People wonder if what they see happening with a family member or friend, or what they are experiencing themselves with a therapist is professionally appropriate. It’s disheartening when the behaviors people ask about are what we call “red flags.”
She asked, “Do people really talk to you?” I took a brief second to collect my thoughts, and responded with an enthusiastic “Yes, people do talk talk to me.” With the elevator still moving to her designated floor, she asked her next question, “Why?”
Where’s the ethical line between effective networking and subtle manipulation for psychotherapists? What's ethical in promoting our professional services? When the emotional connection is already there in a non-therapy context, is it ethical to use it-or is that manipulation?
Clients can ask questions that catch us off guard like, "Can I have a ....?" "Could you help me with ....?" of "Do you have some .... ?" How might we respond ethically and what did we do to prompt these questions?
The therapist has the professional responsibility to keep the client’s well-being as the primary focus of the relationship. When a psychotherapist loses sight of this responsibility, a boundary lapse is likely to happen
The process of ending psychotherapy is a relatively neglected topic. Therapists might miss some obvious signs that psychotherapy should end and clients might not be sure of how to bring up the topic. We provide two reasons for ending therapy and suggest exiting strategies for clients if they aren't sure how to bring up the issue.
The good news is that most psychotherapy has good outcomes. The not-so-good news is that sometimes therapy doesn't work, or does harm. When therapy is not working, or when you think your therapist is behaving unprofessionally, it's OK to "fire" them and look for another therapist.
Good therapy takes hard work by the client and therapist and getting better through therapy doesn't always mean feeling good right at the start. Psychotherapy is rarely a smooth process. Like the stock market, it will have some ups and some downs. But one thing is always necessary-a therapeutic relationship that feels safe for the client.
On more than one occasion, we have been asked the question, "What should I look for when I shop for a psychotherapist?" Based on our experience and reading, we have developed a list of issues or criteria for our colleagues, friends, and acquaintances to consider. The list includes "green flags" (professional behaviors and attitudes that prospective or current clients should expect from a psychotherapist) and "red flags" (professional behaviors and attitudes that prospective or current clients should take note of and either not hire the professional or strongly consider ending therapy at the next session).
It's easy to see psychotherapists who behave unprofessionally as mean people. But very often they don't mean to be unethical. Sometimes they get caught on a "slippery slope." We've all seen situation comedies where a person tells a small lie, but then has to tell bigger and bigger ones and finally is caught in the web. Sometimes unethical behavior is like that.