Get help with counselling concerns
In therapy and have concerns?

Although most people’s experiences of counselling and psychotherapy are good and helpful, sometimes things can go wrong. 

Perhaps something just doesn’t seem right about your therapy, or you’re not sure what you’re experiencing in your therapy session is usual. Maybe your therapist behaves or speaks in a way that feels uncomfortable to you. Or you may think your therapist has behaved unethically and you don’t know what you can do about it.

If you feel awkward about raising your concerns with your therapist, BACP's Get help with counselling concerns service can provide information, guidance or reassurance. We will help you make sense of what you think has gone wrong and discuss what to do next.

Contracting

Making a contract is necessary to ensure good working relations.

What should a contract include?

You have the right to know the conditions of counselling, such as:

• time, length and location of the counselling sessions
• fees and terms of payment
• number of sessions
• cancellation and record-keeping policies

The therapist should also tell you about:

• the theoretical approach underlying their counselling process
• goals (by clarifying your goals, practitioners can assess whether they are competent to provide the therapeutic service you require)
• limits to confidentiality
• any contact between sessions

Can I contact my therapist between sessions?

Contact between sessions is usually only for arranging appointments, but some counsellors and clients may agree ways of working that include additional contact to provide the client with extra support for brief periods. This should be discussed and agreed at the start of therapy and ideally stated within the contract

My therapist wants to charge me for a missed or cancelled appointment even though I’ve given them notice. Is this right?

Therapists will usually specify a notice period but, regardless of this, they should discuss fees at the initial contracting stage before you start therapy. This should also include arrangements for missed sessions and holidays. This means you are fully informed and agree with what is being offered before therapy even starts and can make an informed decision whether to work with that therapist. Contracts should preferably be written and therapy shouldn’t begin until a contract has been agreed.

My therapist stopped seeing me without any warning? Is that ok?

Ending therapy abruptly without any warning would not be considered best practice in most instances.

Whether you're entering into short or long term therapy, the ending should not come as a surprise but should be planned, discussed and agreed between you both. Your therapist should be aware that endings can be difficult, so they will start talking about the end of therapy several sessions before it is due. They may even discuss it at the start. For example, with short term therapy this can be at the very beginning, with a planned beginning, middle and ending explained in the first session.

Addressing the end of therapy early on means you have time to get used to the idea and that any anxiety or new problems that arise can be dealt with in the remaining sessions.

Notes and record keeping

Will my therapist keep notes of our sessions?

Current practice varies. Although there’s no legal requirement for therapists to take notes, there’s a growing expectation that therapy records should be kept, and most therapists do. Some may write quite in-depth notes and others just short memory aids.

Good practice is that the therapist tells you about their note taking at the start of therapy, gets your consent and lets you know what happens to those records and who might see them.

Counsellors who are employed by an organisation should follow that organisation’s policy regarding record keeping and retention. If working privately, they can make their own policy but need to take data protection law and their membership body’s ethical codes into account.

How can I get a copy of my notes?

You can ask your therapist for a copy of your notes. If they’re not forthcoming, you can contact the Information Commissioners Office (ICO) to discuss getting a copy of your notes through a data subject access request. The ICO gives independent advice and guidance about data protection and freedom of information.

You can contact the ICO helpline on 0303 123 1113 or 01625 545745 from between 9am to 5pm, Monday to Friday. Or see Your right of access.

Who can see my notes?

If you're seeing a therapist via an organisation, your therapist’s line manager could see your notes as part of their management role, but this should be explained at the start of therapy.

• Couples counselling
  Both clients are part of the contract and, if one client wants a copy of the notes, they can only ask for the parts relating to them unless the second client gives consent. If one partner does not consent, all information relating to them must be redacted.
• Children
  Under data protection law, a child with capacity to make their own decisions has a right to see their own records. If the child does not have this capacity, those with parental responsibility have the right to make decisions relevant to therapy and to see the child’s therapy records. (There are exceptions which allow the therapist or school to maintain secrecy to safeguard the health or safety of the child or others, or to safeguard a police or other investigation in the context of child protection.)
• Police
  The police will sometimes ask therapists for access to their records in connection with ongoing investigations. The police do not have the right to access therapeutic records without a warrant issued by a judge.

Confidentiality

Will my therapist ever breach my confidentiality?

The boundaries regarding confidentiality should be explained clearly to you at the start of therapy and discussed at any time if you want clarification. There are only a few situations when a therapist may find it necessary to pass on information about you to another person, and this will only be to another professional for a legitimate reason.

Examples of situations when this might occur are:

• when the law requires it
• when you or another person are at risk of harm
• therapists talking to their professional supervisors about their therapeutic work
• referring you to another professional for help, or sharing basic information relating to health with a health professional involved in your care

It's important that the therapist talks to you initially about their concerns, unless the law expressly forbids it.

Introduction to counselling and psychotherapy (pdf 260KB)

What do counsellors and psychotherapists mean by boundaries? (pdf 140KB)

What happens when therapy goes wrong? (pdf 169KB)

Ending therapy (pdf 218KB)

Your relationship with your therapist

I feel that sometimes my therapist is judging me, my lifestyle, my family and my friends. Is this OK?

Therapists should remain impartial rather than judging you or imposing their values. They should aim to be impartial and express warmth and empathy to help you talk openly about your feelings and emotions. They should also be non-judgmental (not judging what you disclose about yourself, your attitudes or behaviours), fair, open and trustworthy to enable a respectful working relationship to develop between you.

What are professional boundaries?

Therapists must protect clients from psychological harm and boundaries enable you to experience the therapy relationship in formal way, rather than as confiding in a friend or having a conversation with a stranger. Boundaries maintain clear standards and, if respected, protect you from poor or unethical practice. Setting up, monitoring, explaining and maintaining boundaries are the responsibility of the therapist and should be made clear at the beginning of therapy.

My therapist hugged me at the end of our first session? Is it ok for me to hug my therapist?

Hugging can happen within therapy, but it shouldn’t be a spontaneous action. Therapists should discuss this carefully with their supervisor because it can change the dynamics of the counselling relationship and your expectations.

I want to be friends with my therapist after therapy has ended. Is this ok?

Some believe a therapist can never change the power imbalance that comes with a therapeutic relationship and professional boundaries should be maintained after therapy ends as well as during. If a therapist decides to become friends (or have an even closer relationship) with a client then almost inevitably something will go wrong. The therapist may then be held responsible for not preventing harm to the client.

The therapist is the professional and should maintain professional boundaries to avoid harm to the client. They should work towards empowering the client to be independent.

I want to end therapy, but my therapist wants us to continue. What should I do?

The decision to end therapy would ideally be made together with your therapist. However, ultimately it is your decision and you shouldn’t feel forced to remain in therapy against your wishes. You have the right to decide when to stop as well as the right to look for another therapist at any time.

My therapist has done something that I’m not sure is right. I think a professional boundary has been crossed, but I’m unsure. What should I do now?

If you feel uncomfortable with anything that has happened in the session, it’s important you try to speak with your therapist about your concerns as giving feedback can often help therapy move forward. Your therapist should encourage, and allow time for, you to give regular feedback about what aspects of the therapy have been helpful and what have not. This should help issues to be dealt with when they arise.

I would like to make a complaint about the unethical practice of my therapist. How do I do this?

Please see How to complain about a BACP member for details.