When we think about “bad therapy,” we often imagine dramatic ethical violations—like a therapist sleeping with a client or sharing confidential information. While those examples clearly fall into the realm of malpractice, bad therapy more often occurs in quieter, more insidious ways. It may not always make headlines or result in lawsuits, but it can still leave clients feeling confused, invalidated, or even harmed. So, what does bad therapy actually look like?
While therapy is a deeply personal experience and there is no one-size-fits-all formula, licensed psychologists and psychotherapists broadly agree on several red flags that point to ineffective—or even damaging—therapeutic practices. In this post, we’ll explore some of those red flags, distinguishing between a therapist who simply isn’t the right fit and one who may be engaging in clinically unsound or unethical behaviors.
Lack of Empathic Attunement
A core component of effective therapy is the therapist’s ability to empathize—to genuinely connect with and understand the client’s experience without judgment. Therapists who are cold, dismissive, or invalidating can cause more harm than good. In fact, research consistently shows that the quality of the therapeutic relationship is one of the strongest predictors of positive outcomes across all modalities (Wampold, 2015).
When a therapist is emotionally unavailable, interrupts often, or seems to be “phoning it in,” clients can feel unseen or unworthy. Over time, this can reinforce internalized shame or distrust of others—especially in clients with relational trauma.
Rigid or Inappropriate Use of Technique
Effective therapists are flexible and attuned to the needs of the person in front of them. Bad therapy often involves rigid adherence to a model or technique, regardless of its relevance to the client’s goals or emotional state.
For example, immediately jumping into exposure therapy for trauma without first building safety and trust can retraumatize a client. A meta-analysis by Cuijpers et al. (2019) found that while structured approaches like CBT can be highly effective, their success is largely dependent on proper timing and personalization. Therapy should never feel like a “one-size-fits-all” script.
Poor Boundaries and Self-Disclosure
Some level of therapist self-disclosure can help build rapport, but when a therapist frequently talks about themselves, shares personal problems, or blurs professional boundaries, the client may feel like they are emotionally caretaking the therapist rather than receiving care themselves.
Poor boundaries also include texting clients excessively, meeting outside of session without clinical justification, or making the therapeutic relationship feel like a friendship. These behaviors can lead to confusion, dependency, and a loss of therapeutic clarity.
Failure to Collaborate or Set Goals
Therapy should be a collaborative process—not a lecture, not a guessing game. If a therapist doesn’t invite the client to explore their goals, check in about progress, or reflect on what’s working and what’s not, the client can feel powerless or directionless.
According to the American Psychological Association’s guidelines for evidence-based practice, ongoing feedback and client collaboration are essential to effective treatment. Therapists who resist feedback or get defensive when challenged may prioritize their ego over the client’s wellbeing.
Ignoring Cultural Context
Another hallmark of bad therapy is the failure to consider a client’s cultural, racial, religious, or gender identity in treatment. Culturally incompetent therapists may make assumptions, dismiss the impact of systemic oppression, or lack the skills to navigate culturally sensitive topics.
Therapists are ethically obligated to seek training in multicultural competence, and failure to do so can lead to harm, especially for marginalized clients. As Wendt and Gone (2012) explain, ignoring a client’s cultural context can invalidate their lived experience and replicate the very dynamics that led them to seek therapy in the first place.
Imposing Personal Beliefs
Therapists are not life coaches, religious advisors, or parents. When a therapist imposes their own values—about relationships, religion, politics, or lifestyle—they cross a line. Good therapy helps clients explore and clarify their own beliefs, not adopt someone else’s.
Unwillingness to Refer Out
No therapist is the right fit for everyone. Ethical therapists recognize when they’re out of their depth—whether it’s a lack of expertise in a specific disorder, or the presence of complex trauma requiring specialized care. A bad therapist may avoid referring out due to pride, financial incentive, or lack of insight. But staying in a mismatched relationship can stall progress or exacerbate symptoms.
Conclusion
Bad therapy isn’t always dramatic. Sometimes, it looks like a client feeling worse after every session, doubting their own instincts, or feeling emotionally abandoned in the presence of another human being. While no therapist is perfect, there are widely accepted standards—empathy, collaboration, cultural humility, ethical boundaries—that separate effective care from harmful care.
If you’ve had a bad therapy experience, it’s not your fault. Finding a good therapist is like finding a good relationship—it takes time, self-advocacy, and a little luck. But when it works, the impact can be life-changing.
References
Cuijpers, P., Karyotaki, E., Weitz, E., Andersson, G., Hollon, S. D., van Straten, A., & Ebert, D. D. (2019). The effects of psychotherapies for major depression in adults on remission, recovery and improvement: A meta-analysis. Journal of Affective Disorders, 273, 455–464. https://doi.org/10.1016/j.jad.2018.10.019
Wampold, B. E. (2015). How important are the common factors in psychotherapy? An update. World Psychiatry, 14(3), 270–277. https://doi.org/10.1002/wps.20238
Wendt, D. C., & Gone, J. P. (2012). Urban American Indian community perspectives on resources and challenges for youth mental health services. Journal of Behavioral Health Services & Research, 39(1), 4–19. https://doi.org/10.1007/s11414-011-9241-z