Everyone knows someone who tried therapy, disliked it, and never went back, even when they desperately needed support.
But the frustrating reality is that the therapist-client relationship is just like any other: finding the right fit can take time, and sometimes a partnership just isn’t a match, no matter how hard you try.
We call these “therapist red flags,” or signals that a particular provider isn’t the right fit for you and your needs at this time.
Key takeaways:
- Therapist red flags can indicate a poor fit for clients’ needs
- Look for red flags like poor listening skills and lack of empathy
- Ensure therapists have proper credentials and clear specializations in therapy
- Watch out for unprofessional conduct, lack of boundaries, and unethical billing practices
- Seek therapists with effective techniques, relevant knowledge, and a strong therapeutic relationship
Red flags can be interpersonal: for instance, you are a concrete thinker, and your therapist speaks in more abstract ways. They can also be practice-related: maybe the provider is struggling to cope with their own life and can’t provide the level of care you need.
“But don’t let that color all of therapy for you. That’s why there are so many therapists out there working in so many different ways, because there are all shapes and sizes of people,” says Tami Zak, a licensed mental health professional with Grow Therapy. “It is okay to go find that right person.”
To help navigate this search, we’ve put common red flags into two categories: “get out” flags and “could be better” flags.
“Get out” flags (#2, #4–5, #6–9, #12) are indicators that a therapist is acting in unprofessional, unethical, or clinically incompetent ways. If you notice them, consider terminating the relationship. For ethical flags, you might also consider submitting a complaint to your state’s licensing board (which the therapist should have offered in your first session).
“Could be better” flags (#1, #3, #5, #10–11, #13–14) suggest that you may find a more natural therapist-client fit elsewhere. Therapy takes time, finances, and energy. Finding a good fit can help maximize your investment.
Qualifications and Professionalism
Red Flag #1: Poor Listening Skills or Lack of Empathy
When you share your experiences, do you feel that your therapist understands without needing explanations? Are they curious about your stories and day-to-day life? “That’s the most critical thing, that you actually feel like the therapist gets you and that you feel a connection to your therapist,” says Zak.
Some potential therapist red flag behaviors include:
- Dismissing your feelings
- Ignoring your concerns
- Minimizing your experiences
- Dominating the session
- Talking over you consistently
You should feel held, so to speak, especially when you offer vulnerable self-disclosure, according to Zak. Part of therapy’s healing power is in receiving attention, validation, and care in these tender moments.
Red Flag #2: Credentials and Licensing
Licensure indicates that a provider has been trained, supervised, and vetted to practice mental health care in a particular state or territory. Confirming a clinician’s credentials may seem like an unnecessary step, but doing so can ensure you find a safe, effective, experienced provider. Here’s how to check a provider’s license in two steps:
1. Note the letters after their name, which indicate their licensure:
- ACD or LADC: Licensed Addiction Counselor
- CATC: Certified Addiction Treatment Counselor
- LPC or LPCC: Licensed Professional Counselor
- LCSW: Licensed Clinical Social Worker
- LMFT: Licensed Marriage and Family Therapist
- MD or DO: Psychiatrist
- Ph.D, PsyD, EdD: Psychologist
2. Search licensing board websites. Each state runs its own licensing process and usually hosts a publicly available database of licensed practitioners online. Through these databases, you can find individual professional’s license type, number, status, and expiration date. One way to find your state’s licensure website is through nationwide professional organizations for a specific specialty, such as the Association for Addiction Professionals and find your state’s licensure board there.
Red Flag #3: Lack of Clear Specialization or Expertise
Your provider should have at least one clear specialization. They could specialize in a specific population group (e.g., LGBTQ or couples therapy), a particular condition (e.g., bipolar disorder or eating disorder treatment), or a treatment method (e.g., psychotherapy). This is usually true even with recently credentialed providers, as supervised clinical hours are part of the licensure process.
When searching online for a therapist, you may notice that some list 20 or more specialties. Note the first 3–5, often the areas in which a provider has the most experience.
Red Flag #4: Unprofessional Conduct or Behavior
To put the matter simply, your provider should treat you well. This means respecting your time by not being late; returning phone calls and emails promptly; and devoting your sessions to your life experience (and not over-sharing about their own). You should never feel manipulated, abused, or discriminated against by your clinician. You should feel respected and honored in your time together.
Red Flag #5: Lack of Boundaries or Boundary Violations
In the first session, the clinician will typically work with you on setting treatment goals, defining each of your roles, and setting the limits of your relationship. For both in person sessions and online therapy, these professional boundaries help keep the client safe and the therapist within practical, ethical bounds. For example:
- Goal: “I want to work on lessening my anxiety in public places.”
- Therapist’s role: “I will help you grow. This process can be uncomfortable, but you can stop at any time and I won’t push you past your limit.”
- Client’s role: “I will lean into discomfort in this process. I’ll respect your expertise while staying aware of my well-being and asking for breaks when needed.”
- Limits: “We won’t extend our relationship into a ‘real life’ friendship outside therapy.”
Consistently committing boundary violations is red-flag therapist behavior, a clear indicator to end the relationship. If your therapist hasn’t defined these professional boundaries, suggest devoting part of a session to talking through them. If your therapist resists or dismisses you, it could be time to move on.
Ethics and Professional Conduct
Red Flag #6: Violation of Confidentiality or Privacy
Therapy should be a safe space for self-disclosure. Your therapist should never share this information with others, according to the ethical practice requirements they accepted as part of licensure.
These violations can happen when a therapist has a “dual relationship” with the client. “It’s the idea that you’re seeing somebody too close to your life,” says Zak. A dual relationship could happen when a client is also a business associate of the therapist, for example, or when the client is a friend of the therapist’s spouse.
An exception: in some states, therapists must report if you have threatened serious physical harm or death to yourself or others, as well as in cases of medical emergency, suspected child/senior abuse or neglect, and for some court orders signed by a judge. This varies by state. The National Conference on State Legislatures offers state-by-state guidance on mental health professionals’ duty to warn.
Red Flag #7: Abusive or Exploitative Behaviors
As a client, you may not notice abusive or exploitative behaviors at first, especially if abuse is part of your history. However, these are serious offenses. If you have concerns about your provider’s behavior, end the therapeutic relationship and contact your state’s licensing board for support.
Therapist abuse is not common but can be frightening. Signs of abusive behavior include (but aren’t limited to) threats, boundary violations, inappropriate language (e.g., profanity, racial slurs), excessive emotions directed at you (e.g., yelling), and demeaning behaviors. If you go into a session feeling on edge or fearful, you may need to seek outside help from a trusted friend or family member.
Professionals also generally should not carry on a relationship with a client during or after treatment, as the client can be vulnerable.
Red Flag #8: Unethical Billing Practices
Licensed therapists are legally required to bill clients and insurers accurately, and the American Counseling Association’s article on mental health billing can give you an idea of what to expect. Unethical billing practices include over-charging you for services, double-charging you for services, charging you for services not rendered, or “misrepresenting the quantities of medications or items” you received. Also professionals should not be asking you to use things like Venmo, CashApp, etc. as these are not HIPAA compliant.
Therapeutic Approach and Competence
Red Flag #9: Ineffective or Inappropriate Therapeutic Techniques
A strong therapeutic relationship works on two levels. First, your therapist’s methods need to “work,” meaning that you’re making progress toward your goals. If you’re struggling to see progress, can your therapist point to examples of your growth? Do they have success stories with your specific conditions, concerns, or population?
Second, consider if the therapist’s approach is a good fit for your personality, communication style, and preferences. If you’re looking for structure, does your therapist provide “homework” and follow up on it? If you prefer exploratory conversations, does your therapist create space for this? Your provider may be clinically competent but not an ideal match for your style, and it’s okay to find a provider that’s a more natural fit.
Red Flag #10: Limited Knowledge in Relevant Areas
Before starting therapy, think through the facets of your experience and how these might translate to your ideal provider. For example, if you’re working through race-based traumatic stress, you may want a provider with specific knowledge and/or a lived experience similar to yours. If you are parenting a child with cancer, you may look for a therapist with years of experience with families with sick children. Make a list of your ideal qualities (e.g., a Latin American man who speaks Spanish, a parent with biracial children, a Black woman with children who takes your insurance). You may not find an exact match, but your list can help narrow down the options. Completing a consultation with the therapist before scheduling with them can help to ensure they are able to meet your needs.
Red Flag #11: Outdated Knowledge in Relevant Areas
Imagine that you’ve found a provider who includes your specific concern among their specialties. Next, research or ask how recent this experience is. A therapist who interned at an eating disorder care facility over 15 years ago, for instance, may not be the best fit for treating bulimia nervosa today. Of course, keep in mind that recency of clinical experience is just one data point, and give your provider a chance to elaborate on their qualifications or continuing education, which most professionals are required to complete every year.
Therapeutic Relationship and Communication
Red Flag #12: Power Imbalance or Authoritarian Attitude
A classic perspective on power imbalance in therapy concedes that the therapeutic relationship is inherently unbalanced in terms of power. The client invests the therapist with power, which the therapist then uses to help the client empower him/herself. Power dynamics present in society, such as race or socioeconomic background, could further affect your relationship if not discussed.
Ideally, a mental health provider will become a trusted, professional partner in healing. Your therapist should have more expertise than a family member or friend but ideally can relate with you in similar kind, friendly ways.
A therapist should not boss the client around or really tell them what to do – a positive therapeutic alliance comes from feeling comfortable being in the driver’s seat. A therapist should seek to understand what you want to accomplish, rather than prescribe you goals that you aren’t invested in.
Red Flag #13: Lack of Trust or Building Rapport
Some clients enjoy light-hearted conversations before the session starts; others want to start counseling work. A good therapist will perceive or ask about your preferences, then arrange your sessions to help you feel comfortable. This is part of building trust and rapport — “Things that can make a difference to you feeling understood and that therapy could be effective for you,” says Zak. Feeling thrown off by your therapist’s communication style isn’t a sign of unethical behavior. But the disconnect suggests that another provider could be a better fit.
Red Flag #14: Feeling Unheard or Invalidated
The last flag is one of the most basic, but most essential of all. In your therapist’s presence, you should feel heard, both literally and emotionally. A mental health professional’s role is to understand you enough to help you, and if you feel this isn’t happening over time, you should consider moving on. Furthermore, while unconscious biases may be unavoidable, they should not affect your treatment. Feeling invalidated in your identity or experience is a red-flag behavior.
Before Ending the Relationship Over Potential Red Flags…
Therapy is meant to be healing, but the irony is that some of the biggest breakthroughs happen through feeling pain and getting uncomfortable. For clients, especially those who have experienced abuse, it can be difficult to tell the difference between a healthy challenge and unhealthy treatment.
Here are three questions to consider before breaking up with your therapist. However, note that your sessions should always feel like a safe space; feeling unsafe is a sign to end the therapeutic relationship — no questions asked.
Are You Avoiding Conflict?
Conflict is uncomfortable, especially with someone you have grown to trust. “Remember this is a relationship with your therapist, and relationships are inherently filled with conflict because human beings are very complex. Your therapist is over there being a human being,” says Zak.
If your therapist says or does something that hurts, try leaning into conflict and allowing them an opportunity to repair with you. A self-aware therapist can own their mistakes and apologize, or they will be able to gently guide you into greater self-honesty.
Have You Given Your Therapist Feedback?
A therapist can be a powerful partner in your healing journey, but they can also make mistakes. If your therapist has said something that doesn’t feel good to you, consider sharing this feedback. Being open is an opportunity for you to practice communicating hurt feelings in real life — and also for your therapist to repair your relationship. “If you give the feedback and that doesn’t go well, then you should head out,” says Zak.
A good therapist should welcome and even ask for feedback, so please don’t feel uncomfortable or unsafe providing honest feedback or asking your therapist to meet your needs. That is their job.
How Does Your Therapist Respond to That Feedback?
A good therapist will be able to hear your feedback and process it with you. They will be responsive and work with you to rebuild trust in your relationship. However, if your therapist responds poorly to your feedback (e.g., dismissing you, invalidating your experience, ignoring the feedback), then you know it’s time to go.
Taking Action and Finding the Right Therapist
If you need to, know that you have the right to report your therapist/professional to your respective state or local licensing board, as well as file complaints or grievances with the company.
Finding a good therapist — one who understands, supports, and protects you — may take a few tries. But thoughtful, caring, effective therapists are practicing all over the world, and Grow Therapy can help you find them.
