Boundaries and Red Flags in Therapy

Yes—to a point, and with the understanding that they may not answer. Some therapists, particularly those who ascribe to a psychodynamic approach, aim to project a “blank slate” and may decline to answer personal questions out of concern it could interfere with the client’s progress. Cognitive behavioral therapists, on the other hand, may be more willing to answer reasonable personal questions if they determine it will help strengthen the therapeutic alliance. But knowing too much about a therapist’s life does have the potential to obstruct progress, so regardless of modality, good therapists will set firm boundaries and decline to answer questions that they deem too personal or irrelevant. If a client feels that their lack of knowledge about the therapist is a problem, they should bring it up; together, therapist and client can explore the feelings and possible solutions.

The therapeutic relationship requires trust, intimacy, and significant time together; as a result, some clients do develop romantic or sexual feelings for their therapist. When these feelings are usually mild, they likely won’t interfere with progress and may even spark increased disclosure, but when they’re intense or prolonged, they can cause shame or embarrassment for the client or distract from therapy itself. Clients should recognize that the therapist will not reciprocate their attraction—as any romantic or sexual behavior would be a fundamental ethical breach and perhaps result in the loss of their license—but that doesn’t mean it can’t be discussed.

Many clients (and therapists) avoid the subject of religion, either because they fear accidentally offending the other or because they assume it isn’t relevant to the therapeutic process. But studies have found that religious and spiritual beliefs are important to the emotional lives of many people and that they can play a significant role in mental health. Clients who wish to discuss religion with their therapists are encouraged to bring it up; even if the therapist does not share the client’s faith, they should be able to discuss its role in the client’s life in a non-judgmental way.

Many clients find themselves feeling curious about their therapist’s life beyond what is shared in session. Searching for the therapist online can satisfy some of this curiosity, but it can be a double-edged sword. On the one hand, it could help a client discover something he or she shares with the therapist, which could boost connection; it could also, in very rare cases, uncover information about a therapist that could protect the client from harm, or information that has been falsely planted by a disgruntled former client. Clients who have searched for their therapists online and feel uncomfortable about what they learned should bring this up in a session.

Even the best therapists aren’t perfect, and effective therapy won’t always be easy or pleasant. But unfortunately, there are some therapists who are unqualified or simply bad at their job. If a therapist talks excessively about themselves or overly discloses personal information, cannot accept constructive criticism, or refuses to discuss what the process will be like and what kind of progress can reasonably be expected, they are likely not the best choice for most clients. Other warning signs include: being judgmental or critical of the client’s choices or lifestyle, appearing bored or distracted during sessions, treating the client as emotionally or intellectually inferior, or seeming easily overwhelmed or upset by information the client discloses.

Though the focus of a therapy session should be on the patient, any therapist will need to talk from time to time. How much talking is acceptable varies, both by modality (a cognitive-behavioral therapist will likely talk more than a psychodynamic one, for instance) and by the client’s personal preference. If the therapist often goes on long monologues—particularly if they are personal in nature and not related to the client—interrupts, or appears unable to sit through silences of any length, they may be impeding progress. Conversely, if a therapist fails to ask useful or probing questions or to offer input, this, too, is a problem.

Clients sometimes misinterpret normal therapeutic interactions as flirtatious when they aren’t. But a very small number of therapists do cross lines in ways that are unethical. If a therapist touches a client excessively or inappropriately, is very focused on the client’s sex or dating life in ways that feel disconnected from the client’s primary concerns, or frequently comments on the client’s attractiveness, sex appeal, or body, it could be a sign that they are crossing professional boundaries and taking advantage of the client.

Clients should always speak up if they feel that their therapist is crossing boundaries; a competent, ethical therapist will take the concerns very seriously and be willing to address them. If the therapist is dismissive, rude, or threatens the client in some way, it is likely in the client’s best interest to terminate therapy. In cases where clear lines were crossed—the therapist attempting to kiss the client, for example, or giving graphic details about their own sex life—the client should report the therapist to his or her licensing board.

Many therapists use texting to schedule sessions with clients. But beyond that, professionals are divided as to whether it’s a good idea to text clients between sessions about issues that are bridged in therapy itself. Some therapists are open to occasional texts or calls from their clients outside of session, particularly if the client is feeling overwhelmed or particularly low. But others worry that such communication could interfere with the boundaries between the client’s life and the therapist’s, while some are concerned that if a client texts them while in a crisis, they won’t be able to respond in time. Clients should discuss texting with their therapist and whether (and when) it’s acceptable. If a client is in a true emergency, they should always call 911.