There are diverse types of Therapists out there with many varying qualifications. However, what are the qualities that allow for mental health professionals to make and maintain a good therapeutic alliance with their clients?
In this piece, we shall explore together the good traits of a therapist and some red flags that show that they are not working in a healthy way with their clients and you should either not consider them or leave them as soon as possible.
In the first part of this piece, I’m going to add some personal perspectives from my experiences in psychotherapy.
A Therapist Should Be Willing to Validate
Validation doesn’t just mean the Therapist accepts and acknowledges the emotions and feelings of their client, but that the Therapist believes in the ability of their client to grow, change, and get better. This is vital, as the client may lack the ability to believe these things about themselves.
I have been to many Therapists, but the best I’ve ever had the pleasure to work with was extremely validating not only of my emotions and feelings but of my ability to conquer my mental challenges. Without this validation, (when I saw Therapists who were not validating), I found myself stagnated and unable to move on with my life. A firm belief that I could get better and succeed in life came only AFTER my Therapists were able to believe in me, even when I didn’t believe in myself.
A Therapist Should Try to Understand the World from Which Client Emerged
There can be many differences in the upbringing of both clients and Therapists. Some are obvious, such as religion and minority, others are less obvious such as sexual orientation and family of origin dysfunctions. A great Therapist will seek to lay aside their own biases to collaborate well with their client. A good example would be if the Therapist was brought up as a Catholic and has a client who is an avowed Atheist. The Therapist will not change themselves into an Atheist, but they will not try to push their religious beliefs onto their client either. The Therapist always has the right to refuse to treat a client if they feel they cannot be objective.
The Therapists I have worked with did not share their personal feelings on such matters as religion or ethic thoughts, but rather they remained a blank slate. They would always ask me before they offered a personal perspective and never pushed their thoughts and beliefs onto me. I very much appreciated this professional approach as it must be exceedingly difficult for them at times.
Therapists Should Not Feel Superior to Their Clients
There are a lot of ways that humans can feel superior to others, such as intelligence, financial affluence, and the fact that they have their health. A great Therapist does not hold such views. They will never look down on a client because they are of lower intelligence, poor or because they live with a mental illness. They treat all clients with respect and dignity.
It is unfortunate, but I have met Therapists who treated me as less than themselves because I live with a mental illness. I have been treated as though I were a little child and my dignity has been trampled on. I’ve had two great Therapists whose primary focus was on me as a fellow human being who needs assistance and who should be treated with dignity and respect. Never allow yourself to be treated by someone who does not see you as an equal. Yes, they have endured many years of training and perhaps because of their point of view as a Therapist, they can see a bigger picture yourself. That does mean they are better than you.
Good Therapists Have a Deep Self-Knowledge
Great Therapists have a deep and honest understanding of themselves. This doesn’t mean they do not have blind spots, but for the most part, they are willing to challenge their opinions and ideas. Many have undergone Psychotherapy themselves as a part of their training to help them see themselves in a true light. Like all humans, they will still have some prejudices and fears, but they willing to acknowledge them when they rear their ugly heads and face them honestly head-on.
I’ve seen one great Therapist who was willing to look herself straight in the eye and ask tough questions of herself. She would admit to me that she had to do some introspection to understand why she found herself full of reservations over a topic I had brought forward. I deeply appreciated this honesty.
The Therapist Sets Clear Boundaries
Boundaries are vital to the emotional survival of a Therapist and for successful recovery of the client. A boundary is a limit set to keep oneself from being manipulated or violated. Manipulation may involve telling a Therapist a lie to win favor.
A violation might be going to the Therapist’s home uninvited.
The Therapist needs to be upfront and honest about what they will and will not accept from their clients in terms of behavior. If they will not tolerate being lied to, then the Therapist needs to express this to their client in clear and concise language. If the Therapist does not wish their client to visit their home they need to say so, and if necessary, repeat this requirement as many times as deemed necessary.
The client needs to always respect these boundaries. They are vital to successful recovery because Therapists are only human. They need their personal space and time not to be interrupted as much as is humanly possible. They need time to recoup after a week of listening to the problems of others.
In my experience in therapy, I have tried to always respect the boundaries of my Therapists. I’ve needed to call my Therapist at home a few times and was always told she would call me back once she returned to her office. I’ve been told by a Therapist that she does not email or text. These things may seem trivial, but to a person who has lived a long week listening to other people’s problems they can be the difference between a successful career and burnout. Respecting boundaries is a fantastic way to pay back the respect and help received from a great Therapist.
A Good Therapist is Unafraid to Challenge a Client’s Understanding of the World
Clients often enter therapy with many confusing and ineffectual beliefs about their world. A great Therapist will be courageous in that they will not be afraid to challenge these belief systems that are holding their clients back from achieving a fulfilling life. Some of those beliefs may be related to relationships, such as feeling that all marriages fail. The courageous Therapist will gently but firmly help their client to see that this is not the case. They will challenge this notion using paradigms easily understood by their client, and in vernacular they can understand.
When I first entered therapy, I had many beliefs that were untrue based on childhood experiences. For instance, I believed that everyone heard other voices in their head and that losing time was something everyone experienced. My Therapist gently challenged these beliefs, explaining they were not a “normal” phenomenon, but rather symptoms of Dissociative Identity Disorder.
A Good Therapist Would Never Allow a Sexual Relationship
It is very unethical for a Therapist and a client to form a sexual relationship during or after the therapeutic alliance has been formed. Because of transference, it isn’t surprising that some people may become sexually attracted to the person who is helping them.
In any other type of relationship, this can be a healthy bond, but in a therapeutic setting, these strong emotions can be extremely detrimental to the healing of the client and the objectivity of the Therapist. Not only is this true, but the licensing board which regulates a Therapist’s ability to practice frowns very heavily on this type of activity. In other words, a Therapist who acts on his or her amorous feelings towards a client can lose their license to practice. It cannot be stressed enough that a sexual relationship between a Therapist and their client cannot and should not exist.
Although I have felt like my Therapists were my mother, I have never had the experience of having sexual feelings towards them. I have also never been approached sexually by a Therapist. I do have a friend who had sexual feelings towards her Therapist to the point where her Therapist said they could no longer see each other.
This was a very appropriate and ethical response to a situation which could have gotten out of hand. I would urge anyone who is in therapy to keep in mind that any amorous feelings you may be experiencing are the result of transference and not permanent. Not only this but to allow oneself to become the lover of their therapist is to be involved in the form of an abusive relationship. No good can come from this type of behavior. If a Therapist sexually approaches you to stop seeing that person immediately and report them. Don’t give up your power by falling into a predator’s trap.
Confidentiality is the cornerstone of psychotherapy and one of the most important terms of which clients sometimes have little understanding. It is important to know your rights and how confidentiality works to protect yourself and to reassure yourself that your privacy will be maintained by your Therapist. It is only with confidentiality that a client can feel free to tell their Therapist the secrets that bind them from being able to move on with their lives. Without this privacy, healing would not be possible.
An important rule many clients do not understand is the Health Insurance Portability and Accountability Act of 1996 (HIPPA). This rule protects most “individually identifiable health information” held or transmitted by a covered provider or their business associates.
This information may be in any form, electronic, paper, or oral. This act was passed into law in the United States by congress to protect the privacy of health information. With this important law, a client’s information, whether it be something written down, posted to a website or verbal, cannot be given or transmitted without the express permission of the client. Even in the case of insurance companies billing for services, the only information that is necessary, such as a diagnosis code, may be shared. In other words, anything said or done in the confidence of a Therapists presence is protected by law. This gives the client a lot of assurance and opens the door for meaningful and healing dialogue.
There are myths about confidentiality that are perpetuated by television programs and movies that simply are not true. One of the most prevalent is that everyone who offers psychotherapy services is bound by rules protecting confidentiality. This is incorrect. Some service providers, such as life coaches, are not regulated enough and are therefore not bound by the rules that have been set up to protect the client’s privacy.
Another myth is that a licensed professional can never tell anyone information shared during a therapeutic session. This too is incorrect. Under certain circumstances, a Therapist may indeed share information they have learned in their office from a client, but only if the life of that client or someone else is endangered. They may also have to share information as a mandated reporter if a child, the elderly, or a disabled person is suspected of being abused. If they are subpoenaed by a court of law, they may have to testify about what they have learned during sessions with a client, but it takes unusual circumstances for them to have done so
As can be seen, the client’s rights are strictly regulated. If a person believes their rights have been violated, they have the privilege and the right to report such abuses to the licensing service of their Therapist. They may also have grounds for a lawsuit.
Here are Some Red Flags of a Harmful Therapist
Not all therapists do their job correctly and just as in any other profession, there are some who harm their clients either due to ignorance or due to deliberate detrimental acts. There is a lengthy list of things a therapist should not do. Some of these activities are harmful, but some are much more hurtful than others. Below I’m going to give you a list of things a therapist should not do and a list of things a therapist must absolutely never do so it will be easier to recognize a poor or harmful therapeutic alliance.
A few things on the following lists may seem redundant, but they are so important I felt they needed reiterating.
Things a therapist should not do:
- Miss or cancel appointments without a compelling cause
- Not return your calls or not have someone on their staff do so
- Eat or sleep during the session
- Discuss other client’s problems with you
- Talk excessively about their life
- Fail to refer their clients to other professionals if the problem they are treating are out of their knowledge base
- Give unwanted advice and expect you to follow it
- Express anything but positive regard toward you
- Respect your personal boundaries
- Respect your religious beliefs
- Respect your sexual or other orientation
- Try to force you to conform to their normal
When considering or in your current relationship with your therapist he/she absolutely must not:
- Ask you to meet them outside of the office unless it is an extreme emergency
- Recreate the same relationship you had with an abuser
- Lock the door blocking your exit
- See you at hours when no one else is around
- Eat, shop, or perform other acts with you
- Tell you that you are more special than anyone else they treat
- Touch you in any way that is inappropriate or uncomfortable
- Become angry with and insult you
- Break confidentiality
- Ask for gifts or money
I know these lists are long and scary. However, being informed of the red flags that a therapist is harmful can help you navigate away from them and help you find the one that is right for you.
Understanding What to Do If You Have a Bad Fit with a Therapist
Should you be unfortunate enough to get involved with a poor or bad therapist, know that you can leave them anytime with no excuse given. The therapist is not your mother nor are they god. They are human beings and just as likely to fail or be wicked as anyone else.
I will not lie to you, firing a therapist and moving on can be extremely painful. The pain is made worse if the therapist tells you inappropriate things like you must stay because they are the one who can help you or other poppycock.
You have the right to take your bat and your ball and play elsewhere. A therapist, while they are seen as authority figures, are only people with a diploma. They have no right to impede your life or your leaving them if you feel you must.
Also, if a therapist does any of the red flags of things they absolutely must not do (see above), you have the right to turn them into their licensing board for them to investigate them. You are not being mean or cruel in doing this, you are helping to protect yourself and others who are, have been, or will be treated by that person in the future.
Finally, Some Important Tips for a Successful Therapy Experience
Therapists are people first and professionals second. They have lives outside the office and experience their fair share of annoying or tragic circumstances at home. That is why one should never set a therapist on a pedestal because they are doomed to fall, and you will be hurt. Therapists are people, no more, no less.
One important and perhaps the most important, tip I have is to remember that your therapist is not your friend. Rather, they are paid professionals who are trained to help you through tough times in your life. They are not priests you confess to who can absolve you of things you have done. Therapists are required by law to report to the authorities if you have harmed someone else, especially children, the disabled, and the elderly.
As I stated, therapists are not your friend so please, don’t get caught into the trap of believing they are because such thinking is a delusion.
Therapists also are not your mother or father. Again, they are paid professionals who can teach you how to become your own parent.
Bottom line is this. Therapists are people, flawed, and human. However, that does not give them the right to use their degree against innocent people who go to them for help.
By keeping in mind what a therapy session is and what the therapeutic alliance should look like can help you not only find a great therapist but enable you to heal.
Individual psychotherapy – that is, engaging a distressed fellow human in a disciplined conversation and human relationship – requires that the therapist have the proper temperament and philosophy of life for such work. By that, I mean that the therapist must be patient, modest, and a perceptive listener, rather than a talker and advice-giver. ~ Thomas Szasz
“Courage doesn’t happen when you have all the answers. It happens when you are ready to face the questions you have been avoiding your whole life.”
~Shannon L. Alder