Hawkins & McMahon (2020:13)
Abuse in therapy is subtle and gradual and very hard to spot. Here are just some of the ways professional standards start to slip.
Gradual Boundary Crossing: Abuse often starts subtly, with the therapist pushing boundaries gradually, similar to the "boiling frog" fable.
Initial Trust and Gradual Abuse: Clients initially trust their therapist, making them vulnerable to gradually increasing inappropriate behaviour.
Majority Female Victims: Most clients who experience abuse by a therapist are women. But are they, or do just men not report it?
Gender Differences in Abusive Therapists: While most abusive therapists are men, a significant number are women, with differences in their methods of abuse.
Manipulation of Client's Desire for Approval: Therapists may inappropriately manipulate clients' natural desire to be liked and thought well of.
Sexual Abuse by Therapists: Abuse often starts with compliments on appearance and can escalate to boundaries being broken.
Non-Sexual Abuse by Therapists: Therapists may abuse their position by asking clients for personal favours or services, blurring the lines between professional and personal relationships.
Abuse as Medical Malpractice: Therapist or psychiatrist abuse, regardless of its form, is considered a form of medical malpractice.
Social Media Connection: Friending or following you on social media platforms.
Isolated Appointments: Setting appointments at times when no one else is around.
Vague Treatment Goals: Lack of clear treatment goals or not involving you in goal-setting.
Undermining Confidence: Making you doubt your abilities in work, parenting, or social interactions.
Unscheduled Check-Ins: Calling to check on you outside of planned teletherapy sessions.
Inappropriate Communication: Contacting you for non-professional reasons, including texting or emailing.
Special Treatment: Offering free sessions or unusually long sessions.
Meetings Outside Office: Proposing meetings outside the office for non-therapeutic reasons.
Undermining Support System: Making negative remarks about your friends or family, which can result in isolation.
Creating Dependency: Suggesting they are the only one who can help you.
Over-Identification: Presenting themselves as a uniquely perfect fit for you.
Blaming Client for Therapy Issues: Blaming you for lack of progress or not considering referral to other professionals.
Personal Disclosures: Sharing their personal issues to gain your sympathy.
Here are bullet points summarising just a few of the possible key points on how to identify abuse by a therapist
No Sexual Behaviour: A therapist should never engage in or ask for or manipulate a client into any sexual behaviour, regardless of the client's feelings or actions.
Inappropriate Sharing: Discussing details about other clients or sharing your information without authorisation is a sign of abuse.
Comments on Appearance: Excessive, unexpected or sexual comments about your physical appearance are inappropriate.
Meetings Outside Office: Asking to meet outside of the therapy office is a red flag, especially encouraging dual relationships.
Inappropriate Communication:
Contacting you outside of session or for non-professional reasons, including social media connections, is not acceptable.
Personal Confidences: Sharing personal life details, especially about their sex life, is unprofessional. A therapist self disclose should be limited to demonstrating points which cannot be achieved any other way and in line with the clients goals.
Shaming or Degrading Comments: Any communication that is shaming, humiliating, or degrading is abusive.
Dependency Creation: Making you feel like they are the only one who can help you is a manipulation tactic.
Pressure to Do Uncomfortable Things: Pressuring you into actions that make you uncomfortable and don't aid your independence is a warning sign.
Encouragement of Harm: Suggesting self-harm or ignoring suicidal statements is extremely dangerous and abusive.
Financial or Other Favours: Requesting financial assistance or favours outside of therapy payments is unethical.
Trust Your Instincts: If something feels off in the therapeutic relationship, it's important to trust your gut.
Blame and Threats: An abusive therapist may blame you for their actions or threaten to disclose sensitive information. These may be direct or indirect or implied.
Risk of Staying:
Remaining in an abusive therapeutic relationship can be harmful and increases the risk of severe outcomes like suicide.
Seek Help and Report Abuse:
If you suspect abuse, it's crucial to seek help and report the therapist to prevent further harm to yourself and others.
Steps to Take if You’re Experiencing Abuse from a Therapist
If you feel that your therapist is behaving abusively, know that you have the right to protect yourself and seek safety. Isolation can make you feel trapped, and abuse in therapy may create confusion, especially if you feel blamed or gaslit. Here’s how to start freeing yourself from this situation:
Acknowledge Your Feelings without Shame
It’s natural to feel conflicted or even loyal to a therapist, even if they’re harming you. Recognize that feeling attached, confused, or even ashamed is common and does not mean you’re at fault. Abuse in any form is never acceptable, and it's understandable that separating yourself from a therapist can feel challenging.
Break the Isolation
Talk to someone you trust about what’s happening. Isolation can reinforce abuse, but sharing your concerns with a friend, family member, or another support figure can help clarify what you’re experiencing and make it easier to take steps toward safety.
Document What’s Happening
Keeping a record of troubling interactions can help you ground yourself in your experiences, especially if gaslighting is involved. Write down specific behaviors, comments, or incidents that feel wrong to you. Reviewing these notes later can help you see the pattern and remind you of your truth.
Use Ethical Standards to Seek Validation
Comparing what you’ve documented to the ethical guidelines for counsellors may help validate your experience. Many professional bodies, such as the BACP, NCS, and other organizations, have clear standards that therapists must follow. You might find it helpful to use tools like ChatGPT to interpret ethical codes or ask for guidance on what constitutes unethical behavior in therapy.
Take Action if You Feel Ready
If you feel safe to do so, consider reporting the therapist to their professional body, or ask for support from advocacy organizations that protect therapy clients. You deserve to be in a therapeutic relationship that upholds your dignity, safety, and rights.
Remember, abuse in therapy is a serious violation, and it’s not your fault. By breaking the silence, documenting your experience, and finding external validation, you can take steps to free yourself and begin healing.
In the UK, several bodies and organizations focus on addressing abusive relationships, offering support, protection, and legal recourse.
Police and Criminal Justice System
Local Police:
Responsible for responding to reports of domestic violence or abuse. They offer immediate protection, conduct investigations, and can enforce restraining orders if necessary.
Crown Prosecution Service (CPS): Decides whether there’s enough evidence to prosecute individuals for abuse or violence.
Courts: Issue restraining orders, non-molestation orders, and in some cases, emergency orders for immediate protection.
Local Councils and Social Services
Local authorities provide social services, including safeguarding vulnerable adults and children, and coordinating housing for those needing refuge due to domestic abuse.
Multi-Agency Risk Assessment Conferences (MARACs): Local conferences where police, health, housing, and social services discuss high-risk cases to create coordinated safety plans.
National Domestic Abuse Helplines and Charities
Refuge: Runs the National Domestic Abuse Helpline (0808 2000 247), providing advice, support, and access to safe housing.
Women’s Aid: Offers support, advocacy, and information for women experiencing abuse and offers resources like the Survivors’ Handbook.
Respect: Provides a helpline for those who recognize abusive behaviour in themselves and want help to change.
Men’s Advice Line: A helpline specifically for male victims of domestic abuse, operated by Respect.
Galop: Supports LGBTQ+ individuals facing abuse, including domestic and hate crime.
Health Services and Mental Health Support
NHS: Trains professionals in recognizing signs of abuse, offering medical and psychological support to survivors.
Independent Domestic Violence Advisors (IDVAs): Work alongside health services to help survivors navigate legal and support systems.
Specialized Charities and Advocacy Groups
NSPCC: Focuses on children, offering support to those exposed to domestic abuse.
Victim Support: Provides emotional support, information, and practical help for victims of crime, including domestic abuse.
SafeLives: Research domestic abuse and advocates for systemic change to better protect survivors.
Each of these organizations has distinct roles and methods for addressing abuse, whether through legal channels, direct support, mental health services, or advocacy for broader systemic changes.
Step 1: Plan Your Exit Carefully
Decide on a Safe Time to Leave: Choose a time when your abuser is unlikely to notice, such as when they are at work or away.
Pack an Emergency Bag: Prepare a bag with essential items, such as ID, important documents (birth certificates, passports, bank details), medication, a change of clothes, some cash, and important contact numbers. Store it in a safe place, perhaps with a trusted friend.
Identify Safe Contacts: Share your plan with only a few trusted people. If possible, use a secret code with them to signal when you’re leaving or need help.
Step 2: Contact a Domestic Violence Support Service
Call the National Domestic Abuse Helpline (0808 2000 247): They can offer confidential advice, help create a safety plan, and connect you with refuge services.
Independent Domestic Violence Advisors (IDVAs): If you’re at high risk, you may be assigned an IDVA who will guide you through the process, liaise with police, and help with relocation.
Access Safe Spaces: Many pharmacies, like Boots, have "Safe Spaces" where survivors can privately use a phone to contact support services.
Step 3: Arrange for Safe Housing
Apply for Emergency Housing Through Your Local Council: Inform them that you’re fleeing domestic abuse. Councils have a legal duty to provide emergency accommodation for survivors.
Find a Refuge Placement: If you need immediate safety, organizations like Refuge and Women’s Aid provide secure, confidential shelters where you can stay until you find more permanent housing.
Specialized Housing Support for Men and LGBTQ+ Survivors: Contact Respect (for men) or Galop (for LGBTQ+ individuals) to find suitable accommodation and support.
Step 4: Secure Legal Protections and Financial AssistanceIn order to apply for a non-molestation order go to:
To apply for a non-molestation order, visit GOV.UK and search for form ‘D89’
Apply for a Non-Molestation or Occupation Order:A Non-Molestation Order prevents the abuser from contacting you or coming near you.
An Occupation Order can remove the abuser from your shared home, allowing you to stay there safely.
Seek Financial Assistance: If financial support is an issue, you may be eligible for benefits, such as housing benefit, Universal Credit, or a special domestic abuse grant. Contact Citizens Advice or your local council for guidance.
Step 5: Move to Your New LocationMaintain Privacy About Your Location: Be cautious about sharing your new address. Avoid posting your location on social media or revealing it to people who may inadvertently disclose it.
Update Your Contact Details with Relevant Agencies: Register with a new GP, update your address with benefit providers, banks, and schools if you have children.
Access Local Support Services: Connect with local community services, such as Women’s Aid or Victim Support, which offer assistance and peer support groups in many areas.
Step 6: Build a Support Network in Your New Location
Mental Health and Counselling Services: Reach out to organizations like Victim Support or the NHS, which offer counselling services tailored for survivors of abuse.
Join Peer Support Groups: Many charities run support groups that can help with adjusting to life after abuse, allowing you to share your experience with others in similar situations.
Step 7: Secure Your Finances and Legal Documents
Monitor Bank Accounts and Credit: If you shared finances, monitor any joint accounts and consider closing them if possible. Also, check your credit report to ensure no fraudulent activity is happening.
Update Legal Agreements: If children are involved, review and update any custody arrangements or legal documents to reflect your new situation and location.
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