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Something Doesn’t Feel Right

Good therapy sets clear boundaries and establishes respect between a therapist and patient. When therapy doesn’t feel quite right, it may seem impossible to separate natural instincts from the underlying issues being confronted during treatment— especially if the therapist is using manipulation tactics. The list below provides examples of behaviors that could indicate inappropriate treatment. Checklist excerpted from: Is There Something Wrong or Questionable in Your Treatment? By Estelle Disch, Ph.D., BASTA! Boston Associates to Stop Treatment Abuse, Copyright 1990, 1992 with permission from author.

Link to original PDF

Inappropriate Business Practices

• Therapist has discounted my rate as a favor to me
• Therapist expects me to bring them food or gifts in exchange for treatment
• Therapist is billing my insurance for sessions that never took place
• Therapist is billing my insurance under a different practitioner’s license/name
• Sessions frequently run significantly over or under the agreed-upon time
• Therapist prefers to book my session as the final appointment of the day
• Therapist requires me to pay in cash or write checks out to cash without providing a receipt
• I owe my therapist a substantial amount of money
• Therapist often answers phone calls during my sessions
• Therapist invites me to conduct sessions in a restaurant or during a meal
  

Dependency, Isolation and Goal Derailment

• Therapist encourages me to distance myself from close relationships
• Therapist encourages me to book extra sessions I don’t feel I need or can afford
• Therapist invites me to call or text him outside of treatment
• Therapist often shares personal stories that do not relate to my treatment
• Therapist accommodates my frequent schedule changes/cancellations without addressing them
• Therapist encourages me to quit school
• Therapist discourages me from advancing my career or education
• Therapist offers treatment for no charge (free)
• Therapist suggests what clothing I should wear or buys me clothing
• Therapist discourages me from discussing treatment with anyone
• I’ve suggested consulting a second therapist about my treatment, and my therapist insists against it
• Therapist spends time/offers to spend time with me outside of treatment
• Therapist understands me better than anyone in my entire life
• Therapist regularly reminds me that they are the only person who truly cares about me or understands me
  

Inappropriate Social Conduct

• I have attended parties with my therapist or traveled in the same social circles
• My therapist invites me to social events
• I have invited my therapist to events which they attended
• My therapist and I attend the same AA or Al-Anon (or equivalent) meetings
• My therapist drives me places, or I drive my therapist places
• I have spent the night at my therapist’s house/office
• I have socially interacted with my therapist’s family/friends
• I am/have been involved with one or more members of my therapist’s family/friend circle
• My therapist and I have close friends in common
• Therapist implied that we remain friends after treatment is over
• Therapist drinks alcohol or takes drugs with me
• Therapist has given me illegal drugs or drugs without a prescription
• I have seen my therapist nude or partially clothed
• I have access to my therapist’s personal information from mutual friends or colleagues
• We have never discussed how social contact outside of treatment might affect our professional relationship
  

Inappropriate Client Ideation

• Therapist tells me I am their favorite client
• Therapist discusses other clients with me or in my presence
• Therapist tells me they have never met anyone like me before
• Therapist gives me gifts and tells me how important I am to them
• Therapist discusses other clients in a way that makes me feel important/trusted/special
  

Cult Themes

• Therapist has many clients who have a close relationship with them, and I have met or heard about them
• Therapist enjoys fostering a sense of family and community among clients, which I have taken part in
• There are parties/gatherings at my therapist’s home, which I have attended
• Therapist takes former/current clients on as trainees at their training/education/healing institute
• Therapist acts as leader/guru for their clients and has a vision of how the world should be. Therapist is trying to develop a community of clients to participate in this community
• I have been involved in the planning process for my therapist’s community/vision
• Therapist talks openly about other clients I know without respect for their right to confidentiality
• Ritualized group activities such as ceremonies were part of my relationship with my therapist and their community
• Ritualized or sadistic activity is performed in the presence of others
• I have been involved in ritualized or sadistic activity with my therapist
  

Mind Control

• Therapist uses hypnosis as part of treatment without explanation
• I feel hypnotized or in a trance-like state in the presence of my therapist, though they don’t claim to use hypnosis
• My therapist has made hypnotic suggestions that I am uncomfortable with
• After treatment, I began to recall things my therapist said or did while I was in a trance-like state, which feels uncomfortable or abusive
• My therapist suggested I commit suicide
• Therapist failed to take my suicidal feelings seriously or implied I might be better off dead
• Therapist has made me feel dependent on them and tries to convince me to do things I am uncomfortable with
• Therapist has insulted important aspects of my life
• My life felt more chaotic after the start of treatment, and my therapist never seemed concerned
• Sometimes I feel/have felt drugged after sessions
  

Sexual Misconduct

• Therapist engaged (with or without force) in sexual contact such as: kissing of the mouth, breasts, genitals; sexual hugs (prolonged full-body hugs, pelvic thrusts, obvious erections); partial or complete disrobing for the purpose of sexual contact; fondling of breasts or genitals (with or without clothing); masturbation; oral sex; vaginal or anal intercourse; use of sex toys; sexual activity while I was drugged or sexual activity against my will
• Therapist suggested or initiated sexual activity under the condition that I keep it a secret
• After our sexual relationship ended, my therapist threatened to expose embarrassing parts of my psychological history if I told anyone or filed a complaint with authorities or the licensing board
• Therapist claims that if I don’t work on my repressed sexuality by engaging in sexual acts with them, I will never get better
  

Inappropriate Seductive Language and Nonverbal Interaction

• Therapist makes suggesting remarks like “If I’d known you back then, we’d have made a great couple.”
• Therapist compliments my body
• Therapist tells me I’m sexually attractive
• Therapist tells me they want to have an affair with me
• Therapist appears to have a voyeuristic interest in my sex life
• Therapist mails/emails/texts profession of their love for me
• Therapist provides me with sex toys to use at home and tells me how to use them/asks for details on how I’ve used them
• Therapist suggests how I can make myself more sexually attractive
• The way my therapist looks at me makes me uncomfortable/seems voyeuristic
• After treatment ended, my therapist asked me out on a date
• A short time after treatment ended, I began a sexual relationship with my former therapist
  

Inappropriate Treatment Process

• Therapist shares their problems and allows me to offer advice
• Therapist talks a lot about their life/personal experience, and I don’t understand the relevance for my treatment
• Therapist seems to free associate their experiences with what I say, and I feel my issues are not being addressed
• Therapist acts like they know what is best for me without asking me
• Therapist is cold/distant/rigid
• Therapist gets angry and sometimes yells at me
• Therapist interprets issues that happen between us as transference, even when I’m sure they had an apparent effect on my feelings
• Since starting treatment, I feel worse, and my therapist doesn’t seem concerned or explain why it is happening
• Rather than being concerned about my diminishing quality of life after treatment, my therapist seems more interested I remain dependent on them
• I’ve felt suicidal since starting treatment, and my therapist doesn’t appear concerned
• Therapist is hostile or sadistic
• Therapist appears to enjoy my pain
• Therapist insults me/ tears me down
• Therapist threatens that if I don’t do what they say, I will never get better, and it feels wrong
• Therapist diminished the seriousness of a prior abusive therapist
• Therapist is close with one or more members of my family
• Therapist and I are colleagues or peers in a work setting
• Therapist and I are engaged in a joint business venture
  

Conflicting Dual Roles

• Therapist is my clinical supervisor or vice versa
• I work for my therapist
• I work for my therapist in exchange for treatment
• Therapist is/was my teacher, dissertation advisor, etc.
• Therapist and I are friends outside of treatment
• Therapist is a relative of mine