Many hurdles can stand in the way of finding a therapist, including cost, your schedule, navigating insurance and a therapist's availability. And it's not only logistics: There's compatibility, too.
"What we know from current research is that the therapeutic relationship is one of the biggest factors for therapy being effective," says Jenna Brownfield, PhD, a licensed psychologist who specializes in supporting queer and trans clients.
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Given the deep intimacy of the therapeutic relationship, it's no wonder a good fit is so important. During therapy, you "allow a complete stranger to hear about the darkest areas of your life," says Raafat Girgis, MD, triple board-certified psychiatrist and medical director at Moment of Clarity rehab center.
That means, you'll want to make sure your therapist has the experience and ability to offer you help — and is someone you feel comfortable with. "You should not feel obligated to continue therapy if it's a poor fit. In fact, you may be delaying your progress in therapy by doing so," Brownfield says.
Here, mental health professionals share some tip-offs that a therapist isn't the right fit, along with signs that your therapist-client relationship is healthy and effective.
8 Therapist Red Flags to Look Out For
1. They Lack Courtesy and Professionalism
Sometimes, it's obvious when a therapist is not right for you.
Elise Oras, who lives in Raleigh, North Carolina, recalls an appointment with a therapist recommended by a friend that went very wrong. "During the 50 minutes of our second session, she picked up her phone three times. First was her contractor (a house remodel, I guess), once for her lunch order and once for her child. Of our 50 minutes, she spent 20 on the phone, not to mention the interruptions."
Time management matters, Dr. Girgis says. Barring an emergency, your therapist should stay focused on you during your session (and not pick up the phone). Frequent cancelations — especially without warning — are also unprofessional.
It's also reasonable to expect that your sessions will take place in a comfortable setting, with access to bathrooms, Dr. Girgis says.
Here's another reasonable expectation: Your therapist should pronounce and spell your name correctly. Seems easy enough but Christine C. from Brooklyn, New York "tried online therapy and they spelled my name wrong out the gate."
2. Your Gut Says "No"
"When we first meet people, we often have an instant opinion," Dr. Girgis says.
Of course, over time, opinions can shift a lot, as you've probably learned with friends, coworkers and acquaintances. But if you have "a persistent feeling of discomfort or unease during sessions," that can be a sign the therapist isn't the right fit for you, says psychiatrist Ryan Sultan, MD, assistant professor of clinical psychiatry at Columbia Irving Medical Center and medical director of Integrative Psych.
You should feel comfortable talking to your therapist, Dr. Girgis says. "It is their job," he adds. That means they should make direct eye contact and be good listeners, which are traits that help build trust.
3. They’re Bored
"I had a therapist fall asleep while I was talking. I'm still bitter," recalls Laura R. in Brooklyn, New York.
Listening is a core component of a therapist's job, but it's not just about hearing your words — it's also about being an engaged listener. It's hard to imagine feeling ready to open up and go deep with someone who's yawning.
"If I meet a person that does not seem interested in what I have to say this is a HUGE tip[off] that we are not going to be a fit," Dr. Girgis says.
4. You’re Censoring Yourself
Therapy is a place to open up.
"If you feel like you have to censor yourself or hide parts of yourself from your therapist, especially after you've given it several sessions, this may be indicative of it not being a good fit," Brownfield says.
If after several sessions in, you feel like you're still not connecting, or the therapist doesn't fundamentally understand you, consider it a potential red flag, Brownfield says.
There's a chance, of course, that you're mistaken, and that your therapist does understand you — or could grow to. But you should feel "confident in your therapist's ability to guide you," Dr. Sultan points out. If you don't, it's hard for the process to work.
5. Your Identity Is Invalidated, Ignored or Overemphasized
Finding a therapist can be particularly challenging if you're LGBTQ+.
Some therapists can invalidate your identity, Brownfield points out. "This could mean the therapist misgenders you, makes statements about your identity "just being a phase" or makes assumptions about your identities," she says.
Bad therapy experiences can also involve an overemphasis of your LGBTQ+ identity, or the reverse: ignoring it entirely, Brownfield says. "This silence can be very telling for queer and trans folks," she adds.
The ideal situation is a therapist who will affirm your identity, and "can balance talking about your identity alongside talking about your present mental health concerns," Brownfield says.
6. You Feel Judged
While a therapist is not there to automatically agree with your every thought, feeling and reaction, it's a bad sign if you consistently "[feel] judged or invalidated by your therapist," Dr. Sultan says.
That's what happened to Oras, whose therapist took several phone calls during her second session. "I didn't think I should have to pay for the session because she ignored me for almost half of it," she recalls.
After discussion, she and her therapist agreed on a complimentary third session. But once there, the therapist "started the session by saying that she wanted to talk about my sensitivity to money, and needing attention, and [said that] I was hypersensitive and lacked empathy," Oras says.
Needless to say, Oras did not return for a fourth session.
7. They’re Unlicensed, Inappropriate or Unethical
"When seeking a therapist, make sure they are licensed and have a clean history in the area of mental health treatment," Dr. Girgis says. Licensed professionals have a code of standards and ethics to follow, such as maintaining confidentiality.
Any type of proposition — be it romantic, financial or otherwise — is inappropriate.
"Another form of an inappropriate therapist relationship is one that is threatening and uncomfortable for the client," Dr. Girgis adds.
8. You’re Just Not Getting Anywhere
Therapy is a process, and can take time. Still, there should be some feeling of momentum. One sign of a poor fit is "a lack of progress despite several sessions," Dr. Sultan says.
In order to make progress, you and your therapist need to have a clear sense of your short- and long-term treatment goals. If you're unclear about these goals, speak up!
And, if over time, you begin to "[doubt] your therapist's competence or expertise in the area you need help with" consider moving on, Dr. Sultan says. Therapists often specialize; that means one therapist might be the right fit if you have anxiety, but another is best if you're having relationship issues.
It's a good idea to ask a therapist about their speciality during your first introductory session, to see if they're right for you.
What to Expect in an Effective Relationship With a Therapist
When you start therapy, it helps to know the red flags — like being stood up or not making any progress — but it's also helpful to have a sense of what a therapeutic relationship looks like when it's working successfully. Here are some green lights to keep in mind:
- Your therapist pays attention: They should be engaged, not distracted, says Brownfield. "They remember who you are and remember your story."
- Their communication skills are strong: You should understand both the short- and long-term goals of your treatment plan, Dr. Girgis says. And your therapist should offer "a back-up plan for you when you are in crisis or when they are not available," he says.
- You trust your therapist, and feel comfortable sharing: It's a good sign if you feel like your therapist gets you, and you're comfortable being honest, Brownfield says.
- Your therapist offers insights: Keep in mind counselors aren't miracle workers, Dr. Girgis says. But through listening to you closely, they can help steer you toward solutions and changes. They can also help you "find coping skills to manage your feelings and communicate more effectively," he says.
- You feel like you're moving forward — even though sometimes it's hard: You should see progress "even if it's slow, in the areas you are seeking help," Dr. Sultan says. But know that the process won't necessarily be smooth or easy. "While therapy should offer comfort, its primary goal is not just to make you feel good in the moment. Effective therapy should challenge you, prompting introspection and growth," Dr. Sultan says.
That last bullet point is worth expanding on: During therapy, uncomfortable emotions and memories may bubble up to the surface. It's not always pleasant, and it can be tricky sometimes to distinguish between natural therapeutic challenges and a therapist who is a poor fit.
If you're uncertain, it can be helpful to consider your connection with your therapist, Brownfield says. "If you feel like your therapist doesn't get you, isn't trying to understand you or you feel alone during the hard parts of sessions, it may be a sign that it's a poor fit and not the therapy itself," she says.
When It’s Time to End a Relationship With a Therapist
If you've encountered some red flags with your therapist, should you end the relationship right away? Maybe.
"If you've been working together for a very short amount of time, or if the therapist has been dismissive of you, ending the relationship sooner (via email or phone call) may be fitting," Brownfield says. That is, there's no reason to stick around if your therapist takes non-emergency calls or acts inappropriately during your time.
But if you're in doubt, our experts recommend giving it some time.
"I always suggest three sessions before calling it quits," Dr. Girgis says.
With time, a first impression might shift, and you can move from the introductory phase into a working phase, Brownfield says.
And, before you stop therapy, consider communicating with your therapist: If you do feel "unheard, misunderstood or uncomfortable with your therapist, tell them," Dr. Sultan recommends. This will give them a chance to adjust, he says. "In therapy, rapport is foundational," he adds.
But, of course, if the adjustment doesn't make a difference, that's a cue to part ways.
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