Just this past month, New England newspaper The Daily News reported that former Fox commentator, best-selling author, and renowned psychiatrist Dr. Keith Ablow has had his medical license indefinitely suspended by the Massachusetts Board of Registration in Medicine for sexual misconduct with three female patients who saw him for treatment of depression.

I’m a big believer in the power of psychotherapy and proudly confess that I’ve been on the other side of the couch on more than one occasion. I’ve been lucky to have a few well-trained, ethical and compassionate therapists that really helped me see my way out of a few tough spots in my life. Of course, being a psychologist, I’ve had the luxury of getting referrals from mental health professionals I respect. Unfortunately, a lot of people have to rely on the luck of the draw – they get a list of names from their insurance company and start dialing, or they do a google or yelp search for a nearby shrink. For many, this strategy works out or, at the very least, they get better with time.

But an unfortunate few make their way into a therapist’s office who is not only unable to help, but makes things worse. Therapists are human beings and even the best can make a mistake; in fact, a friend of mine said that it was when her therapist forgot a session and, when confronted about how upsetting that was to the client, sincerely apologized and took complete ownership of what happened, that she really started to trust her. However, all therapists are not good therapists and here are a few clues that it might be time to find another one:

  • They don’t pay attention. Yes, it’s true that you have one therapist and your therapist has multiple clients. However, while s/he may not remember every detail, s/he should remember key facts about you (your name, what brought you to therapy in the first place, issues you’re struggling with). Similarly, you deserve- and should expect – your therapist’s undivided attention during the session. If your therapist often disrupts the session by answering phone calls, eating, texting, or falling asleep, take your concerns elsewhere.
  • They over-share. Some therapists share tidbits of their lives with their clients in order to find common ground. A few, though, share too much about their own life, bragging about their accomplishments, drawing attention to themselves, or pulling you in to take care of them. Any disclosure a clinician makes should benefit you in some way – by being relevant to what you are talking about or helping to establish rapport.
  • You feel judged, criticized or emotionally unsafe. This includes anything disrespectful or condescending a therapist might say or do, such as rolling their eyes in response to your thoughts or opinions, dismissing someone’s culture or values, or treating you as inferior in subtle and not so subtle ways. Unfortunately, some therapists seem to hide their own problems by holding a magnifying glass to their clients. If your therapist spends more time diagnosing you than listening or empathizing, it’s time to take a second look at what you’re getting for your money.
  • They behave unethically. I was recently contacted by an anonymous reader of one of my blogs who said that her therapist had made numerous inappropriate comments to her during the course of their relationship (and included a list of them). I strongly encouraged her to contact the state licensing board; any sign that therapy is moving from a professional relationship to a sexualized one should be considered a bright red flag. But unethical behavior isn’t just sexual advances; I recently listened to a podcast called The Shrink Next Door in which a psychiatrist allegedly took over a client’s life for more than thirty years and took advantage of him in numerous ways. 

Good therapy can be wonderful, insightful, scary, uncomfortable and life-changing. It’s normal to sometimes disagree with your therapist and to be challenged (even anxious or irritated) by some of their feedback. Unless there’s been a serious breach of ethics (such as a sexual overture), it’s always good to talk with your therapist about your concerns about the relationship before dropping out; at the very least, it gives us a chance to practice open and honest communication. 

At the same time, anyone has the potential to abuse power. A therapist who fosters dependence instead of determination or self-doubt instead of self-reliance is not someone with your best interest at heart.