Danger Signs of an Exploitative Therapeutic Relationship

The Therapy Exploitation Link Line (TELL) describes the danger signs of a therapeutic process that is broken down and has moved towards exploitation of the client.  They offer a look at what a healthy therapeutic process looks like and some of the sign of when the boundaries have slipped.  But they also provide a complete list of what that relationship looks like when it has become seriously damaged: [1]

1. The therapist talks about his/her personal problems, including sexual relations with others.
2. The therapist makes sexual or suggestive jokes.
3. The therapist asks questions about your sex life when you are talking about an unrelated issue4.     The therapist suggests seeing you outside the office or professional setting (e.g., dinner, movies, home visit)
4. The therapist offers to cut fees, see you for extended session with or without fee, and wants to reschedule you to be the last patient of the day.
5. The therapist tells you not to talk about your therapy with anyone else, that therapy is a secret.
6. The therapist talks to you about his/her other patients.
7. The therapist tells you, explicitly or implicitly, to stay away from friends or family.
8. The therapist touches, fondles, hugs, or otherwise makes overt physical contact with you.
9. The therapist offers food, alcohol, or drugs.
10. The therapist gives you gifts or accepts them from you without discussion about their meaning.
11. The therapist suggests that you trust him/her absolutely.
12. The therapist asks you to work for him/her or solicits your advice on business, investing, or other area of your expertise.
13. The therapist requests detailed information on your finances
14. The therapist uses fines or other types of punishment for infraction of his/her imposed rules 
15. The therapist seeks to borrow money, your car, or other of your belongings.
16. The therapist shows up at your house or suggests that your house would be an appropriate place to meet.
17. The therapist tries to get you together socially or romantically with his/her other patients. 
18. The therapist threatens you in any way, such as the threat to tell others – including your family members – about you, to say that you’re crazy or to reveal confidences you have shared in the therapeutic context.  
19. The therapist promises to be your caretaker and/or to protect you from others. 
20. The therapist justifies any of the above behaviors by telling you that you are special, that he/she has never felt this way about a patient before, and that the boundary violations occurring are okay because of the special and different nature of your relationship.
21. When you express discomfort with any of the above, or any aspect of therapy, the therapist becomes angry and/or tells you this is your problem and/or part of your illness, rather than discussing your discomfort openly.

[1] List is taken verbatim from. “Psychotherapy: The Good, The Bad, and The Dangerous,” Ilana W. Rosen, MSW (need complete list of authors) TELL: Therapy Exploitation Link Line. http://www.therapyabuse.org/t2-unsafe-psychotherapy.htm