Warning Signs Of Abuse In Therapy

Medically reviewed by Melissa Guarnaccia, LCSW
Updated March 23, 2024by BetterHelp Editorial Team
Content Warning: Please be advised, the below article might mention trauma-related topics that include abuse which could be triggering to the reader. If you or someone you love is experiencing abuse, contact the Domestic Violence Hotline at 1-800-799-SAFE (7233). Free support is available 24/7. Please also see our Get Help Now page for more immediate resources.

Therapy is a form of mental health care that individuals undertake to find support, care, and guidance. Those experiencing symptoms of a mental health condition may be looking for insights on navigating their symptoms. They often trust that the professionals they turn to will provide ethical, supportive, and compassionate care.  

If a mental health professional breaches that trust, it can compound negative feelings and cause further mental harm. While many therapists do not display abusive behavior, some use their position of power in a potentially damaging way.

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What is abuse in a therapeutic setting?  

A therapist's job is to provide professional care to clients seeking emotional support and guidance about mental health-related concerns. However, not all therapists uphold the professional relationship they are expected to maintain with their clients. These therapists may take advantage of a client's trust to make sexual advances, exploit the individual financially, violate secrecy, or act in abusive ways. 

The American Psychological Association (APA) outlines ethical guidelines for all therapists to practice. One of these guidelines is not to cause undue harm to a client. Abusive dynamics can cause harm and may be a reason for a therapist to lose their license to practice. 

Abusive therapists can further traumatize individuals who may already be vulnerable. Abusive treatment may exacerbate symptoms of a mental illness like depression or post-traumatic stress disorder (PTSD) and erode the client's trust in the effectiveness of therapy. If you're concerned about the possibility of your therapist acting unethically, stop attending sessions and report them to their state board.  

Warning signs of abuse in therapy

Therapist abuse may occur gradually, and it may be challenging to recognize if you have not seen another therapist before. The following are potential warning signs to be aware of if you feel your mental health provider is abusing the therapeutic relationship.

Shaming or blaming you 

A therapist is often chosen as a source of support for individuals experiencing mental health concerns or life challenges, which can put them in a vulnerable state. If a therapist passes judgment or places blame on a client who turns to them for help, it may be a warning or one of the signs of a bad therapist, or an unhealthy dynamic. As a mental health specialist, a therapist must often be an empathetic, professional, and understanding provider for their clients. Judgment and shame may further harm a sensitive client.   

Unhealthy behaviors from a therapist may build up and become more apparent over time. If you believe your therapist may be abusive, consider how you feel while working with them. Do you feel safe? Do you feel your therapist is someone you can trust and confide in, even when discussing uncomfortable topics? Do you feel heard? If one of your answers doesn't feel right, your provider may be acting in a potentially harmful manner.

Financial exploitation

Unhealthy therapists might use their position to benefit themselves financially to the detriment of their clients. Financial exploitation may happen in several ways, including overcharging their services, asking for payment for services not provided, or stealing financial information. If your therapist changes the terms of their payment structure or you notice that you're being charged more than you were previously, consider broaching the subject with them. 

Talking about other clients

Revealing personally identifying information or sensitive topics about another client can violate declaration agreements. Therapists often have discreet agreements they must follow, which can be violated if they discuss other clients with you or anyone else.

Speaking about clients with others breaches the trust in a therapeutic relationship. If a therapist reveals other clients' profiles, you may wonder whether they're also divulging information about you. If you have a therapist who engages in this conduct, you can report their behavior to the proper authority, a licensing board, or another governing entity. 

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Sexual advances

Romantic advances or sexual attention are against the codes of conduct for mental health professionals, whether the interaction is consensual. For example, the ACA Code of Ethics prohibits sexual or romantic counselor-client relationships or interactions. Sexual harassment from therapists may be progressive. If your therapist seems to be increasingly interested in details of intimacy or other topics that are sexual in nature, it could be a warning sign. 

The professional dynamic should remain intact for clients to have the best opportunity to heal, improve, and achieve the desired results from counseling. If your provider is overly inquisitive about your sexual history or fantasies, makes inappropriate physical contact, or suggests forms of treatment that include touching or intimacy, end the relationship and consider reporting them to the board. 

If you are sexually or romantically interested in your therapist, it may benefit you to find a new provider. Being interested in your therapist may take away from your ability to connect on a professional level.  

Adverse impacts after sessions

Many people seek therapy to overcome obstacles or manage mental health concerns. If you're noticing adverse impacts you hadn't experienced before therapy, such as anxious thoughts or feelings after sessions with your counselor, your therapist may not be practicing appropriately. If you experience negative feelings or find your symptoms worsen after a counseling session, consider how your therapist treated you in therapy. 

Therapy can sometimes be challenging, and uncomfortable emotions and memories may be brought up. Differentiate these areas from your therapist and determine the underlying cause. Ask yourself if you feel upset because of a challenging topic discussed or because of your therapist's behavior. Taking note of what happens after your sessions with a therapist may help you understand and identify your feelings. However, if you don't feel safe and find yourself questioning your sessions often, it may be beneficial to find a new provider, even if your therapist isn't acting abusively or unethically. 

A final word on abuse in therapy

Abuse in therapy can affect an individual emotionally, psychologically, and physically. If you or someone you know is experiencing abuse from a counselor, know that help is available. You can terminate therapy at any time without letting the therapist know and report the professional to their state board so that your complaint is on the record. If the therapist has a pattern or specific proof is shown, they may lose their license. 

Note, however, that many providers practice ethically and professionally. A therapist can provide you with comprehensive, empathetic support and guidance so that you can address mental health-related concerns and life challenges.

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Healthy counseling options 

If you have experienced a negative relationship with a therapist in the past, it may be scary to reach out to a new provider. However, many therapists offer healthy, ethical practices. Because having a sexual abuse counseling session with them helps you feel validated and comfortable expressing your emotions. If you're worried about your boundaries being crossed, you might feel safer re-entering therapy through a distant option like remote online therapy. Through this type of counseling, you can choose whether you partake in phone, video, or live chat sessions. 

Online therapy can be a valuable tool, with studies suggesting that it can be as effective in treating various mental health conditions as face-to-face therapy. A study conducted by the University of Zurich found that online therapy can be more effective than in-person therapy in the medium and long term. Researchers found that participants continued to experience improvement far into treatment and several months post-treatment. 

Specifically, three months post-treatment, 57% of online clients continued to experience a decline in their depression symptoms compared to just 42% of in-person therapy clients.

Online therapy may be effective if you feel you could benefit from working with a counselor. 

Online therapy platforms like BetterHelp can match you with a professional therapist that best suits your needs. BetterHelp has a thorough vetting system for providers that includes cross-referencing credentials, interviews, and thorough criteria for acceptance. Understanding this, you may feel safer signing up to meet with a new provider.  

Therapist reviews

“I have found great healing from Cecilia's support and guidance. Her kindness, patience, acceptance, intuition, nurturing spirit, and ability to listen well have been great catalysts in my desire for deep growth and change. I have had bad experiences in the past with therapy and was very nervous to start. I am so grateful that BetterHelp paired me with her. She has completely changed my view of how therapy should look. I have a long way to go but am much less intimidated by the process now. If you have any fear towards the difficult process of growth and healing, I recommend her!”

“Daniel is wonderful. I have tried in-person therapy before and have never been successful. Daniel gets to know who he is talking to and how to best help them with what they are going through. I appreciate his sense of humor because that is how I communicate. My review here doesn’t do him justice. I am thankful to have him as my counselor.”

Takeaway

An individual's ability to trust their mental health professional can be vital to the therapeutic process. If a therapist violates that trust, they may exacerbate symptoms of mental health conditions and erode the individual's confidence in mental healthcare. If you're ready to reach out to a new provider, consider contacting a therapist online or in person to gain further empathetic support. You're not alone, and professional treatment is available. 

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