Early signs of an unhelpful therapist to watch out for.
(And what to actually look for, within your means)
This article is long, but detailed and hopefully organised enough.
I’ve been in therapy for over a decade, thanks to childhood trauma. I’ve also been in therapy DURING childhood, funded by my abusive mother, because she kept trying to bribe the psychologists to give me some kind of diagnosis that would justify keeping me dependent on her forever (her dream! No freedom for me even after 18! Forever her slave and captive oracle, all for herself, advising her and only her. My life is stranger than fiction) — but they wouldn’t collaborate with her and instead gave me normal therapy. This is something I only found out recently, and it’s finally making sense why I went to therapy as a child to casually chat with the therapists and achieve nothing. Thank god the worst case scenario never came true!
Anyway, backstory aside… my experience in therapy, like anything else in life, has been very mixed. Sometimes it’s great, other times it’s only kind of helpful, and other times it’s bad — or occasionally, terrible.
I’m here to lend you some of my experience when it comes to identifying red flags in a mental health professional. In doing so, I will also talk about what therapy is SUPPOSED to feel like (the green flags that should be in place of the red ones), and (I don’t know if this slang exists, but if it doesn’t, I’m coining it now) the “yellow flags” to look for. What are yellow flags, maybe you’re wondering? I am keeping with the whole traffic lights metaphor — green for go ahead, red for stop (bad to keep going), so yellow is the third option in between: it’s not ideal to go ahead, but you probably won’t be in danger if you do. And why is that necessary? The short answer to that is: because I live in Ireland. The long answer: I know what it’s like to be in a place where mental health is underfunded, professionals are underprepared, there is cultural stigma around this topic, and even the locals wouldn’t be able to recommend you a good one. In that case, the chances that you would run into a therapist full of green flags is almost zero. I’ve been consulting via zoom with people in other countries, for example. But not everyone has that opportunity; some perhaps prefer it to be in person (understandable!), don’t speak the language of the countries where good + affordable therapy can be found, or need it to be through a community project because it’s cheaper, or [insert reason here]. So there are occasions where you’ll have to settle for less-than-ideal. That’s a yellow flag. Better and less harmful than red.
For ease (and to keep this article short), here is the code to follow:
🔴 Red flag
💚 Green flag
💛 Yellow flag
A note before we start: if you’re a mental health professional, and you felt offended at the above because how dare I “rank” therapists by how helpful or unhelpful they can be… I’m not interested in your input. Keep it to yourself. Every profession gets reviews. Some industries perhaps need to eat a bit more humble pie instead of inflating their egos like that. And mind you, I have been A FILMMAKER. I’ve networked with people who stereotypically have huge egos, AND STILL their egos cannot compare to those of certain mental health professionals. This is a problem. I will not shut up about it. Take my message or leave it.
The red flags I will discuss are about objectively bad (and/or unethical) behaviour. I know there are things certain mental health professionals do that work for this person but not for that person; That’s not what I’m discussing here. Preference involves nuance, and all this nuance is inside green and/or yellow flags. So does specialisation — some professionals don’t specialise in PTSD, for example, and others do. That’s not the subject of today’s article either.
Without further ado:
1. Therapists who are new to the industry
These tend to be young [and full of themselves. Sorry, not sorry], but not necessarily so. There are some older people who decide to change careers and pursue Psychology later in life, so look out for their years of experience in the industry, not their age. Usually their rates are lower than average to reflect that (but don’t take this as gospel. If someone is REALLY unethical, they will try to rip you off, by which I mean, charging what the more experienced and well-known professionals in the same region and specialisation area charge. Yes I’ve seen that happen. Yes you have a right to ask why, and should).
Main thing to keep in mind: inexperienced therapists are super legit, a great choice, and not to be overlooked! But always remember that they don’t make miracles. If your mental health problem is too serious, too rare, or requires special attention, maybe they won’t help — and that’s not a red flag, that’s a natural limitation.
🔴 They get defensive if you ask about their background, how many years they’ve been in this industry, what their credentials are (ie, what college they went to and when), where they’re from, what inspired them to study Psychology or Psychiatry or whatever, etc. Go easy here! I’m not telling you to ask ALL of these questions in one go. Anyone would feel cornered, lol. I’m just giving you examples and you can pick one or two. This is because, when someone is new AND unhelpful, they’re not in it to help you with whatever means they have (or else I would have said “helpful”); They’re in it for your validation only and will probably be overbearing or authoritarian going forward. Don’t waste your time.
Alternatively, a red flag inexperienced therapist would lie and make their background look a bit more impressive than it truly is. I’m not telling you to Google every therapist too much, but it doesn’t hurt to take a look at the surface-level easy-to-find information about them to see if it matches what was said in the session. I’m not necessarily saying someone would lie to you about other things too if they lied about their background — this is not my point. Some people don’t. But lying about their background is bad enough because it indicates insecurity. And an insecure professional will need constant validation from you to keep “playing on your team”, without accidentally (or even callously and vengefully! Yes I’ve seen that one too!) retraumatising you down the line.
💛 In contrast, a yellow flag would be someone who answers the above questions and asks you “why do you ask?” (or similar). Note that I’m not mentioning the tone here, because it truly doesn’t matter. “Why do you ask” could be said in an intimidating tone, or in a curious and friendly tone, but both still indicate some degree of expecting your validation; Expecting you to explain yourself; Putting YOU — the customer *— under pressure for no good reason. These questions are not illegal, immoral, OR unethical to ask because they’re not personal, you’re not inquiring about their families or love life or whatever, you’re just trying to find out if this therapist will be able to relate to you through life experience AND is prepared enough technically to help you. They really are okay! Giving no explanation is already good enough; And if you want to explain yourself, do, but it’s your choice. A yellow flag therapist won’t be the best choice, we already know that, but it’s still ok to give them a chance. They’re not entirely depending on your validation; they’re just a bit immature but can potentially help you anyway if you turn a blind eye to certain mishaps.
*Yes, you are the customer. I know you’re also considered the patient, but in the majority of cases (with mental health; Physical health is another story), you’re paying out of your own pocket. This means you hold all the power of decision over whether to keep going or not. Don’t let anyone fool or manipulate you into believing otherwise.
💚 They will answer these questions briefly and move on to the actual therapy. Inexperienced green flags understand that it’s not necessary to give their patient a TED talk about their background — first because they’re new to the industry, so it will be short anyway; Secondly because this kind of therapist has their ego under control, and a controlled ego can exist in any profession, at any age, at any level of experience. Alternatively, a green flag might already have this info in the leaflet or web page or wherever you got their contact information from, along with what they specialise in (or, let’s be honest, what they are mainly interested in. Inexperienced folk are seldom specialists. When it DOES happen, and isn’t a lie, it’s because they’re coming from another previous profession that comes in handy). But you can still ask “when”, because these bios tend to come without time periods. Long story short: inexperienced green flags admit they’re inexperienced, have an open mind, will handle any question without egotism (will answer the ones they can, won’t answer what they can’t and will calmly — not defensively — tell you why, etc), because in the end of the day, they are grounded, mature individuals.
They understand that they’re working with MENTAL HEALTH, and they can’t expect a patient to always be sweet and kind and sociable if they’re coming in to talk about PROBLEMS in the first place (That’s like expecting someone with a brain injury to accurately tell you every time how many fingers you’re showing them. That’s how absurd it is to expect a mental health patient to cater to you emotionally. But some obvious things need to be said, amazingly). They know not to take it personally if a patient is “difficult”, know not to hold on to a patient who is struggling with a challenging problem or something beyond their means — because referring is good, referring is ethical, referring doesn’t make you as a professional a failure or ashamed [or insert ego wound here].
2. Therapists who have a few years of experience
🔴 I was going to add to the title “…and have a specialisation or two”, but actually, never mind, let me tell you the tea: therapists with a few years of experience DEFINITELY have a bio somewhere, will share it with you if you haven’t seen it, and are quite proud of the info in it. Beware of those who have too many specialisations. I’m not saying they’re lying (although some could be, you never know), I’m saying it’s worse than that: they half-arsed most of these qualifications. Right? Because a liar is a liar, is a liar… But at least a liar puts effort into the lie! It’s similar to those kids in school who go to great lengths to design the ultimate cheating prompt, the one no teacher will ever catch, the one they can proudly share with friends… And end up actually learning from all this note-taking! I’m sure you know the ones. So, counterintuitively as it sounds, if your therapist has more specialised qualifications than months in a year, and they’re NOT lying, they probably don’t care all that much about these subjects and are just trying to make a good first impression without substance behind it.
Anyway… Another red flag to look for with an average-experience therapist is their bad habit of jumping to conclusions too fast. Maybe they won’t diagnose you straight away (although some do…) but they are, as I tend to joke, “professional assumption makers”. And boy, do they set those face-value assumptions in stone! You mention you have a religion, and they instantly register in their minds “this patient is homophobic” (which you later find out because of the therapist’s attempts to show you that prejudice is unhealthy… And you go like “hold on a second… Why did I have a prejudice, again? When did I say that? And what prejudice is that?”). You get the idea, you need a crystal ball to deal with this kind of therapist because they make so many assumptions that you’ll inevitably end up having to talk about your cat that died of a heart attack — except you don’t have cats, never had any, you’re allergic. It goes without saying: steer clear of professional assumption makers unless you’re into oracles. Actually, no… No, not even if you ARE an oracle can you deal with them. That’s my lane. #NotAllReligions #NotEvenTryingToGetToKnowThePatient. #YesIMakeLongHashtagsForNoReason.
💛 This therapist looks like your run-of-the-mill mental health professional and you will probably scroll past (or turn the page on) their info before it even catches your attention, if at all — which is a pity, because these “unremarkable at first” people with average experience in the industry tend to be good professionals to try out! Nothing about them looks too impressive and there’s no wow factor… But that’s a good sign. It means that for better or for worse, they aren’t too attached to the idea of making a good impression on you — so they won’t try hard to keep you coming even when it’s unwise to do so, and you can probably talk them out of any assumptions they make about you without offending them. They’re just there “for the 9 to 5”, if you get me. They haven’t made Psychology their entire personality, so they won’t feel personally attacked when a mistake they made is pointed out to them. These professionals will not go the extra mile to try and help you if your problem is something out of their comfort zone (yes, even if this comfort zone turns out to be a very niche specialisation). In rare occasions, they might refer you to someone else, but [according to my experience] what they usually do instead is guide you to talk about other issues in your life until you can both arrive at a topic they ARE knowledgeable at and can happily assist you with.
This yellow flag is, to put it bluntly, “what the red flag would be if they were honest and not a try-hard”. That’s because they’re both putting exactly the same (small) amount of care and effort into the profession; the (important) difference is, with the yellow flag, they don’t roleplay as amazing and instead admit to be mediocre. They understand, pretty well, that the mediocre are very welcome everywhere in the world because sometimes you just have to do your job and keep it down-to-earth. They’re wonderful in emergency situations, when all you need is some help to keep going during a traumatic or otherwise very difficult period of your life you can’t yet get out of. These are, generally speaking, the mental health professionals who will stand by you no matter what and help you simply persevere, without digging up deeper stuff OR leading you astray.
Yellow flags in this category can have as many years of experience as you want. The sky is the limit. A lot of professionals stay mediocre forever and make a decent living, so they fall here.
💚 These have a specialisation or two (not thirty, lol), and instead of using that as an initial “selling point”, they might mention the specifics of what they specialise in DURING therapy with you when relevant. I’m not saying it’s not green flag to briefly add those to the bio; I’ve nothing against that! What I AM saying is the green flag average therapists will prioritise helping the patient, not inflating their ego. For example: you complain of flashbacks, and the therapist goes on to mention they once did an internship helping war veterans who turned out to have PTSD, and they had a similar symptom. Was that a brag? No. That was one (of the many!) effective way of letting you as a patient know that you’re not alone, previous work and/or research has been done on the symptom you’re describing (so there’s hope for you too), AND there is a possibility of diagnosis but let’s not jump to that straight away. This example is very simplistic, but I hope it helps. See how different that is, compared to taking instant conclusions all the time in a desperate attempt to appear good and effortless at the job (when in fact you’re average and low-effort, not because it’s easy and comes naturally, but because you just want the results without the hard journey towards them)?
3. The best of the best (or worst of the worst)
There is no middle ground.
💚 Yes I’m inverting the order, since green flags are more common in this category. There are more “best of the best” than “worst of the worst” mental health professionals in the world, thank god, but we should STILL keep in mind that here lies high risk and high reward (with a price tag to match both). So, pay close attention to the green flags: a good psychologist at the top of their game won’t necessarily be famous or (gasp!) even have studied in a prestigious University — although either, or both, can happen. What differs them from everyone else in a good way is their amount of dedication and good will coupled with their many years of experience. You see, vast experience will have allowed them to know the ins and outs of counselling people from pretty much every walk of life; But it’s their good will and kind heart that give them an extra advantage over the competition which is usually made up of a mix of self-preserving yellow flags (see category #2), stubborn old dogs who don’t wanna learn new tricks, and self-serving sociopaths. There is no magic trick to identify them, it’s all about trusting your gut. ANY master of counselling with vast experience under their belt can “pass” all the tests above for the other categories… And still be a red flag. (Hence, always investigate HOW LONG someone has been in business. I cannot stress that enough). The secret is in really examining how this person makes you feel. Are you happy and fulfilled overall (despite the occasional moments of dread, because therapy can be difficult)? Or do you feel taken care of, but something you can’t quite put your finger on is telling you to run to the hills? Listen to that instinct. Yes, even if you’re very new to therapy. We all have that instinct.
🔴 I called these red flags the “worst of the worst” and I fucking mean it. They’re not just having “oopsie” moments as it can happen with the categories above. No, they KNOW better, and STILL CHOOSE to mess people up. Here you find gay conversion therapists, fanatics (of religion, of politics, of everything, you-name-it), sadists, manipulators, snake oil sellers, and unethical people who are happy to accept bribes. Here you will also find narcissists with a delusion of grandeur who believe they have single-handedly discovered a new method of therapy no-one else has ever or will ever know the ins and outs of. These people, these worst-of-the-worst, are why we can’t have nice things such as allowing across the board a holistic integration of spiritual services with Psychology or revolutionary movements with Psychology, to name a few danger areas. Yes, ethical holistic professionals exist (namely, the ones who cater to people who ALREADY PRACTICE a specific religion and DO NOT NEED CONVERSION; or the people who ARE ALREADY ONBOARD with this or that movement and DO NOT NEED CONVERSION), because honestly? Sometimes, say, you’re into Tibetan Buddhism (like is my case!) out of your own free will, and you feel like talking about your practice — as part of “talking about your life” — with someone who gets it. Same story if you’re a devout Christian, or Muslim, or Shaman, or [insert religion here]. Sure, you can totally tell your Atheist (or whatever) green flag therapist of ANY aforementioned category about religion or political dogma, there’s no rule against doing that, but all they can do is nod and stay silent. Someone who relates could weigh in because of life experience. Same for politics and other danger areas — they are danger areas, not because “it can’t be done” objectively, but because worst-of-the-worst professionals exist. Unfortunately. And usually they try to deceive you in order to manipulate you slowly into serving their selfish interests. You won’t notice it straight away. Some damage always gets done, even if you have the intuition of an oracle. Hence, high risk and high reward.
I won’t even get into bigotry. Some things are not politics; they’re bigotry, straight-up. Nazism is not “a political ideology” — it just claims to be that, but in fact it’s hate speech. So is every kind of [insert group of people]-phobia. If your therapist promotes any of that, they are a red flag. Regular people promoting hate speech can still be innocent (because maybe they’ve been manipulated or indoctrinated, and aren’t actual psychopaths), but we shouldn’t cut THERAPISTS any slack when they do the same. They know better. I’m not saying mental health professionals can’t have opinions of their own outside of work — even if these are VERY misguided opinions — I’m saying they shouldn’t air that stuff. When someone keeps obsessing over “how bad” this or that group of people is just for existing, what kind of mental health service do you think they’re able to provide? Humane and open-minded? I think not. When someone hates certain people and proudly airs that hate (even if it’s disguised as “concern” — FUNNY that it’s always in public, ISN’T IT? A concerned psychologist would talk to the patient IN PRIVATE about “the concern”. Not in public to gain likes and applause), do you really think they would respect whoever is paying them for help? I think not.
It’s this kind of thing that makes me support the idea of making mental health professionals swear the Hyppocratic Oath just like doctors do. But sure, what do I know?
I’m just a user of mental health services. A lifelong customer of this industry. But if I can help other customers, I will. That’s why I write.
