When the Helping Profession becomes harmful: Warning signs of a dysfunctional therapy practice
When the Helping Profession Becomes Harmful: Warning Signs of a Dysfunctional Therapy Practice
Therapy practices often speak the language of safety.
Trauma-informed care. Empowerment. Boundaries. Authenticity. Healing. Accountability. Relational safety. Compassion.
These are meaningful values. They are also relatively easy to put on a website or curate on a social media feed.
The more difficult question is: What happens when those same values are required of the people in leadership? What happens when leadership speaks of those values, but doesn’t actually embody them?
Therapists are human beings. Practice owners are human beings. Clinical training does not automatically make someone self-aware, emotionally stable, relationally healthy, ethical in every interaction, or skilled at managing power.
And therapy practices are not only healing environments. They are also workplaces, businesses, interpersonal systems, and hierarchies.
That means they can develop the same dysfunctional dynamics found in any other organization: blurred boundaries, favoritism, coercion, scapegoating, triangulation, retaliation, unstable leadership, poor communication, and misuse of power.
Sometimes the most concerning environments are also the ones that present morally sound from the outside. But inside, there may be dozens of accounts that reveal a consistent pattern of instability and inappropriate behavior rather than just one person’s account. That is difficult to dismiss and deserves further examination.
No single uncomfortable interaction proves that a workplace is abusive or unethical. People can misunderstand each other. Leaders make mistakes. Employees make mistakes. Conflict happens.
What deserves closer attention is pattern, repetition, power, impact, and the response to accountability.
Here are some warning signs worth paying attention to.
1. The Mission Statement and the Lived Environment Feel Like Two Different Places
A practice may publicly describe itself as compassionate, relational, empowering, trauma-informed, collaborative, or committed to emotional safety.
Meanwhile, behind closed doors, employees describe the boss and the work environment using remarkably different language:
“Chaotic.”
“Controlling.”
“Unstable.”
“A different person every day.”
Or even:
“A shit show.”
One unhappy employee does not establish an organizational pattern. Neither does one difficult interaction.
But when multiple people independently describe a significant discrepancy between the organization’s stated values and their lived experience, that discrepancy deserves attention.
A mission statement tells you what an organization believes about itself.
Culture tells you what people actually experience.
2. High Turnover Starts Telling a Story
People leave jobs for countless reasons.
Higher pay. Better opportunities. Burnout. Family changes. Career transitions. Personality differences. Poor fit.
Turnover by itself doesn’t prove dysfunction.
But context matters.
What happens when multiple people who became close to leadership were fired, pushed out, or left on “bad terms”?
What happens when employees disagree?
What happens when someone challenges inappropriate behavior or policies they don’t agree with?
Do employees repeatedly leave on “bad terms”?
Are people fired or pushed out after conflict?
Does leadership consistently describe former employees as unstable, difficult, disloyal, problematic, or somehow uniquely responsible for what happened?
And perhaps most importantly:
Did similar conflicts happen before you arrived—and continue after you left?
That last question matters.
Because sometimes a boss who is weaponizing therapy-speak or performing vulnerability may try to scapegoat an employee or blame their behavior or reactions on them “I acted this way because of you!”, while evidence of the boss’s behaviors and patterns exists from before they even met that employee.
If numerous people across different periods independently experience similar dynamics with the same person or organization, it becomes increasingly difficult to explain the entire pattern through one employee’s personality or reaction.
Sometimes the most important information about a system is its history.
3. Boundary Violations Become More Serious When Power Is Involved
Imagine beginning a new job.
During orientation, your boss shares highly personal or traumatic details about their entire life story before an appropriate professional relationship has even been established.
The relationship quickly becomes emotionally intense.
Perhaps they behave hot and cold.
Perhaps there are blurred personal and professional boundaries.
Perhaps they attempt physical or romantic intimacy without a prior conversation establishing safety, consent, or clarity about what is happening or how this would impact your role at the job.
Perhaps you are significantly younger, professionally less established, dependent upon the position, or otherwise situated lower in the organizational hierarchy.
And afterward, the relationship remains chronically ambiguous.
None of these dynamics should be examined without considering power.
A relationship between peers is different from a relationship between an employer and employee, supervisor and supervisee, professor and student, or therapist and client.
The person with greater institutional power has greater responsibility for maintaining clarity and appropriate boundaries.
4. The Environment Creates Dysregulation—and Then Your Dysregulation Becomes the Entire Story
This is one of the more psychologically confusing dynamics that can happen in dysfunctional systems.
Someone enters an environment characterized by inconsistency, ambiguity, blurred boundaries, unpredictability, power imbalances, conflict, or emotional intensity.
Over time, they might become increasingly distressed.
They may become hypervigilant.
Anxious.
Angry.
Confused.
Reactive.
Preoccupied.
Desperate for clarity.
Eventually, the conversation becomes:
“Look at how dysregulated this person is.”
Or:
“Look at how they’re reacting.”
But nobody asks:
What happened before the dysregulation?
That does not mean people aren’t responsible for their reactions.
They are.
But responsible assessment requires looking at both individual behavior and relational context.
A person’s reaction cannot always be understood accurately when it is surgically removed from the environment in which it developed.
Sometimes a system contributes to chronic fight-or-flight and then uses the resulting distress as evidence that the distressed person was the problem all along.
That’s not thoughtful assessment.
5. One Person Becomes the Identified Problem
Dysfunctional systems often simplify complicated relational dynamics by locating the problem inside one person.
Instead of:
What happened between us?
The question becomes:
What’s wrong with them?
Instead of:
What did leadership contribute?
The narrative becomes:
Look at how the employee reacted, or didn’t perform, or even embellishing details to make the employee look like the problem (they’re retention rate is “low”, meanwhile you could’ve kept 15 consistent clients throughout the years working there, or “they had a stain on their shirt one time!”).
Instead of:
What could we have handled differently?
The conclusion becomes:
They simply weren’t the right fit.
Sometimes someone genuinely isn’t a good fit.
Sometimes an employee behaves inappropriately.
Sometimes termination is completely warranted.
But when the same organization repeatedly resolves relational conflict by identifying one person as the problem while leadership remains largely exempt from examination, scapegoating becomes a possibility worth considering.
Healthy accountability moves in more than one direction.
6. People Who Challenge Leadership Repeatedly Become the Problem
Healthy leaders do not have to agree with every criticism.
They do, however, need the capacity to tolerate disagreement.
We need to pay attention to what happens when several employees raise similar concerns, not just one, because that may be indicative of a pattern rather than simply one “difficult employee.”
“I don’t think this is appropriate.”
“I experienced that differently.”
“I need clearer boundaries.”
“I disagree.”
“This policy concerns me.”
“I think leadership contributed to this problem.”
Does the organization become curious?
Defensive?
Punitive?
Does the employee suddenly become characterized as difficult?
Does access or warmth disappear?
Are they excluded?
Pushed out?
Fired?
Does their reputation change after they stop complying?
A workplace cannot meaningfully call itself psychologically safe if safety only exists while everyone agrees with the person holding the most power.
7. The People Who Remain Have the Least Institutional Power
Many therapy practices rely heavily on interns, provisionally licensed clinicians, recent graduates, and early-career therapists.
There is nothing inherently concerning about that.
Training environments can be extraordinary places to learn.
But patterns matter here too.
If experienced clinicians— like program managers, clinical supervisors, directors, or clinicians who were once close to the boss—repeatedly leave on bad terms or are forced out after challenging leadership’s dysfunctional behavior, while younger, newer, less-established, or more professionally dependent employees disproportionately remain, it is reasonable to ask why.
People early in their careers may depend heavily on supervisors for hours, recommendations, networking, employment, references, and professional opportunities.
That creates a meaningful power differential.
Good leadership recognizes that vulnerability and protects against exploiting it.
It should never rely on it.
8. Leaving the Workplace Doesn’t Actually Let You Leave the Relational System
Employment ends.
But somehow the relationship doesn’t.
A former employer continues talking about you.
Attempting to influence how others perceive you.
Inserting themselves into new professional or personal relationships.
Offering interpretations of your motives or psychological functioning to people from afar without having the full context.
Being unable to see beyond their own projections, motives, or incomplete assessments.
Competing for influence or attempting to pull your relationships away from you.
Trying to control the narrative long after the professional relationship should have ended.
At that point, the issue is no longer ordinary workplace conflict.
People deserve the ability to leave an organization without remaining psychologically tethered to its internal relational dynamics indefinitely.
And when this behavior isn’t being thoroughly examining or questioned, that’s also concerning.
9. Mental-Health Professionals Begin “Assessing” People From Afar
This deserves particular scrutiny in the helping professions.
Clinical training can sometimes create an illusion of certainty.
A therapist hears one person’s story.
Reads someone’s social media.
Observes a conflict from a distance.
Sees fragments of communication.
And suddenly believes they understand the entire psychological landscape.
They don’t.
None of us do.
Appropriate clinical assessment requires sufficient information, context, curiosity, and in-depth relational data gathered over time. It requires consideration of competing explanations and humility about what remains unknown.
It also requires a therapist to strive for objectivity, recognize potential biases, and manage their own countertransference. If they cannot do that, they should not be positioning their interpretation as the definitive account of a situation.
A therapy practice owner who can’t recognize that conflicts of interest exist, and examine how they can obscure objectivity, ability to gain accurate data and clinical formulations, and influence relational dynamics, deserves examination or further questioning.
One person’s account is information.
It is not omniscience.
Social-media posts are information, they are curated forms of expression that may or may not be accurate or true.
They are not a mental-status examination.
Personal impressions are information.
They are not comprehensive assessment.
Professional credentials do not transform speculation into fact.
10. Therapeutic Language Becomes Relational Leverage
Words like trauma, grief, safety, nervous system, attachment, healing, abuse, boundaries, and validation describe real and important human experiences.
But therapeutic language can also acquire enormous interpersonal power.
Consider a situation where someone says, in effect:
“You’re traumatized.”
“We’re both grieving, that’s why we regressed. But it’s okay, don’t examine it further. I’m the right fit!” (using performative vulnerability as an attachment/connection point).
“I understand what happened to you.”
On the surface, this may sound deeply compassionate.
Sometimes it is.
But the more important question is:
What does that compassion lead toward?
Does it encourage curiosity?
Independent thinking?
Tolerance for Direct communication when harm repair is essential?
Better questions?
A fuller assessment?
Consideration of perspectives that might complicate the existing narrative?
Or does it function more like:
“Don’t investigate this further. Don’t talk directly to the other person. Don’t seek an objective perspective. I’m a better fit for you. Stay here with me.”
That distinction matters.
Compassion should expand someone’s capacity to think objectively, examine their own relational impact, examine the system in which they and the other party are operating within, and how that influences thoughts, feelings, and behaviors.
It should not require them to stop thinking flexibly, examining themselves in entirety, not just the conclusions that person is motivated towards, or conclusions that they’re subtly planting seeds to lead them towards.
If using therapy speak as an attempt to strengthen connection simultaneously strengthens an alliance against someone else, discourages direct communication, reinforces incomplete narratives or assessments, or creates competition for relational influence, then triangulation may still be occurring.
And connection shouldn’t be formed on performative vulnerability, control, or sinister motives disguised as “compassion”.
11. Psychological Explanations Become Excuses for Harm
Understanding behavior matters.
Someone may be grieving.
Traumatized.
Depressed.
Overwhelmed.
Burned out.
Activated.
Experiencing significant relational distress.
Those realities deserve compassion.
But explanation and accountability are not opposites.
Someone can genuinely be struggling and still:
violate boundaries,
triangulate,
manipulate,
behave coercively,
create chronic ambiguity,
compete for relational influence,
avoid accountability,
or repeatedly interfere with other people’s relationships.
Understanding why someone behaved a certain way does not make the impact disappear.
Sometimes compassion means holding both truths at once.
And sometimes when someone is struggling, examining the patterns across time (before and after they met you), across context, with dozens of people offering the same account, it begs the question of personality instability or severe pathology is actually the real main source of their struggle, rather than “grief” or “trauma” from one person. Especially, as mentioned before, “grief” becomes a weaponized therapy word for sinister motives like influencing someone’s relationships.
13. Look at the Pattern Before and After You
This may be one of the most important forms of reality-testing available in a confusing relational system.
Ask:
What happened before I arrived?
Were other people hurt?
Did other employees leave under similar circumstances?
Were there previous boundary problems?
Did several other people describe similar experiences?
Then ask:
What happened after I left?
Did the same dynamics continue?
Did new conflicts emerge?
Did additional people report similar concerns?
This doesn’t mean collecting gossip or building a case against someone you dislike.
It means resisting the temptation to understand an entire organizational pattern through the most recent conflict.
Sometimes dysfunctional or abusive dynamics are explained through the reactions of the latest person involved:
They caused this.
They were unstable.
They were obsessed.
They were difficult.
They misunderstood.
But if the same relational wreckage repeatedly appears around different people across time, eventually the pattern itself deserves examination.
14. Charisma and Psychological Sophistication Can Hide Dysfunction
Some harmful leaders do not look harmful.
They may present well.
Appear warm.
Be educated.
Emotionally expressive.
Appear to have social support.
Compelling speakers.
Excellent marketers.
Somewhat familiar with basic psychological theory.
They may speak about vulnerability, trauma, relationships, grief, spirituality, or healing.
None of those qualities tell us how someone behaves when:
they are challenged,
someone sets a boundary,
they lose control of a narrative,
an employee disagrees,
someone leaves,
they feel rejected,
or they are asked to take responsibility.
They also don’t tell us how it feels to be around them in their day to day life.
Character is not revealed only by how someone behaves while being admired, when they’re motivated by an ego need to “win”, or when they have time to think and curate a social media feed.
It is also revealed by what happens when and how they handle another person becomes autonomous.
15. Therapy Practices Should Be Held to the Values They Teach
Therapy practices occupy an unusual position.
They are businesses.
But they are businesses built around people’s psychological wellbeing.
Their leaders supervise clinicians who may themselves be caring for highly vulnerable people.
That makes organizational health matter.
Being a therapist does not make someone incapable of causing harm.
Owning a therapy practice does not make someone psychologically healthy. It may mean they are decent at organization and business skills, but lacking the mental health capacity to effectively keep it running.
Having experienced trauma at a young age does not eliminate responsibility.
Being able to articulate some psychological concepts does not guarantee the ability to practice them.
And talking beautifully about healing means very little if the people closest to the organization repeatedly experience something very different.
When Should Someone Consider Reporting a Therapy Practice or Clinician?
Not every toxic workplace is an ethical violation.
Not every interpersonal rupture warrants a licensing complaint.
Not every bad boss is practicing incompetently.
Those distinctions matter.
But therapists and practice owners are not exempt from professional accountability.
If you believe conduct may involve ethical violations, professional misconduct, boundary violations, confidentiality concerns, exploitation, inappropriate dual relationships, supervisory misconduct, or behavior that may place clients or clinicians at risk, you can learn about the reporting or consultation options available in your jurisdiction.
Before doing so, it can be useful to:
Document observable events.
Write down what happened, when it happened, who was present, and what communication exists.
Separate evidence from interpretation.
“I received this message on this date” is different from “they sent this because they’re a narcissist.”
Prioritize firsthand information.
What did you personally witness or experience?
Preserve relevant documentation appropriately.
Consult objective professionals when needed.
Depending on the situation, that might include an attorney, licensing board, professional association, ethics consultant, clinical supervisor, or another therapist who is sufficiently removed from the relational system.
And perhaps most importantly:
Let the appropriate body determine whether professional standards were violated.
Reporting a concern and determining guilt are two different things.
The Bottom Line
Therapy practices should be able to tolerate the same values they encourage clients to practice.
Boundaries.
Consent.
Accountability.
Curiosity.
Repair.
Respect for power.
Emotional safety.
Humility.
Direct communication.
And the willingness to examine one’s own contribution to relational harm.
A healthy organization will not be perfect.
Neither will its leaders.
The standard should not be perfection.
The standard should be the capacity to recognize harm, tolerate feedback, examine power, take meaningful accountability, repair when possible, and change behavior when something isn’t working.
Because perhaps one of the clearest warning signs in any helping environment is this:
The people in charge can identify “dysfunction” everywhere except in themselves.
At The Relational Space, I work with other therapist and mental health workers who were severely harmed by dysfunctional and chaotic therapy practices. I also work well with people who experienced any particular type of toxic workplace trauma in New Jersey and Philadelphia. Reach out to me via my consult form here to schedule a free 15 minute consultation.
