Dr. Viktor Frankl, Logotherapist, and author of Man’s Search For Meaning, coined the term “iatrogenic neurosis” to describe an illness “caused” or made worse by a provider of healthcare. It’s hard to imagine that a health care provider, specifically a mental health professional, could make an illness worse. How is it possible for a professional to create more problems for a client seeking help?

If I were to quiz you on the 10 worst signs of a bad therapist would you know what they are? What did you like or dislike? It’s often difficult for people to distinguish a good therapist from a bad therapist until something unethical happens.

It is often much easier to spot a good therapist than it is to spot a bad therapist. We all look for kind, loving, compassionate, and caring people to connect with. Yet, for a variety of reasons, we are hardly able to pinpoint when someone is taking advantage of us. It’s who we are and how we have been molded in society – and even in our families – to think about “professionals.” The first few nonverbal signs we look for when we meet someone new is genuine smiling, eye contact, and maybe a touch (a touch on the arm or hand) to convey friendliness, and a positive tone of voice. When we do not see these things, we often do one of two things:

Ignore the behavior: Because the therapist may offer cheap rates, may be close to home, or offers other incentives. Make excuses: “Maybe she/he is having a bad day,” or “maybe he/she just doesn’t like me.” “Maybe he/she needs time to warm up to me!”

The act of ignoring the behavior and making excuses is often referred to, in psychology, as cognitive dissonance. Cognitive dissonance refers to a situation that makes us uncomfortable in some way due to our current conflicting thoughts, beliefs, or feelings about something. It occurs when we hold two conflicting thoughts in mind. For example, if you find a therapist who has 20+ years of experience and has been published in multiple journals but doesn’t seem to be genuine or even helpful, you may begin to experience cognitive dissonance. You are struggling with the thoughts of your therapist being a poor therapist because of the many credentials your therapist has and the years of experience.

When seeking help from someone who will be diagnosing you, giving recommendations, referrals, and offering insight, you really need to be picky.

If you are a parent, family member, or caregiver of someone in therapy or considering therapy, I encourage you to do a little of your own research before the first meeting. I also recommend that if an individual is meeting with a therapist for the first time, especially youngsters, that someone else go with them. It’s always good to have a second opinion from someone close to you. It’s also good to have another set of eyes and ears.

Even more , I often recommend to my clients to watch carefully for subliminal behaviors that may be hard to identify during a first, second, or even third session. These behaviors may include:

Answering the telephone while you’re in session: There is a thin line between having to take a call because it is important and taking a call because the person feels too important to give you their undivided time. Life is life and sometimes emergencies happen. When this occurs, a good therapist will apologize and make an effort to do better next time. If they don’t, I encourage you to move on. Eating while speaking with you: Believe it or not, some therapists have very bad manners. If you are on the phone or meeting in-person with your therapist and they are eating, you might want to consider their ultimate goal of working with you. Some therapists have medical conditions or take medication and must eat during a certain time of the day. Some have trouble trying to balance their jobs with lunch times. So be fair here , but if you find that eating while speaking to you is constant, you may want to look elsewhere. Talking too much about themselves: Some therapists are so self-centered that they enjoy speaking about their accomplishments, their dilemmas, their jobs, articles, families, etc. Be keen to this because some therapists attempt to find a common ground with their clients and use their own lives to teach. But other therapists just like bragging. Doesn’t answer your calls in a reasonable time: Life is hard for all of us. Even a therapist has trouble making calls, returning calls, and answering them. I can attest to this! Sometimes therapists have more than 25 messages on their work machine in a given day. So we must be fair. But if your therapist ignores you and doesn’t attempt to call you back, answer your calls, or even call you to reschedule or change something, move on. What if an emergency comes and you need your therapist? Crosses boundaries: As hard as it is to believe, some therapists flirt with their clients. Even if the therapist is held strictly to professional ethics and the policies of their agency/company, some will still cross barriers. Watch for subliminal behaviors, yet be careful not to assume all behaviors are “flirty.” Some therapists just have an appealing personality and charm. Be sure you can differentiate.

For the other 5 signs of a bad therapist click here.

All the best to you

Editor’s note: This article was originally published October 30, 2013 but has been updated to reflect comprehensiveness and accuracy.