I often think about what makes a good therapist, and find it a hard question to answer in an organized and concise way. What’s far easier, and maybe as helpful to anyone looking for therapy, is the reverse question. So, in the style of CGP Grey’s 7 Ways to Maximize Misery, I hope this list of what makes for a bad therapist can help you find a good one.
- A bad therapist lacks all curiosity.
They assume that their education or experience or inherent wisdom means they just know what the client means and wants and needs, even if (sometimes especially if) the client disagrees. They rarely use reflective listening or Socratic questioning, and rather than reserving assertions for psychoeducation and normalizing, instead tell the client precisely what they think is wrong, what mistakes the client is making, and/or what the client needs to do to improve, all stated with confidence rather than as hypotheses. And if your therapist does all this within the first session? Run away.
- A bad therapist will not respond well to negative feedback.
They expect their therapy style and modality to be perfectly suited to any client, and are not willing to adapt or learn how to best help their client. This isn’t to say all therapists and clients are suited to each other, but if reports of dissatisfaction are turned back on you with accusations of projection or “resistance to treatment,” that’s a great red flag to find another therapist.
- A bad therapist pathologizes constantly.
Anything unusual about the client, from their hobbies to their fetishes to their philosophy, is suspected of causing dysfunction regardless of whether it actually does. These therapists conform to the broader culture they’re embedded in, and act as agents of social control on all manner of moral issues, from sexuality to family dynamics to choice of profession. If your therapist speaks in clichés such as “Family always forgives” or “Marriage is a sacred bond,” find a more open minded one.
- A bad therapist shames their client, or makes them ashamed of themselves.
Guilt can be a powerful generator for change, but a therapist’s role is to gently guide the client to better understand themselves, and the sometimes complex relationship between what we value and what we do. If your therapist demonizes your thoughts or feelings or desires rather than helping you better understand them, you’re dealing with another therapist too trapped in their culture or biases to properly facilitate lasting healing and growth.
- A bad therapist pushes their worldview onto the client.
A religious therapist who insists that “God works in mysterious ways,” or an atheist who dismisses spiritual comforts are not only unlikely to help their grieving client of the opposite beliefs, but can cause extra harm by making them feel alienated and unheard. Finding a therapist who matches your worldview can be valuable, but any competent therapist should be able to leave theirs (mostly) at the door.
- A bad therapist can’t remain objective.
Early signs of this may be a therapist who talks too much about themselves or seems overwhelmed by their client’s problems. More subtly, therapists can struggle not to triangulate with a parent or child or spouse against child or parent or spouse. It may even seem like a positive, if for example the therapist starts to act like a friend, focusing on comfort to the detriment of growth. To be clear, objective doesn’t mean perfectly balanced; sometimes objectivity requires pointing out that some mistakes are one-sided, but if you don’t feel like your therapist is making an effort to include everyone’s perspectives, find another one.
- A bad therapist will insist that their model is the only one with value.
These therapists view all of mental health through a single lens, the causes and solutions to illness forced into the mold they developed during their education or personal experiences. While an expert in a specific modality can be invaluable, a professional should always be ready to refer a client elsewhere if they encounter a problem in treatment, rather than blame the client and insist they’re not understanding or not trying hard enough.
- A bad therapist is okay with therapy lasting forever.
I may be being too normative here, but I think it’s suboptimal for a therapist to make no effort to set concrete goals or give the client the tools they need to move on without them. If within a month you don’t have a good sense of what it would take for you to feel satisfied ending therapy, or at least reduce the frequency of sessions, then it’s worth bringing it up yourself to see if the therapist has a sense of direction or goals in mind. Vague and subjective goals are better than nothing, but ideally there would still be some observable change in the client’s life that they can use as a metric of growth. It’s also fine to go back to therapy every few years as needed; it’s just the unending years of therapy that, to me, indicates something suboptimal is going on.
- A bad therapist can’t properly balance uncertainty and responsibility.
This is the kind of therapist who attempts to hospitalize their client due to non-critical self-harm, or for simply talking about their suicidality, rather than because there is imminent and specific threat to life. Unfortunately there is little you can do to predict that your therapist is like this ahead of time, but you can at least get a sense for how well they understand the limits of confidentiality when they explain it to you; a good therapist should clarify this distinction so their client feels safe being open about how they feel.
- They think therapy is about talking, not doing.
This may just be me being too normative again, but while a large part of therapy is talking, it’s been a century since Freud borrowed the phrase “Talking Cure” and ran with a model of therapy aiming purely for catharsis. I think therapy should be doing more than just venting and processing; it should also involve learning new tools to be practiced between sessions, so that you can reach a point where the therapist is no longer needed. To be clear I’m thinking in terms of suggestions rather than strict “homework,” and some clients may prefer not having even those. But if you feel like therapy isn’t doing much for you and you your hasn’t suggested things for you to do between sessions, start asking for some.
I hope people find this helpful; as I said, it’s not a great guide to help finding a good therapist, but I’ve heard enough horror stories in my professional life by this point to at least try to minimize the amount of bad ones people waste their time, money, and emotional energy with.
I should also clarify that while I hesitate to label anyone a “bad therapists” by some of these more than others, I think each of them does drastically limit the amount of people and situations a therapist can help. For example, therapists who are stuck in a certain cultural zeitgeist can still help clients who conform to that culture’s norms, and therapists who never plan to discharge clients can also still be beneficial to them; hopefully that’s why the client would keep going!
But in my experience at least, each of these represent real failure modes in the therapeutic process that can end up causing more harm than good.
As a final note, I deliberately avoided mentioning anything that would count as a violation of therapeutic ethics and professional norms. If your therapist breaks confidentiality, tries to date you, regularly misses sessions, etc, the label “bad therapist” is no longer sufficient; at that point they shouldn’t be a therapist at all, and should be reported to their licensing body.