Incompetent therapists: How to tell if your therapist isn’t up to standard

Therapy is often the bedrock of mental health treatment. In many cases, the relationship between a therapist and their client can significantly contribute to the client’s well-being. If you have been seeing your therapist for some time and aren't experiencing the improvements you'd hoped for, you may be wondering if your therapist is a fully competent professional.

When first starting treatment, it is not always cause for concern if you have trouble with your therapist, or if attending therapy initially makes you feel worse. At the start of therapy, you are likely challenging long-held attitudes and behaviors and potentially making big changes to your life, which can feel disruptive. However, these negative effects are generally short-lived. 

Keep reading to learn more about these behaviors and what to do if you come across them.

Inappropriate or sexual behavior

One of the most problematic red flags in interactions with a therapist is feeling like the therapist is taking advantage of you in some way. Therapy can be ineffective if you don't feel comfortable being completely open and vulnerable with your therapist, and it’s important that you feel safe during your sessions. Your counselor should not ever use their psychological understanding of you or the information you have discussed with them in confidence to manipulate you or your relationship with them.

The American Psychological Association (APA) has developed a code of ethics that all mental health professionals must adhere to. The code explicitly bans sexual relationships between therapists and their current clients and extends that ban to sexual relationships with a current client’s significant other, close relatives, or guardians, if applicable. 

Relatedly, the code of ethics prevents therapists from accepting a person as a patient if they have had a sexual relationship with that person in the past. If a therapist is interested in pursuing a sexual relationship with a former client, that relationship may be allowable under the ethics code, but only if more than two years have passed since the client has stopped seeking treatment from the therapist. Even in those circumstances, the therapist needs to prove that there is no possible exploitation of their former client. In short, sexual advances from your therapist are off-limits.

That is not to say that therapists are completely barred from touching their clients under any circumstances. Some therapeutic treatments, such as eye movement desensitization and reprocessing (EMDR)—a therapy used to treat post-traumatic stress disorder (PTSD)—may require a small amount of physical contact. Physical touch may be a source of comfort for many people during therapy sessions, which can elicit strong emotions. However, the physical touch in these circumstances should be limited to purely supportive contact, such as putting a hand on a client's shoulder or giving them a brief hug. 

Any therapist that makes you feel as though your trust in them is being taken advantage of in any form, but especially in a sexual manner, should be reported to their state licensing board. 

Behaving in a judgmental way

When you talk to a therapist, you should be able to describe your mental health, feelings, thoughts, actions, perspectives, goals, and life choices without the fear of being criticized or judged. Effective therapists take a nonjudgmental approach, providing their clients with validation, empathy, and advice. This approach can enable their clients to make positive life changes without the use of fear or shame as a motivator. 

It may be a sign of therapeutic incompetence if your therapist engages in any of the following forms of judgment during your sessions: 

• Using critical language to describe you, such as lazy, stupid, useless, etc.
• Expressing bias against any part of your identity, such as your race, ethnicity, gender, sexuality, religion, or other aspects of who you are
• Telling you that you are using your mental illness for attention or as an excuse to evade responsibilities or otherwise engage in poor behavior
• Pressuring you to talk about parts of your life or past that you don’t want to discuss or don't feel ready
• Making you feel as though you are a bad partner, spouse, friend, employee, parent, or person

Not listening to you

The foundation of talk therapy is just that—talking. Therapists need to let their clients talk and actively listen in order to understand the client's thoughts and experiences. Active listening includes:

• Appearing engaged by reacting to what is being said, such as nodding, changing facial expression, etc.
• Responding appropriately in a way that demonstrates one understands what was just stated (However, at times, therapists may use silence as a technique to encourage their clients to be more open)
• Repeating or rephrasing what was said to ensure both participants in the conversation are on the same page regarding what is being discussed
• Asking clarifying questions

As the therapeutic relationship progresses, your therapist may respond to what you say by discussing patterns they see in your thoughts, feelings, or actions, or mentioning any potential underlying meanings behind your words. Ideally, with a competent therapist, you should feel increasingly comfortable discussing more discreet and personal parts of your life and your mind as sessions continue—the more your therapist knows and understands you, the more you may be able to benefit from therapeutic treatment. 

Your therapist may not be practicing active listening and giving you the attention you deserve if they are engage in these practices:

• Not looking at you while you are talking
• Avoiding eye contact, sighing, checking their phone, or otherwise appearing disengaged
• Not understanding what you are saying or telling you that what you are saying doesn’t make sense
• Not attempt to better understand you through follow-up questions
• Changing the subject abruptly and unpredictably
• Being easily distracted, not present, or taking phone calls or physically leaving the room during sessions
• Frequently talking about their own life or always relating whatever you talk about back to themselves

That said, it's okay for therapists to talk about their own lives during a therapy session to a certain extent. Some therapists may intentionally talk about their experiences to show their clients an alternative perspective or to help their clients feel comfortable opening up. However, the majority of the therapy session should be about the client, and the client shouldn’t feel as though a role reversal is happening. 

Finding a competent therapist

If you are concerned about the competence level of your therapist, you may be considering finding a new one. Finding a new therapist can be a complicated process, especially if you've had negative experiences in the past. You may want to try out a few different counselors to ensure that this time, you find a therapist that works for you. 

Logistically speaking, it can be difficult to attend in-person sessions with multiple different therapists as you search for the right one. Online therapy may make the process of finding the right therapist for you easier. With an online therapy platform such as BetterHelp, you can have initial consultations with several different mental health care providers, all from the safety and comfort of your own home. If you decide on a therapist and later realize you would like to switch providers, you can do so with the click of a button.

The effectiveness of online therapy

Research has shown that online therapy may be as effective as in-person therapy in helping clients address mental health conditions, life challenges, and other concerns. One study found that an internet-based cognitive behavioral therapy (CBT) intervention helped reduce symptoms of mental health conditions, including bipolar disorder, depression, anxiety, post-traumatic stress disorder, mood disorders, phobias, and more. CBT is a type of therapeutic approach that teaches people how to recognize their automatic, unhelpful thought patterns and change them. Consistent use of CBT techniques can alter one’s unwanted behaviors and reduce the prevalence of mental health symptoms.