I recently read a non-fiction book about a colleague that was deeply chilling – though not, truth be told, terribly surprising. Of course, not every therapist is abusive, coercive, or amoral like the individual described in that book. And, on paper, this colleague looks perfectly fine. (Plus, oddly, I owe my return to writing to them.)
That book was the final straw (there have been many straws!). It spurred me to write this piece as my concern about public safety in therapy grows. Checklists: qualifications, accreditations, memberships, publications, are useful, but only to a point. What really matters is how you feel in someone’s presence. And, as with all relationships, it can take time to see what, or with whom, you’re really dealing.
At the very least, there are safeguards in place – systems designed to protect us.
What I’ve realised is that many people simply aren’t aware of those safeguards. And I believe that’s a collective failure on our part. We as therapists have not communicated clearly enough what therapy and supervision actually are, what accreditation means, what all the letters after a name signify – and why they matter.
With the current debacle around CORU standards and public safety concerns, it’s painfully clear that we’ve failed in that communication. Even some colleagues don’t seem to grasp the gravity of the situation we’re now facing when it comes to standards and public safety — some even dismissing it arrogantly as pearl-clutching hysteria. This is disappointing, and most concerning.
Anyway.. *takes breath
I’ve written before about how to choose a therapist and about red flags – do have a look at that piece if you’re currently searching for someone suitably qualified to work with. In the meantime, I’ve gathered some more red flags here, with a twist.
What follows are a few “if-then” scenarios. They may sound unrealistic. But I chose them very deliberately because, and this is the twist, these are things I’ve either observed, or things that have been reported to me by people I know. Friends. Clients.
They shouldn’t happen.
If you, or someone you care about, is looking for a therapist, please bear the following considerations in mind.
1. Title, training, and accreditation: what words really mean
- Anyone can call themselves a therapist. That doesn’t mean they are a psychotherapist. Counselling, coaching, and complementary approaches can be valuable, but they are not psychotherapy. If they call themselves a therapist, and promote themselves in a public or private forum saying that they “deal” with “X” or “Y” “all the time”, be wary.
- A psychotherapist should be accredited and transparent about with whom.
- If someone says they are an “accredited psychotherapist”, you are entitled to ask who accredits them. In Ireland, the main bodies are IAHIP, ICP, IACP, and IPTA.
- Saying one “abides by the ethics of IACP” does not mean they are a member. This genuinely happens. Check the register.
- Describing oneself as a “senior therapist” usually means very little unless it is a formal job title within an organisation such as the HSE.
- Psychotherapists do not diagnose conditions such as autism/ASD, ADHD, OCD, BPD, or psychosis. If they do, be cautious.
2. Supervision, accountability, and professional humility
- A psychotherapist should be in regular supervision, typically at least monthly. It is not rude to ask. It’s responsible.
- If someone says they are too experienced to need supervision, that is a red flag.
- Claims of having saved “countless lives” – directly or indirectly – via websites or testimonials should prompt caution.
- Testimonials themselves are ethically contentious and should be treated carefully.
3. Scope of practice and appropriate competence
- If a therapist agrees to work with your teenager without specific training in adolescent work, that’s a red flag.
- If they attempt to work outside their competence rather than refer on, be wary.
- If they try to sell you gadgets or dietary supplements instead of referring you to an appropriate professional, that’s a major boundary issue.
4. Ideology, certainty, and the misuse of labels
- Affirming a client’s dignity and worth is not the same as “affirmative therapy”.
If a therapist uses the label “affirmative” as a substitute for assessment, clinical reflection, formulation, ethical complexity or to avoid therapeutic curiosity that is a red flag. - If a therapist tells you what you should do (“I think you should…”, “Why didn’t you?!”), this signals undue authority rather than collaborative work. Therapy is collaboration.
- If a therapist attempts to convince you that your belief system – religious or otherwise – is wrong, this is inappropriate.
5. Boundaries, dual relationships, and conflicts of interest
- If you are offered reduced fees if you book several sessions in advance, this is not standard ethical practice.
- If your therapist says you really should attend weekly, (even though you’ve flagged affordability), because weekly is “the only way therapy can really bite”. (omg)
- Working with you on issues about someone they are also working with (for example, your mother) is a serious boundary violation.
- Asking to meet you socially – for coffee or a walk – is a red flag.
- Suggesting experiential “experiments” such as holding the therapist’s baby in the session to help you decide whether you want children is inappropriate.
- A therapist mocking or speaking ill of other therapists on public pages or groups is profoundly unprofessional and often illegal, and sadly, I’ve seen a surge in this outrageous behaviour over recent years.
6. Power, safety, and harm
- Flirting with or sexually coercing a client is abuse. Leave, immediately.
- Suggesting they meet your abuser to decide whether the abuse was “real” – or minimising it because they insisted on meeting the abuser who “seemed fine” to them – is profoundly unsafe.
- Breaking confidentiality to or about you is a serious ethical breach.
7. The therapeutic relationship itself
- Excessive self-disclosure, particularly early on (for example, telling you how similar their life story is to yours), is a red flag.
- Publicly mocking clients or certain presentations on social media is incompatible with ethical practice.
- Therapists are human: if something doesn’t sit right, it is important to name it.
- How a therapist responds to discomfort or rupture matters enormously. Repair can be deeply therapeutic. Dismissal or defensiveness is information – and another big wavy red flag.
Right, so, now that I’ve scared you…
Please know that my intent is not to encourage becoming suspicious or hyper-vigilant. For me this is about informed consent, choice, and safety.
Good therapy can be life-changing, containing, and profoundly healing. Most therapists are thoughtful, ethical people doing their best in a demanding profession.
But you are allowed to ask questions.
You are allowed to take your time.
And you are allowed to leave.
Your instincts matter. Therapy should never require you to override them.
Notes:
- Accreditation and membership: Irish Association for Counselling & Psychotherapy (IACP), Irish Association of Humanistic & Integrative Psychotherapy (IAHIP), Irish Council for Psychotherapy (ICP), Irish Psychoanalytic Therapy Association (IPTA). See IACP Register and IAHIP Register.
- Supervision requirements: “All psychotherapists must engage in regular supervision, typically at least monthly, to ensure ethical practice.” IACP Code of Ethics, IACP Ethics.
- Scope of practice / competence: “Counsellors and psychotherapists must work within the limits of their competence and refer clients elsewhere when necessary.” BACP Ethical Framework, BACP Ethics.
- Affirmative therapy vs affirming dignity: “Affirmative approaches should be evidence-based, reflective, and clinically appropriate. Labeling a service as ‘affirmative’ without assessment or ethical consideration may bypass professional standards.” APA Guidelines for Psychological Practice with LGBTQ+ Clients, APA Guidelines.
- Dual relationships & boundaries: “Therapists should avoid relationships with clients that could impair professional judgment or increase risk of harm.” ACA Code of Ethics, ACA Ethics.
- Power, safety, and abuse: “Any sexual interaction with clients is strictly prohibited and constitutes a violation of ethical standards.” APA Ethical Principles, APA Ethics.
- Use of testimonials: “Practitioners shall not use client testimonials in ways that risk exploitation, coercion, or breaches of confidentiality.” IACP Code of Ethics, IACP Ethics; see also UKCP, BACP guidance on client reviews/testimonials.
- Diagnosis and limits of practice: “Psychotherapists do not diagnose mental disorders; this is reserved for appropriately trained professionals such as psychiatrists or clinical psychologists.” IACP Code of Ethics, IACP Ethics.