In the article “When the Therapist’s Behavior Is Confusing” I talk about situations when people aren’t sure if their therapists are being helpful or if they even know what they are doing. Other common scenario is when the client starts questioning the therapist’s actions beyond the areas of competence or professional judgment. They start questioning ethics and even lawfulness of what the therapist is doing, because some of the therapist’s actions strike them as being so outside of how they normally see a professional service. I often read the descriptions of blatantly unethical behaviors of professionals that aren’t recognized as unethical by their clients.
Excessive self-disclosure with no justifiable therapeutic purpose, hiring the client to do certain tasks for the therapist, a sudden fee increase without an advance notice, talking to the client’s family without their permission – those are just a few among many examples of obviously unprofessional and unethical actions of therapists that many clients have to deal with because they are unfamiliar with therapists’ professional code of ethics.
When the service you are seeking is related to your health care whether physical or emotional/mental, the basic wisdom would suggest doing a little research into the professional ethical code of your health care provider.
Unfortunately, there are virtually no consumer related available and easily accessible public resources that explain in plain English what type of therapists’ actions should not be accepted as normal by clients. The formal ethical codes for various types of professional licenses can be found online but their wording is not consumer friendly and requires further explaining and interpreting even for professionals (this is why professional laws and ethics take an entire course in professional training).
While the absence of consumer oriented information on professional ethics is frustrating, the good news is that in many situations all you need is your common sense to decide if your therapist’s actions are acceptable to you or not without trying to define them in terms of ethics, legality or professionalism. There is no need for you to label the behavior of your therapist in any way in order to decide if it serves your needs and your best interests. After all, everything comes down to you achieving your personal goals in therapy and if the therapist’s behavior doesn’t seem to be aligned with working on your goals, this needs to be addressed and resolved promptly, and if it doesn’t get resolved promptly, there is no reason for you to keep seeing that therapist. Simple as that. Or not?
As simple as it sounds, I understand that this is easier said that done because often people don’t know what their therapy goals are because they don’t even know they need goals in order for therapy to work. But being clear about what your therapy is for and what you are trying to achieve is a must in order not only to make the best of it but also in order to protect yourself from possible harm. Your goals and whether you are moving in the right direction is the ultimate measure of everything that happens in your therapy including your therapist’s behavior.
When you know what you want and your attention is focused on clear objectives, it would be much easier for you to see that when your therapist talks about him(her)self too much, when they become flirtatious with you or try to be chatty, when they are often late for appointments, when they unexpectedly raise their fees and are inconsistent with their business policies, when they are disrespectful, when they talk to your family members about you without your permission – all that doesn’t serve your needs and your best interests.
It is much easier to decide for yourself what you do and don’t need and, consequently, what you are and aren’t willing to accept from the therapist if you think consciously about the purpose of therapy and your specific personal goals than to figure out if a particular action the therapist takes is ethical or not.
Unlike laws, ethics are mostly a grey area and cannot be ensured by the manual of precise instructions that would cover every possible therapy scenario. Therefore, trying to create a checklist of what therapy consumers should watch for is a futile task. The same action that could be appropriate and even therapeutic in one case, could become a slippery slope in another case and outright unethical in yet another case. That’s why professional ethics are set as guidelines rather than strict rules and that’s why professionals are advised to be guided by the general principle of thinking of their clients’ best interests when they face ethical dilemmas.
The same general principle can be used by you, a consumer, when trying to understand if your therapist’s way of working and interacting with you is what you need. While the therapist is obliged to think of your best interests, you don’t have the same obligation towards the therapist. All you need to think of is your own interests, needs and goals and when you are committed to doing that you’ll be better able to understand if your therapist is fulfilling his or her professional role.
That being said, some behaviors of some therapists are so blatantly unethical and even illegal that they need to be pointed out in a separate article, because, sadly, despite their obvious inappropriateness, many people are unable (and somewhat unwilling) to see them for what they are and they get victimized and traumatized as a result.