homework systematically.

These include:

  • Challenges with recommending activities to patients with severe mental disorders,
  • Lack of client motivation to complete homework, and
  • The limited importance clinicians place on between-session activities (Kelly & Deane, 2011).

To engage clients in therapy homework, therefore, counselors may want to consider their approach to recommending it. One strategy suggested by Scheel and colleagues (2004) is to emphasize how the homework activity will benefit the client in a way that matches the client’s beliefs.

Another is to select or design engaging homework activities relevant to a client’s strengths, needs, and interests.

Specialized software and applications are often an easy and efficient way to improve the likelihood of clients engaging with and benefitting from counseling homework, suggest Tang & Kreindler (2017).

Among other things, the authors’ research into maximizing homework compliance suggests that counselors should select tools that foster learning, build connections, and emphasize completion.

Applications such as Quenza, which allow therapists to design and deliver customized interventions, can be particularly helpful when recommending homework. By enabling professionals to create therapy-congruent assignments and tracking client progress, they can help to overcome low motivation and build client accountability.

Couples Counseling: 5 Mistakes

Couples therapyWhile the above counseling mistakes apply across counseling types, several issues are especially applicable within particular counseling contexts.

Couples counseling represents one such situation.

For example, couples counselors must work consistently to avoid showing a bias toward one individual. This is tricky territory, as the counselor may feel that one member of a couple is relatively more at fault.

However, showing favoritism toward one person is likely to perpetuate the couple’s mutual antagonism. Moreover, it may create resentment toward the therapist or alienate a spouse who was not overly motivated about participating in counseling in the first place.

When working with two clients, the counselor also must be mindful that they are dealing with two – often highly opposing – sides of a story. Therefore, to avoid making incorrect assumptions, the counselor needs to collect sufficient information to get a good sense of the couple’s presenting issues and individual perspectives (Methven et al., 2005).

In a similar vein, counselors need to recognize how their own experiences may impact the assumptions they make about clients. For example, Kottler and Carlson (2011) describe a teachable moment in which a heterosexual therapist made the problematic assumption that his clients were heterosexual as well.

Other mistakes made among couples counselors include not identifying the actual client (e.g., the couple versus one individual), not establishing ground rules at the outset, and believing that there is an objective truth to be discovered (Methven et al., 2005).

In summary, when dealing with couples, counselors should avoid making the following mistakes:

  • Showing bias or favoritism
  • Failing to collect enough information about both people to avoid making assumptions
  • Failing to establish ground rules at the beginning
  • Failing to identify the actual client
  • Engaging in a “search for truth”

Group Counseling: 8 Mistakes

group-therapyAs with couples counseling, group therapy requires a seemingly unbiased therapist who allows equal attention and time for each member of the group.

Because the counselor is dealing with multiple people, personalities, and issues at once, they need to be prepared for several problems that may arise. In their informative book Group Counseling: Strategies and Skills, Jacobs, Masson, Harvill, and Schimmel (2012) outline several problematic situations that are common in group counseling.

One such issue occurs when the leader’s approach lacks in purpose or structure. Group counseling is challenging, as it requires a confident leader who establishes the objectives, rules, and general structure of the group at the beginning.

If a counselor lacks the leadership skills and confidence needed to do so, performing group therapy may not be the best idea – at least not until undergoing relevant training. Otherwise, group dynamics may take over, resulting in disorganized and unproductive sessions.

Other salient issues that occur during group counseling include the following (Jacobs et al., 2012):

  • Chronic talkers who monopolize conversations
  • Group members who refuse to speak at all
  • Dominating personalities who attempt to take over the group
  • Pessimistic group members
  • Individuals who try to distract others
  • Persistent criers
  • Those who behave with hostility

Additionally, group leaders are more likely to create successful sessions when they give participants sufficient time to speak, model appropriate ways to respond, are sensitive to minority group participants, react appropriately to tearful individuals, and help quiet group members to be heard (Chen & Rybak, 2018).

Overall, failing to be a confident leader and mentor who can successfully manage these types of situations during group counseling is a proven way to derail the therapeutic benefit for everyone involved.

In summary, when dealing with groups, counselors should avoid making the following mistakes:

  • Lacking a clear purpose
  • Failing to establish objectives, rules, and structure at the outset
  • Lacking in leadership skills or confidence
  • Failing to deal with challenging client personalities and behaviors
  • Failing to show sensitivity to emotional clients
  • Failing to model adaptive responses when needed
  • Failing to divide time among group members fairly
  • Failing to show sensitivity to diversity within the group

Child and Adolescent Counseling: 9 Mistakes

adolescent therapyWorking with children and adolescents is a unique skill that requires many important considerations.

First, counselors working with minors must be highly aware of state laws surrounding issues of privacy (e.g., with respect to sexual behavior or drug use).

Moreover, failure to discuss such laws with both the child and participating adults may result in a variety of problems.

For example, if a parent is not aware that their child has the right to discuss topics privately with the therapist, they may become upset and insistent on breaching the minor’s rights to confidentiality. The therapist’s transparency easily avoids this situation before commencing therapy.

Second, child/adolescent therapists must understand that children are different from adults in multiple ways, including linguistic and cognitive development. As such, expressing emotions may be more challenging for children because of their relative lack of verbal ability and abstract thinking (Prout & Brown, 2007).

Therefore, the counselor may need to create alternative ways for the child to express their feelings. Similarly, counselors may fail to recognize the unique motivation of children/adolescents versus adult family members with respect to attending therapy.

For example, a child or teen may not have volunteered for therapy nor understand why it is needed – situations that may quickly diminish their level of treatment motivation.

Third, child therapists must be able to deal with a troubled and dysfunctional family system. This may result in a child who lacks trust in adults in general, particularly authority figures. Failure to recognize the youth’s perspective concerning treatment and the counselor’s role may result in an unwilling participant.

To avoid this situation, counselors working with children and adolescents need to take extra time and care in developing rapport early on (Vernon, 2002). Additionally, therapists will achieve better results if they avoid perpetuating child labels within the family dynamic, ensure that their young clients are told the truth, and involve kids and teens in counseling-related decisions and objectives (Myers, Shoffner, & Briggs, 2002).

Approaching youth counseling in this way provides young people with the confidence and empowerment that comes from knowing that their opinions matter.

Fourth, successful youth counseling requires the therapist to understand the client’s developmental period (Myers et al., 2002). Clearly, how a child or adolescent perceives the world will be reflected in their behavior. Failure to recognize developmental processes will lead to potential misunderstandings and assumptions regarding client needs.

For example, it is not uncommon for adolescents to display symptoms of depression that are somewhat different than those presented by children and adults. Along with different emotional and intellectual capacities, adolescents are in the unique position of trying to navigate their autonomy while transitioning into adulthood. Failure to recognize this may result in teen clients who feel misunderstood by the counselor.

Group therapy counselors who work with children and adolescents also need to adequately account for differing ages, developmental stages, and behavioral issues. For example, in terms of group size, young children are more likely to benefit from small positive psychology groups. Additionally, children with behavioral problems may require even smaller groups (Prout & Brown, 2007).

Research into online therapy for youth and adolescents is a rapidly developing field, with a recent study suggesting that 72% of adolescents would use online therapy if they experienced a mental health challenge (Sweeney et al., 2019).

As is the case with e-counseling for adults, there is data supporting the efficacy of various online interventions as a treatment for symptoms of anxiety and depression in adolescents (Christ et al., 2020). However, it is not without its risks.

One main consideration highlighted by researchers in this area is that counselors delivering e-therapy may potentially require technical training (Christ et al., 2020).

A study by Glueckauf et al. (2018) also highlights that psychologists should possess the skills required to manage emergency or crisis situations when using online therapy modalities, such as threat of suicide or self-harm.

A final concern is the need for counselors to be aware of the impact that lack of face-to-face interactions may have on treatment efficacy. Technical issues, reliance on text-online communication, and even limited written reading or writing skills can all potentially reduce the efficacy of treatment if not considered, managed, or if online therapy is not a good modality for specific patients (Wong et al., 2018; Navarro et al., 2020).

In summary, when dealing with youths, counselors should avoid making the following mistakes:

  • Failing to understand and communicate privacy issues
  • Failing to recognize the differing needs of children versus adults
  • Failing to communicate the reason for treatment and to motivate children and teens
  • Failing to recognize the youth’s role and perspective within a family system
  • Failing to adequately establish rapport among youths
  • Failing to involve youths in counseling-related decisions and objectives
  • Failing to recognize different developmental periods
  • Failing to understand the unique needs of adolescents in a therapeutic setting
  • Failing to develop a group counseling structure based on the specific needs of youth participants
  • Failing to consider the unique skills, risks, and technical complexities associated with delivering online therapy.

A Take-Home Message

Countless individuals worldwide undergo mental health counseling each year. Therapists are tasked with the difficult job of providing best practices for clients who have a multitude of diverse backgrounds, problems, and expectations. Therapists also have their own biases and other qualities that may affect the counseling process.

The primary take-away from this article is that there is a wealth of research-guided information available to therapists that will help to steer them away from making potentially damaging counseling errors. The relevant skills to avoid these mistakes are wide ranging and fall into categories such as rapport building, confidentiality, client–counselor fit, and multicultural competence.

Additionally, counseling mistakes are easily identified across a range of counseling situations such as couples counseling, group counseling, and youth counseling.

Generally speaking, therapists who approach counseling in a professional, ethical, empathetic, and optimistic way will be on a more positive track toward achieving desired treatment results.

Moreover, optimal outcomes are more attainable when counselors build trust with clients; are sensitive to the influence of boundaries; avoid making assumptions; practice self-compassion; and approach therapy with adequate knowledge, skills, confidence, and flexibility.

By recognizing the importance of these concepts, therapists will avoid countless mistakes and thus be better equipped to support their clients in achieving meaningful therapeutic outcomes.

We hope you enjoyed reading this article. Don’t forget to download our three Positive Psychology Exercises for free.

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Comments

What our readers think

  1. Priyamvada

    Hey! I am currently in my 2nd year of undergrad. I am hoping to become a child therapist. While searching on net I could not find much information about- what is the difference between a child therapist and a child counsellor- education and hierarchy wise? And is a Master’s degree sufficient for both?
    Lastly, who gets paid more?
    Looking forward to a prompt reply! Thank you in advance!

    Reply
    • Nicole Celestine, Ph.D.

      Hi Priyamvada,

      Thank you for your questions. Yes, a master’s degree is sufficient to become either a counselor or a therapist.

      In general (and this applies to practice with adults or children), counselors help clients address immediate and practical issues such as processing grief or anger, identifying options when making important personal or professional decisions, or building better interpersonal or communication skills. In contrast, therapists are expected to have a more in-depth knowledge of psychology to help with things like mental illnesses and addressing root causes for problems. It’s for this reason that psychologists typically get paid more, but this can vary significantly.

      For an in-depth look at the differences and various educational pathways for both, consider taking a look at our digital guidebook, On Becoming a Therapist.

      Hope this helps!

      – Nicole | Community Manager

      Reply
  2. Leila

    Hello! I was reading your article because I’m a little concerned with the relationship between my boyfriend and his female therapist. It might be all in my head but I was hoping maybe I could get a little bit of insight from you to see whether or not it is. So the therapist herself is his best friend’s girlfriend. Not only that, but she is also my boyfriend’s and his best friend’s boss. She is both a therapist and a manager of some sort for the group-home he and his friend work at. They have each other’s phone numbers which I guess is natural being that she’s his boss, but she told him to call her anytime he’s having what she calls a “crisis”. So one time he and I were having an argument and he brought up something she said but wanted clarification, and so he called her thinking those were appropriate grounds. She picked up the phone call and was discussing it with him but when he told her she was on speaker phone and that I could hear her she refused to say more even though he told her it was okay. She also finds that my bf’s case is particularly interesting, and so she asked him to speak about his traumas and life at the college where she apparently also teaches therapy, which is fine… but then she took him out to dinner afterwards with her son. I find that it’s strange how she’s ok with him sharing his personal things to a group of strangers with his permission but not with me. Maybe it is different, I don’t know, but the whole situation still seems somewhat inappropriate. Is there any input you could give me on the matter? Thank you in advance.

    Reply
    • Nicole Celestine, Ph.D.

      Hi Leila,

      The situation where your partner’s therapist is also his boss flags a concern, which is one of multiple relationships. The American Psychological Association highlights potential problems when a therapist provides support to someone with whom they have a personal or professional arrangement (see here for more information):

      (a) A multiple relationship occurs when a psychologist is in a professional role with a person and (1) at the same time is in another role with the same person, (2) at the same time is in a relationship with a person closely associated with or related to the person with whom the psychologist has the professional relationship, or (3) promises to enter into another relationship in the future with the person or a person closely associated with or related to the person.

      The therapist inviting your partner to have dinner with her and her son is also interesting and seems to further point toward a multiple-relationships situation. Ultimately, the APA says that multiple relationships are not inherently breaches of ethical conduct, but they become breaches when they can be reasonably expected to lead to impairments in objectivity or harm for the client:

      A psychologist refrains from entering into a multiple relationship if the multiple relationship could reasonably be expected to impair the psychologist’s objectivity, competence, or effectiveness in performing his or her functions as a psychologist, or otherwise risks exploitation or harm to the person with whom the professional relationship exists.

      Ultimately, I don’t think it would be uncommon for a therapist who accepts calls outside of formal sessions to refuse to speak in a context that wasn’t private (i.e., on speaker), as therapists are strictly bound to ensure that interactions between them and the client are private. However, sharing one’s experiences with mental illness with a class of students is a different situation (i.e., it’s not providing therapy in a public setting).

      All in all, I think having an open conversation with your partner about your concerns and the possible consequences of this multiple-relationships situation could be helpful. You could also ask him to flag any concerns with the therapist, who should be aware of the APA guidelines I’ve discussed above. That way, she can also reflect on possible consequences of the present situation and consider whether a referral to a new psychologist would be best.

      I hope this helps a little!

      – Nicole | Community Manager

      Reply
  3. abdollahzadeh hasan

    Nicole Celestine,Greetings,
    I hope that you are well.
    Your professional and appropriate answers were very informative. Thanks

    Reply
  4. Nilah Complitado

    Greetings,
    I hope that you are well.
    Recently, I just started attending therapy sessions due to recent trauma and history of trauma and abuse…
    These aspects have me concerned about our sessions. Please advise if these issues are professionally appropriate:
    1) My therapist is always late. It seems to get late each session. We meet virtually. Today I waited 20 minutes for her.
    2) Often I noticed that she may appear distracted (like she is watching tv) or she is getting up every few minutes to grab something to drink. She may eat during the sessions sometimes too. I feel that is rude.
    3) Often she has shared her personal experiences with me, as well.
    4) Today, made me uncomfortable. I am open to admitting my flaws, trying different projects to improve self and growing…However, today she informed me several times of what I ‘CANNOT Do, must not DO or SHOULD NEVER DO…What I HAVE to do as a mother and parent…’ It felt judgmental. I presumed that therapy was about a client sharing or venting to his or her therapist. It is acceptable or even beneficial for a therapist to ‘tell’ a client what that MUST DO?
    Please advise. I appreciate your time, perspective, knowledge and energy. Thank you.

    Reply
    • Nicole Celestine

      Hi Nilah,

      Thank you for your comment. Based on what you’ve said, I think you’re right to be concerned. While there is not necessarily anything wrong with sharing some of one’s personal experience as a therapist (within reason and when it is relevant), good therapists will attend fully to what you are saying when you speak and engage in active listening. Being late to sessions also strikes me as unprofessional. Likewise, I’d be wary of any therapist who imposes strong opinions about what you should and should not do in your life, provided you are not acting in a way that risks harming yourself or those dependent upon you (i.e., your children).

      I’d say you’ve got a few options. If you’d feel comfortable, you could get a new therapist. Alternatively, you could raise your concerns directly with the therapist or the company they work for, who should have some guidelines about how your therapist should be conducting herself during your sessions.

      I’m very sorry about this disappointing experience, but don’t give up. There are some amazing therapists out there with a real talent for supporting people who’ve experienced trauma, so please don’t let this particular experience sour your impression of therapy’s potential benefits!

      I wish you all the best with your recovery.

      – Nicole | Community Manager

      Reply
  5. Anthony

    My private lady therapist has terminated sessions after several weeks residency, and five months weekly sessions following.
    She has said that it is unethical to continue as she now believes I am not benefitting.
    I have very difficult circumstances, and had been expecting the support to be available for several years. This had been discussed and considered quite possible if needed.
    I believe there are reasons beyond what she has said as the change in attitude was abrupt, and connection has deteriorated since.
    I can no longer speak with her, but am in touch with the company to seek clarity as to the reasoning behind this change, and the refusal to meet.
    The company supports the therapists view and will not agree to a verbal discussion with management to seek a way forward.
    I am offered an alternative therapist whilst my pre-booked sessions are outstanding.
    I have a life long condition, feel severely let down, without support, and am left feeling that for me, help is now non existent.
    It appears worthless to go through the whole process once more, but to end the same way.
    To me, overall, this seems gross misconduct, and evidences total lack of empathy, or even the vestige of care.
    My therapist appears not to realise that just the fact of having someone with whom to share the burden is very helpful in my life. It is progress just to keep going. She has much to offer, and the current rejection will have permanent negative impact on my life hereon.
    Would you have any advice while attempting a solution with the company, please?

    Reply
    • Nicole Celestine

      Hi Anthony,

      I’m sorry to hear that you feel let down by your therapist. There are many reasons why therapists may terminate their relationship with a client. Often, it is because they feel that their client requires a more intensive level of care than they can offer or that they would better benefit from seeing a therapist with a different skillset. It is also possible your therapist may have felt that continuing to work with you would expose you to greater harm than if you’d discontinued the therapy. These are important ethical decisions therapists must make when deciding whether to continue working with a client.

      I’d encourage you to take a look into alternative services, and don’t give up! When sending out inquiries, provide a thorough background of your experience with therapy so services can match you to the right professional, and hopefully this problem can be avoided in the future.

      I hope this helps!

      – Nicole | Community Manager

      Reply

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