Can a Psychologist Harm a Client? Understanding Risks, Red Flags, and What to Do

Starting therapy is often an act of trust. You share vulnerable thoughts, difficult memories, and parts of yourself that rarely feel safe elsewhere. So when something feels off in therapy — when you leave sessions feeling smaller, more confused, or emotionally worse over time — it can be deeply unsettling.

Many people in the United States quietly ask themselves whether a psychologist can harm a client, but hesitate to say it out loud. Therapy is supposed to help, not hurt. And yet, while psychotherapy is generally safe and effective, it is not completely risk-free.

In most cases, feeling uncomfortable or emotional in therapy is part of meaningful change. Growth can be challenging, especially when old patterns or painful experiences surface. But there are situations where therapy crosses from “difficult but helpful” into genuinely harmful territory — often without obvious misconduct or bad intentions.

This article will help you understand when therapy discomfort is normal, how psychological harm can occur, and which warning signs deserve attention. You’ll also learn what your rights are as a client in the U.S., how to respond if you suspect harm, and when seeking a second opinion or changing therapists may be the healthiest step forward.

If you’ve been questioning your experience in therapy, you’re not being dramatic or ungrateful. You’re paying attention — and that matters.

Can a Psychologist Harm a Client? A Clear, Evidence-Based Answer

Short answer: yes, a psychologist can harm a client — but this is uncommon, and it usually happens through subtle processes rather than overt misconduct.

Psychotherapy is one of the most researched mental health interventions in the United States, and the vast majority of people benefit from it. Still, no human-centered profession is entirely risk-free. Therapy involves power, trust, and emotional vulnerability. When those elements are mishandled, harm can occur even without malicious intent.

What “harm” in therapy actually means

Harm in psychotherapy does not usually look like obvious abuse. More often, it shows up as a gradual negative impact on a client’s emotional well-being, sense of agency, or functioning.

Examples may include:

• increased anxiety, shame, or hopelessness that persists over time;
• growing dependence on the therapist rather than increased autonomy;
• confusion about one’s own perceptions or emotions;
• avoidance of outside relationships or supports;
• worsening symptoms without reflection or adjustment in treatment.

Importantly, these effects can develop even when a psychologist is well-trained and believes they are helping.

Why harm can happen despite good intentions

Psychologists are human. They bring their own blind spots, theoretical preferences, stress levels, and emotional reactions into the room. When these factors interact poorly with a client’s needs, therapy can drift off course.

According to guidance from the American Psychological Association, ethical practice requires ongoing self-monitoring, supervision, and responsiveness to client feedback. Harm is more likely when those safeguards break down — for example, when a therapist dismisses concerns, rigidly applies one method, or fails to notice how their own reactions are shaping the work.

Discomfort vs. damage: an essential distinction

Therapy often involves discomfort. Revisiting painful memories, challenging long-held beliefs, or experimenting with new behaviors can feel unsettling at first. Temporary emotional intensity does not equal harm.

The key difference lies in direction and containment:

• discomfort that leads to insight, relief, or increased coping is usually part of healthy therapy;
• distress that accumulates, erodes self-trust, or limits functioning may signal a problem.

A competent psychologist regularly checks in about how therapy is affecting you and adjusts the approach when something isn’t working.

How common is harmful therapy?

Research suggests that serious, lasting harm from psychotherapy is relatively rare, especially compared to the benefits most clients experience. However, mild to moderate negative effects — such as feeling invalidated or misunderstood — are reported more frequently and deserve attention.

What matters most is not whether harm is common, but whether clients feel empowered to retze it and respond.

If you’re wondering whether your experience is “normal therapy difficulty” or something more concerning, that question itself is worth taking seriously. Therapy should challenge you, but it should not make you feel trapped, diminished, or unsafe.

When Feeling Worse in Therapy Is Normal — and When It’s Not

Feeling worse during therapy can be confusing and unsettling. Many clients expect steady improvement, so when sessions stir up anxiety, sadness, or self-doubt, it’s natural to wonder whether something has gone wrong. The reality is more nuanced: temporary discomfort can be a normal part of effective therapy, but persistent distress may signal harmful therapy dynamics that need attention.

Why therapy can feel harder before it feels better

In well-conducted psychotherapy, emotional discomfort often appears for understandable reasons. Therapy may bring awareness to long-avoided feelings, challenge protective coping strategies, or revisit painful experiences. For some people, especially those working through trauma or long-standing patterns, this activation is part of change.

Common, usually normal reactions include:

• feeling emotionally raw after sessions that address difficult topics;
• increased awareness of anxiety, grief, or anger that was previously suppressed;
• short-term disruption of routines while new insights settle;
• fatigue or emotional heaviness that fades with reflection and support.

Crucially, these reactions tend to be time-limited and occur within a relationship that feels collaborative, respectful, and grounded in your goals.

What makes discomfort different from harm

Here’s the key question: Does the discomfort lead somewhere constructive? Healthy therapy maintains a sense of containment. Even when sessions are challenging, clients usually feel understood, supported, and able to regain emotional balance between appointments.

Warning signs that therapy may be crossing into harmful territory include:

• distress that intensifies session after session without relief;
• feeling consistently misunderstood, blamed, or dismissed;
• pressure to tolerate pain without explanation or consent;
• confusion about what therapy is trying to accomplish;
• a growing sense of dependency or loss of confidence outside sessions.

When these patterns persist, the issue is not “therapy being tough,” but therapy failing to adapt to the client’s needs.

The role of pace, consent, and feedback

Ethical psychotherapy relies on informed consent and ongoing collaboration. A psychologist should explain the rationale behind difficult work, invite feedback, and adjust the pace when something feels overwhelming.

If you express that therapy feels destabilizing, a responsible clinician will explore that concern with curiosity rather than defensiveness. They may slow down, clarify goals, or modify techniques. When concerns are brushed aside or reframed as your “resistance,” that’s a signal to pause and reassess.

Trauma, retraumatization, and risk

For people with trauma histories, the line between productive activation and harm can be especially thin. Trauma-informed therapy prioritizes safety, choice, and gradual exposure. When trauma work is rushed or poorly attuned, it can lead to retraumatization — a state where symptoms worsen and the nervous system remains stuck in threat mode.

This does not mean trauma therapy is unsafe. It means that how therapy is done matters as much as what is addressed.

A simple self-check

If you’re unsure where you fall, consider these questions:

• Do I feel more clarity or more confusion over time?
• Is my therapist open to discussing how therapy feels for me?
• Do I feel respected and emotionally safe, even when sessions are hard?
• Is my day-to-day functioning gradually improving, staying the same, or declining?

Your answers don’t need to be perfect. They’re meant to help you notice patterns — and patterns are what distinguish normal therapeutic discomfort from situations where a psychologist may be harming a client.

How Therapy Can Become Harmful: Common Psychological Mechanisms

Therapy rarely becomes harmful because a psychologist intends to cause damage. More often, harm develops through subtle psychological mechanisms that unfold over time, especially when power dynamics, boundaries, or feedback loops are not handled carefully. Understanding these mechanisms can help you make sense of your experience without blaming yourself or assuming bad faith.

Ruptures in the therapeutic alliance

The therapeutic alliance — the sense that you and your therapist are working together toward shared goals — is one of the strongest predictors of positive outcomes. When that alliance weakens and isn’t repaired, therapy can stall or turn harmful.

Alliance ruptures often look like this:

• you feel misunderstood or unheard, but it never gets addressed;
• your goals drift, yet sessions continue without clarity;
• feedback is discouraged or reframed as a personal flaw.

Small misunderstandings are normal. What matters is repair. When concerns are repeatedly dismissed, clients may begin to doubt their perceptions, which can erode self-trust.

Power imbalance and boundary problems

Therapy involves an inherent power imbalance. Psychologists hold professional authority, clinical language, and influence over how experiences are interpreted. When boundaries blur, that imbalance can become harmful.

Boundary issues may include:

• discouraging outside opinions or support;
• positioning the therapist as the only source of insight or safety;
• oversharing personal information in ways that shift focus;
• making decisions for the client rather than with them.

These dynamics can quietly foster dependency rather than growth.

Emotional invalidation and subtle gaslighting

One of the most damaging experiences in therapy is persistent invalidation. This doesn’t mean disagreement — it means having your emotional reality repeatedly minimized or reframed as wrong.

Examples include:

• “That didn’t really happen the way you think it did.”
• “You’re just being resistant.”
• “Your reaction means you’re not ready to heal.”

Over time, this can lead to confusion, shame, and a loss of confidence in your own judgment — especially when it comes from a trusted professional.

Rigid use of one therapeutic model

Evidence-based therapies are effective when applied flexibly. Harm can occur when a psychologist relies too rigidly on a single approach, ignoring whether it fits the client’s history, culture, or current capacity.

For instance:

• exposure work without adequate preparation;
• cognitive techniques used to bypass valid emotional pain;
• trauma processing without sufficient stabilization.

When methods are applied without attunement, symptoms may intensify rather than resolve.

Retraumatization and loss of safety

For clients with trauma histories, therapy must prioritize emotional and physiological safety. Retraumatization happens when therapy overwhelms the nervous system, recreating a sense of threat rather than fostering regulation.

Signs include:

• worsening flashbacks or panic;
• emotional flooding without grounding;
• feeling unsafe before, during, or after sessions.

Trauma-informed care emphasizes pacing, choice, and consent. When these are missing, even well-intentioned therapy can cause harm.

Therapist stress, burnout, or blind spots

Psychologists are not immune to stress, burnout, or countertransference. When therapists are overwhelmed or unsupported, they may become less attuned, more defensive, or overly directive.

This can show up as:

• impatience or irritability in sessions;
• reduced curiosity about the client’s experience;
• avoidance of difficult feedback.

These factors don’t excuse harm, but they help explain how it can happen — and why supervision and self-monitoring matter.

How these mechanisms show up in real life

Mechanism	What it may look like in therapy	Why it can be harmful
Alliance rupture	concerns aren’t addressed or repaired	erosion of trust and engagement
Boundary issues	pressure to rely solely on therapist	increased dependency
Invalidation	emotions repeatedly minimized	loss of self-trust
Rigid technique use	one-size-fits-all methods	symptom worsening
Retraumatization	overwhelm without stabilization	nervous system dysregulation
Therapist burnout	emotional distance or defensiveness	reduced quality of care

Why understanding mechanisms matters

Recognizing these patterns helps shift the question from “What’s wrong with me?” to “What’s happening in this relationship?” Therapy is meant to increase clarity and agency. When it does the opposite, paying attention is not disloyal — it’s protective.

You don’t need to diagnose your therapist or prove wrongdoing to take your experience seriously. Noticing these mechanisms is often the first step toward deciding whether repair, change, or a different kind of support is needed.

Red Flags That a Psychologist May Be Harming You

Most therapy challenges are subtle. That’s why recognizing red flags matters — not to assign blame, but to protect your well-being. These signs don’t require clinical expertise to notice. They’re based on how therapy affects your sense of safety, agency, and functioning over time.

Red flags related to the therapeutic relationship

A healthy therapeutic relationship allows disagreement, curiosity, and repair. Warning signs often emerge when that flexibility disappears.

Pay attention if you notice:

• you feel afraid to question your therapist or share doubts;
• your concerns are consistently reframed as personal flaws;
• sessions feel one-sided, with little room for your perspective;
• feedback is met with defensiveness or dismissal;
• you leave sessions feeling smaller, ashamed, or silenced.

Therapy should not require emotional submission. Challenge and safety can coexist.

Red flags related to boundaries and power

Because therapy involves a power imbalance, ethical boundaries are essential. When they weaken, harm can follow.

Concerning patterns include:

• pressure to reduce or avoid outside support;
• discouragement from seeking a second opinion;
• excessive self-disclosure that shifts focus to the therapist;
• blurred roles or expectations;
• subtle suggestions that only the therapist truly understands you.

Maintaining clear boundaries protects both clients and clinicians. When those lines blur, clients often feel confused or dependent rather than empowered.

Red flags in how therapy affects your life

One of the clearest indicators of harmful therapy is what happens outside the therapy room.

Be cautious if you notice:

• your daily functioning is steadily declining;
• relationships or work suffer without being addressed in therapy;
• your confidence in decision-making erodes;
• therapy becomes the main or only place you feel “okay”;
• emotional distress increases with no plan to stabilize it.

Temporary disruption can happen during growth. Long-term deterioration without explanation or adjustment is different.

Red flags in communication and consent

Ethical therapy is collaborative and transparent. You should understand why certain approaches are being used and have a say in pacing.

Warning signs include:

• techniques applied without explanation or consent;
• pressure to move faster than feels safe;
• dismissal of your boundaries as “avoidance”;
• lack of clear goals or direction;
• reluctance to discuss alternatives.

If you don’t know what therapy is aiming to achieve, that’s a problem worth addressing.

A note on intent vs. impact

Here’s the important part: harm does not require bad intentions. A psychologist can be caring, experienced, and still cause harm if they miss key signals or fail to adjust. Focusing on impact rather than intent helps clients make decisions without getting trapped in self-doubt.

A practical pause-and-check moment

If you’re unsure whether what you’re experiencing is a red flag, try this brief reflection:

• Do I feel more empowered or more dependent over time?
• Do I trust my own perceptions more — or less — since starting therapy?
• Is there space to talk openly about how therapy affects me?
• Would I encourage a close friend to stay in this situation?

Your answers don’t have to be dramatic. Subtle patterns are often the most telling.

Not every red flag means therapy must end immediately. Some can be addressed through honest conversation or repair. But multiple or persistent red flags deserve serious consideration. Therapy should support your autonomy, not quietly undermine it.

What to Do If You Think Therapy Is Hurting You

Realizing that therapy may be causing harm can bring up fear, guilt, or confusion. Many clients worry about overreacting or feel loyal to their therapist, even when something feels wrong. Still, you don’t need absolute certainty to take care of yourself. There are thoughtful, measured steps you can take without burning bridges or putting yourself at risk.

Step 1: Pause and name what’s happening

Before making any decisions, slow the process down. Try to describe your concerns in concrete terms rather than global judgments.

For example:

• I feel more anxious after sessions and it doesn’t settle.
• I leave feeling blamed or misunderstood.
• I’m unsure what the goal of therapy is anymore.

Clarity helps separate emotional reactions from patterns that deserve attention.

Step 2: Decide whether to talk to your therapist

In many cases, it’s appropriate — and often helpful — to bring concerns directly into the room. A healthy therapeutic relationship can tolerate feedback and use it productively.

You might say:

• I want to talk about how therapy has been affecting me lately.
• I’m feeling worse overall, and I’m not sure why.
• I need help understanding whether this approach still fits me.

A responsible psychologist will respond with curiosity, not defensiveness. They may explore adjustments, clarify goals, or suggest a referral if another approach might be a better fit.

If your concerns are dismissed, minimized, or reframed as your personal failing, that response itself provides important information.

Step 3: Seek a second opinion

Getting another professional perspective can be grounding, especially when you feel confused or stuck. A second opinion does not mean accusing your therapist of wrongdoing. It simply adds context.

A brief consultation with another licensed clinician can help you explore:

• whether your reactions fall within normal therapy challenges;
• whether the current approach fits your needs and history;
• what alternative options might look like.

This step is especially useful when power dynamics or dependency feel present.

Step 4: Consider changing or ending therapy

Ending therapy is a valid choice, even if your therapist hasn’t done anything “wrong.” You are allowed to leave therapy that isn’t helping.

Options include:

• a planned termination with closure;
• a gradual transition to another provider;
• an immediate pause if you feel unsafe.

You do not owe continued therapy at the cost of your well-being. Ethical psychologists understand this and support client autonomy.

Step 5: Know your rights as a client

In the United States, clients have the right to:

• informed consent about treatment methods;
• respectful, non-coercive care;
• seek second opinions;
• end therapy at any time;
• file a complaint if ethical standards are violated.

If you believe harm involved boundary violations or unethical conduct, documenting your experience can be helpful — even if you’re not sure how you’ll use that information yet.

Common concerns and practical responses

Concern	A reasonable first step	Who may help
I’m not sure if this is normal	seek a consultation	another licensed clinician
I feel dependent on my therapist	slow sessions or pause	therapist or consultant
Therapy is worsening symptoms	reassess approach	therapist, PCP, or psychiatrist
I feel unsafe or coerced	stop sessions	trusted professional or crisis support
I think ethics were violated	document concerns	state licensing board

Ethics, Accountability, and Your Rights as a Client in the U.S.

When therapy causes harm, many clients hesitate to speak up because they assume the psychologist “must know better” or worry that questioning a professional is inappropriate. In reality, psychotherapy in the United States is governed by clear ethical standards and accountability systems designed to protect clients, not professionals.

Ethical standards psychologists are required to follow

Licensed psychologists in the U.S. are bound by the Ethical Principles of Psychologists and Code of Conduct, as well as state licensing laws. These standards emphasize:

• respect for client autonomy and dignity;
• informed consent and transparency about treatment;
• avoidance of harm and exploitation;
• maintenance of clear professional boundaries;
• responsiveness to client feedback and concerns.

Ethical practice does not require perfection. It does require ongoing self-awareness, supervision, and willingness to adjust when therapy is not helping or is causing distress.

What counts as an ethical concern vs. a poor fit

Not every uncomfortable therapy experience rises to the level of an ethical violation. It’s important to distinguish between:

• poor fit — mismatched style, approach, or personality;
• clinical error — misjudgment or ineffective technique without malicious intent;
• ethical violation — boundary crossings, coercion, exploitation, or disregard for client welfare.

A poor fit may justify changing therapists. Ethical violations may justify formal action.

Examples that may warrant further action include:

• repeated boundary violations after concerns are raised;
• discouraging you from seeking outside help or second opinions;
• using shame, fear, or pressure to control your choices;
• dual relationships that compromise objectivity;
• sexual, financial, or emotional exploitation.

Your rights as a therapy client

As a client in the U.S., you have the right to:

• understand the nature and goals of treatment;
• ask questions about methods and alternatives;
• set limits and say no to interventions;
• stop therapy at any time;
• seek second opinions without retaliation;
• expect confidentiality, with limited legal exceptions.

You do not need to prove harm beyond doubt to exercise these rights. Your experience matters.

Accountability and complaint options

If you believe a psychologist has acted unethically, several accountability paths exist:

• state licensing boards — investigate complaints and can impose sanctions;
• professional associations — address ethics complaints for members;
• healthcare systems or clinics — internal review processes;
• insurance providers — quality-of-care concerns.

Filing a complaint is a personal decision. Some clients do so to protect others, while others choose to focus on their own recovery. Both choices are valid.

A word on fear and retaliation

Many clients worry about being dismissed, disbelieved, or blamed. Ethical systems are designed to minimize retaliation, and complaints are reviewed independently of the therapist’s perspective. Seeking consultation before filing can help you understand options and feel more grounded in your decision.

Holding professionals accountable is not an attack on therapy. It is part of how ethical care is maintained.

Can You Recover After Harmful Therapy? What Research and Practice Show

Experiencing harm in therapy can leave lasting doubts — not just about a particular psychologist, but about therapy as a whole. Many people wonder whether the damage can be undone, or if they’ll always carry the effects of a negative therapeutic experience. The encouraging news is that recovery is possible, and for many clients, it becomes a meaningful turning point rather than an endpoint.

Yes, recovery is possible — and common

Research and clinical experience suggest that most people who experience harmful therapy effects do improve with time and appropriate support. Emotional harm in therapy typically affects trust, self-confidence, and emotional regulation — areas that are responsive to corrective experiences.

What often helps most is not avoiding therapy forever, but experiencing therapy done differently.

How healing usually unfolds

Recovery rarely happens all at once. It tends to follow a few recognizable phases:

• Reclaiming self-trust. Many clients need time to reconnect with their own perceptions after feeling invalidated or confused. Simply recognizing that something wasn’t right is often the first step toward healing.
• Making meaning of the experience. Talking through what happened with a trusted person or another professional helps separate personal responsibility from systemic or relational issues.
• Restoring agency. Choosing when, how, and whether to re-engage with therapy rebuilds a sense of control that may have been lost.
• Creating new relational experiences. Healthy relationships, including future therapeutic ones, gradually counteract the impact of earlier harm.

Can another therapist help after harmful therapy?

For many people, the answer is yes — with the right conditions.

A skilled clinician will:

• acknowledge past therapy harm without minimizing it;
• move at a pace that prioritizes safety and consent;
• explain how their approach differs;
• invite ongoing feedback and questions;
• emphasize collaboration rather than authority.

In fact, experiencing a respectful, transparent therapeutic relationship can be repairing in itself. It helps restore confidence not only in therapy, but in one’s ability to choose safe relationships.

When stepping away from therapy is also okay

Recovery does not require immediate re-entry into therapy. Some people benefit from taking a break, focusing on supportive relationships, or using self-directed coping strategies before returning — if they choose to return at all.

What matters is that the choice feels self-directed, not fear-driven.

A realistic and hopeful perspective

Here’s the balanced truth: harmful therapy can leave real emotional marks. But it does not define your capacity for growth, connection, or healing. Many clients report that learning to recognize unhealthy dynamics — even in a therapeutic setting — ultimately strengthens their boundaries and self-awareness.

If at any point distress escalates to thoughts of hopelessness or self-harm, immediate support matters. In the U.S., you can call or text 988 to reach the Suicide & Crisis Lifeline. If you’re in immediate danger, call 911.

Healing after harmful therapy is not about erasing the past. It’s about restoring trust — in yourself, in your choices, and, when you’re ready, in safe support.

References

1. American Psychological Association. Ethical Principles of Psychologists and Code of Conduct. Amended edition, 2017.

2. American Psychological Association. Understanding the Therapeutic Alliance. Monitor on Psychology, 2020.

3. National Institute of Mental Health. Psychotherapies. U.S. Department of Health and Human Services, 2023.

4. American Psychological Association. When Therapy Doesn’t Work. Monitor on Psychology, 2019.

5. Substance Abuse and Mental Health Services Administration. Mental Health Treatment Services and Consumer Guidance. U.S. Department of Health and Human Services, 2023.

Conclusion

Therapy is meant to support healing, insight, and growth — but like any powerful human process, it carries risks when misaligned, poorly paced, or ethically compromised. Yes, a psychologist can harm a client, most often through subtle relational dynamics rather than obvious misconduct. Recognizing that possibility does not undermine therapy; it strengthens it.

If therapy leaves you feeling diminished, unsafe, or increasingly confused over time, your experience deserves attention. Discomfort alone is not the problem. Lack of safety, collaboration, and responsiveness is.

You have the right to ask questions, seek second opinions, change therapists, or pause therapy altogether. Harmful experiences can be repaired, especially when clients reclaim their agency and receive attuned support — whether through a different therapist or other forms of care.

If distress escalates to thoughts of self-harm or hopelessness, help is available. In the United States, you can call or text 988 to reach the Suicide & Crisis Lifeline. If there is immediate danger, call 911.

Frequently Asked Questions

Is it common for therapy to be harmful?

Serious, lasting harm from therapy is relatively uncommon, and most people benefit from psychotherapy. However, mild to moderate negative effects, such as feeling invalidated or misunderstood, do occur and should be taken seriously.

Should I tell my therapist that therapy feels harmful?

In many cases, yes. Ethical therapists welcome feedback and will explore concerns collaboratively. If your concerns are dismissed or reframed as personal flaws, that response itself is important information.

How do I know if this is just a bad fit?

A poor fit often involves mismatched style or approach but still feels respectful and safe. Harmful therapy typically involves ongoing distress, loss of agency, or boundary concerns that do not improve when discussed.

Can I quit therapy abruptly?

Yes. You have the right to end therapy at any time. While planned termination can be helpful, your safety and well-being take priority, especially if you feel coerced or unsafe.

Can another therapist help after harmful therapy?

Often, yes. A new therapist who acknowledges past harm, prioritizes consent, and works collaboratively can help restore trust and support recovery.

When should I report a psychologist?

Reporting may be appropriate when there are boundary violations, coercion, exploitation, or repeated ethical concerns. Consulting another professional or your state licensing board can help clarify options.