How to Know if Your Therapist Behaves Ethically

Just as it is important to acknowledge the reality of abuse of clients in therapy, the next step in addressing this problem is to know various ways in which this type of abuse is perpetrated. The extent to which many consumers of therapy are unaware of basic rules of their providers’ professional conduct is stunning. 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.

2 thoughts on “How to Know if Your Therapist Behaves Ethically”

  1. Hi Marina,

    I hope you enjoyed your spring break last month! I agree with your thoughts on the unfortunate minimal amount of sites that are client oriented and provide sound perspective on what to look for in a healthy therapeutic relationship. Yours is one of the few and one of the most comprehensive and thoughtful.

    Learning about ethics was eyeopening for me. It is indeed a grey area as you mentioned. Ethics are worded in a way that can leave too much to interpretation, rendering them vague. The discovery that ethics existed was at first comforting to me, but learning that they are in fact just aspirations for therapists was very disillusioning. Ethics is a thought. Like a serving suggestion on a box of cereal. Nothing more. There is no way to monitor it, except for the client having some knowledge of it.

    The harm that my therapist caused left me devastated. I exhausted both the malpractice lawsuit option and ethical complaint option (with the state licensing board). I was left with the realization that in real world practice, little exists that is in place to actually deal with emotional abuse in therapy. I was left feeling there was no way to go. You have listed the additional avenues towards healing and action that are available with great consideration, including blogging, writing, etc. I started thinking, would there be a way to have something positive come out of my experience. My thought is about the idea of a checklist that you mention. I agree that it cannot be a checklist in the strictest form, because therapy is not so black and white. There are some posts online that list things to look out for that can be an indication of bad therapy, or unproductive therapy. I would like to reframe the naming of this tool, and think of it not as a checklist, but a list of occurrences or interactions for the client to be aware of. To try to use them as a guide, like we do with so many things. I would have liked to have had it years ago. One of the reasons I was in therapy was that I had difficulty standing by my convictions and instinct. And my therapist was very savvy in knowing just how easy it was for her to divert attention from the concerns of lack of progress that I brought up to her by instilling fear or blame in me, and how little she needed to say to get me to stay. A list would serve the client. one could ask oneself how many of these are occurring in my therapy, are they upsetting to me, is there sufficient discussion about it with my therapist if they are upsetting to me, is it interfering with progress. It would reinforce instincts. I think it would help both client and therapist in the long run. The better understanding the client has of the work, then the more likely the client would stay, or would find a better fit, without wasteful months or years. I love your thought that there need not be a label of the therapists behavior. That idea might make the process of leaving less intense or fraught with emotion or guilt or blame. Your suggestion of focusing on the goals is simple yet profound. Is the therapy working or isn’t it? The most important factor is the clients quality of life.

    When I started with my psychoanalyst, I had no idea there were different modalities. She was very rigid and narrow-minded, and her treatment was not appropriate for me. My instincts were telling me that I needed something different, and even generally what changes to make. But I didn’t know at the time those therapies existed. (in reality, anything else would have been better for me). I think with some knowledge and reinforcement, I would have been able to leave earlier than I did.
    What do you think?

    1. Hi G,

      I had enjoyed my vacation break, thank you!

      To answer your question, yes, it would certainly be much easier for clients to leave harmful situations in therapy and unethical practitioners if there were consumer information sources where therapy was described in a real way, exactly how many people experience it instead of portraying it as something that doesn’t reflect clients real experiences and doesn’t speak to their real needs.

      Right now people have virtually no point of reference to evaluate their current therapy in terms of its effectiveness, practitioner’s competence, professionalism, ethics and so forth. If they have doubts about where their therapy is heading, they are left with no help, no independent, impartial third party to help them evaluate their therapist’s performance. All they can do is to address their concerns with their therapists who are often far from capable of engaging in a constructive conversation about it, as your own experience and experiences of many other people show. So, yes, absolutely, independent educational sources like this website are desperately needed to empower people to trust their instincts, common sense and to exercise their independent judgment. I hope there will be more people, professionals and consumers alike, who would step forward and start an honest conversation about what’s going on in our mental health system.

      As far as the “check-lists”, I don’t philosophically oppose the idea of listing some indicators that could show that something in your therapy is off. The problem is that when you try to make those indicators about something specific then, first of all, the list would never end and, also, each item on the list could be debatable because the same behavior that may be inappropriate or questionable in one case may be perfectly benign under different circumstances. This kind of things are always contextual, they come with the territory and cannot be judged one way or another on their own. For instance, giving client a hug at the end of the session may be inappropriate and unprofessional under one set of circumstances, mindless under other circumstances and quite therapeutic and perfectly within professional boundaries in some other cases. That’s why if I were to make a list of things people should be mindful of while in therapy, I’d make it about how their therapy works in general. I’d put together a set of questions one needs to ask themselves to determine if this particular practitioner and the methods they practice is what they need or if they need something different, which is kind of what I am doing on this website.

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