Common Reasons Mental Health Therapists Get Fired

Common Complaints Patients Have About Their Mental Health Therapists (AKA Reasons Therapists Get Fired)

During my tenure as an outpatient mental health therapist in a hospital setting, I served on a patient satisfaction committee. We mailed satisfaction surveys to mental health and addictions patients after formal discharge or when they had not returned for services. We analyzed quarterly reports and made recommendations to improve clinical services and patient satisfaction. I continued to survey patient satisfaction after transitioning into private practice. The results of these patient satisfaction surveys span over 30 years of data collection. Use this feedback as you wish. If you notice anything that applies to you—no worries! Celebrate that now you know, you will do better! If this list affirms that you are aligned with patient satisfaction, celebrate that as well!

I. Time and Attendance Complaints:
1.“My therapist is never on time, keeps me waiting.”
2.“Doesn’t return my calls or emails.”
3.“My therapist keeps cancelling my appointments.”
4.“I was charged for cancelling the appointment during emergencies and illness”.

II. Office Space and Business Management Complaints:
1.“Messy, musty, dirty, disorganized or chaotic office.”
2.“Incorrect insurance billing or information coverage, or errors in copay collection.”
3.“Overcharging: cancellation fees, sending to collections, rude billing office, late billing.”
4.“Loud and obnoxious waiting area or thin walls that violate privacy.”
5.“Late, incomplete, or inaccurate paperwork” Examples: FMLA, disability, accommodations, etc.

III. Unprofessional:
1.“My therapist was not a healthy role model” Examples: disheveled, smoker, obese, anorexic, presented as struggling with own mental illness or addiction.
2.“I felt like my therapist needed me to keep scheduling so they could pay their bills.”
3.“My therapist answers their phone during my appointment.”
4.“My therapist ate food during our appointment, then chewed loudly, mouth open!”
5.“My therapist had more problems than I did.”
6.“My therapist fell asleep during our session, more than once.”
7.“My therapist turned into my friend, but I have friends, I need a therapist.”
8.“I felt sorry for my therapist; I was helping them more than they were helping me.”
9.“My therapist violated my confidentiality by talking about me to family members.”
10.“My therapist violated confidentiality by discussing my upcoming appointment in public.” (at church, school, shopping mall, restaurant, community event.)
11.“My therapist asked about my sex life way too much.”
12.“My therapist made sexual advances”, “flirtatious” “creepy” “handsy”—"insisted on full body hugs.”
13.“My therapist had animals roaming the office.” “pet odor”, “pets distracting, intimidating, noisy, unsanitary.”

IV. Therapy Not Helpful
1.“My therapist couldn’t help. We just talked. I can do that with my friends.”
2.“My therapist didn’t talk. Did not give the feedback I needed. No tools, strategies, plans or ideas.”
3.“I didn’t feel any connection with my therapist.”
4.“I never knew what the point of therapy was. It was a big waste of time.”
5.“My therapist always wanted to talk about my past and my parents.”
6.“My therapist pushed religion on me.”
7.“My therapist didn’t care, just watched the clock.”
8.“My therapist did not seem to know what to do. Looked freaked out and stressed out.”
9.“My therapist never addressed the real problem.”
10.“My therapist did not challenge me or confront things I should have been confronted about.”
11.“Therapists spent too much time talking about themselves.”
12. “My therapist wouldn’t refer me elsewhere for additional help, wanted me to stay with them even when I asked for a referral to try someone else.”
13.“My therapist told me not to take my medication.”
14.“Our therapist sided with my spouse and then they both ganged up on me.”
15.“My therapist said it was normal for our son to use pot at 15. That therapist counseled our son for 5 years. Now, with hindsight, I wonder if we could have saved our son’s life if we had not enabled his drug use from the very beginning.”

Now What? What's a therapist to do to improve services?

1.Ask your clients for feedback each session. Ask about their experience, progress, stagnation, and resistance. Provide feedback to client each session as well.
2.Review sessions by asking:
“What has been helpful today?”
“What is not really working for you?”
“What is your main take-away from our time together today?”
“Where are you stuck?”
“How can we do better in our work together?”
3.Review your clients’ attendance, response and follow through in treatment.
4.Ask client to “help me understand” or “tell me more” when you are not clear what their attendance, response or follow through in treatment means.
5.If you have absolutely no idea why a client disappears or “fires” you, reach out to ask for feedback about their experience. Don’t be creepy, stalky or defensive. If you are not sure how to do this follow-up, seek advice from a trusted mentor or well-respected colleague.
6.You can’t please or satisfy everyone—but you can learn and grow!