Written by Adrian Yates, psychotherapist and hypnotherapist with nearly 20 years of clinical experience.
What should happen when a therapist gets something wrong?
Therapists are not perfect.
They can misunderstand, forget, misjudge a situation, say something that lands badly, move too quickly, fail to notice an important change, or make a decision the client does not agree with.
A mistake does not automatically make someone a bad therapist.
But there is a difference between getting something wrong and refusing to take responsibility for it.
That difference often becomes visible when the client speaks.
This did not feel right.
I felt judged when you said that.
I do not agree with your interpretation.
I need to slow down.
I think this has harmed me.
Can the therapist stay present long enough to hear the concern?
Can they consider their own part without immediately turning the attention back onto the client’s diagnosis, history, resistance or sensitivity?
Can they accept that good intentions do not erase impact?
Accountability is not perfection.
It is the willingness to be answerable for professional power.
Why accountability is different in therapy
Therapy is not an equal friendship, even when the conversation feels warm and informal.
The therapist has a professional role. They usually have more knowledge about therapeutic processes, boundaries, ethics, complaints and the possible effects of the work. The client may be sharing private material while frightened, grieving, ashamed, dependent or unsure of their own judgement.
That creates a power difference.
The difference does not mean the therapist is always right. It means the therapist has a greater responsibility to use their position carefully.
A client should not have to manage the therapist’s defensiveness, protect the therapist’s reputation, or present a perfectly organised case before a concern deserves attention.
The therapist may need clarification. They may remember an event differently. They may genuinely believe that a challenge was clinically useful. Accountability does not require automatic agreement with every complaint.
It requires openness, thought, honesty and a willingness to examine whether professional authority is being used to avoid an uncomfortable truth.
Intent and impact
Therapists often mean well.
They may have been trying to challenge a pattern, encourage independence, protect safety, maintain a boundary or help the client look at something difficult.
Intent is part of the picture.
It is not the whole picture.
A therapist can intend to help and still cause harm. They can believe they were being honest and still humiliate someone. They can believe they were encouraging growth and still push beyond a client’s consent or readiness.
Likewise, a client can feel hurt without the therapist having acted unethically. Difficult feelings can arise in good therapy. A boundary may be necessary. A therapist may say something the client does not want to hear.
The task is not to choose between intent and impact as though only one can be real.
A more honest conversation holds both
The therapist may say, “That was not what I intended, but I can hear the effect it had on you.”
They may also explain what they were trying to do and invite discussion about whether the approach still fits.
What is less accountable is using good intention as the end of the conversation: “I was only trying to help, so you should not feel harmed.”
Good intentions may explain an action. They do not decide its impact for the client.
What therapist accountability looks like
Accountability can appear in ordinary moments, long before anything reaches the level of a formal complaint.
A therapist may check how the work is affecting you rather than assuming silence means agreement. They may ask whether the pace feels right. They may explain why they are suggesting an approach and accept that you can refuse it.
When something goes wrong, they may pause rather than defend.
They may acknowledge what happened in clear language.
They may apologise without asking you to comfort them.
They may take the issue to supervision or management, review their records, seek further training, change a procedure, correct inaccurate information or stop using a method that is not suitable.
If there is an immediate risk of further harm, they should act to reduce it.
These actions do not guarantee that trust will return. They show that the therapist understands the concern is not only about how they feel as a person. It is about what their professional responsibility now requires.
What a meaningful apology sounds like
An apology in therapy should not become another performance that the client has to manage.
“I am sorry you feel that way” often leaves responsibility with the client’s feelings.
“I am sorry, but you misunderstood me” may close the issue before it has been explored.
“I made a mistake. I can see how it affected you. I am sorry. This is what I will do now” is different.
A meaningful apology names what happened, recognises the impact, avoids excuses and includes action where action is possible.
It also allows the client to remain angry, uncertain or unwilling to continue.
An apology is not a contract requiring forgiveness.
Repair is more than saying sorry
Repair means trying to address what happened and reduce the chance of it happening again.
Sometimes repair happens within the therapeutic relationship. The therapist listens, changes something, and trust slowly returns.
Sometimes the relationship cannot be repaired.
The client may decide to leave. The harm may have been too serious. The therapist may no longer be the right person to help. A complaint or independent review may be more appropriate than further discussion inside the therapy.
Accountability does not mean the therapist gets to keep the client because they apologised.
Nor does it mean the client must participate in a repair process that feels unsafe or emotionally costly.
Repair should increase choice.
It should not become another way of keeping the client in the room.
Supervision is part of responsibility
Many therapists use professional supervision to think about their work, notice blind spots and consider ethical or relational difficulties.
Supervision should not be used as a shield.
A therapist cannot simply say, “My supervisor agrees with me,” as though an unseen authority settles the client’s experience.
Nor should confidential details be shared carelessly.
Good use of supervision may help the therapist ask difficult questions about their own behaviour. Did personal feelings affect the work? Was a boundary unclear? Was the client pushed too quickly? Did the therapist become defensive because the concern touched something they did not want to see?
Supervision is not proof that the therapist is right.
It is one place where they should be willing to examine the possibility that they are wrong.
When accountability is missing
A therapist may avoid responsibility in ways that initially sound clinical.
They may say you are resistant, projecting, splitting, avoidant, triggered, attached, personality disordered or not ready for the work.
Any of those ideas might sometimes be relevant. The red flag is when psychological language becomes a closed system in which every disagreement proves the therapist’s interpretation.
You may be told that wanting to leave shows the therapy is working, that anger proves the therapist has touched the real issue, or that remembering events differently means your account cannot be trusted.
This can make the client doubt themselves.
Maybe I am too sensitive.
Maybe I am avoiding the work.
Maybe therapy is supposed to feel like this.
Maybe questioning them proves that they are right.
Therapy can be uncomfortable. It can involve challenge, frustration and disagreement.
But discomfort is not the same as being silenced, blamed, frightened or emotionally cornered.
Good therapy should help you hear yourself more clearly.
It should not teach you to ignore yourself whenever the therapist is involved.
Defensiveness can be understandable without being acceptable
Therapists are human. A complaint may trigger shame, fear, anger or worry about reputation and livelihood.
Those feelings do not make the therapist uniquely bad. They do make reflection, supervision and professional support more important.
The client should not have to absorb the therapist’s panic or reassure them that no complaint will be made.
Professional responsibility includes managing personal reactions without making the client pay for them.
Accountability after serious harm
Some situations go beyond an ordinary therapeutic mistake.
Sexual contact, exploitation, threats, stalking, deliberate breaches of confidentiality, financial abuse, serious boundary violations, discrimination or practising while dangerously impaired may require an independent process rather than attempted repair inside therapy.
The therapist may still owe honesty and cooperation. But the client should not be pressured into a private conversation designed to protect the therapist or service from scrutiny.
You do not have to confront the therapist first
If returning feels unsafe, seek independent advice before deciding what to do.
Keep relevant messages, contracts, invoices, dates and notes when it is safe. Avoid altering or deleting original material.
If there is immediate danger, a crime may have occurred, or a child or vulnerable adult may be at risk, use the appropriate emergency, police or safeguarding route. The Crisis Resources page lists urgent UK support.
Your rights as a client
No matter how experienced, qualified or respected a therapist is, you remain a person with choices.
You can ask about training, current professional registration, methods, confidentiality, records, fees, boundaries, supervision and complaints.
You can question an interpretation.
You can refuse a method or exercise.
You can pause or stop therapy.
You can seek another opinion.
You can raise a concern without agreeing to discuss your whole childhood first.
You can leave without attending a final session if returning does not feel safe.
A therapist may have thoughts about your decision. They may wonder whether an old pattern is involved. They may disagree with you.
They should not punish, threaten, shame or frighten you into staying.
Therapy should support autonomy.
It should not quietly take it away.
The Cognisance principle and accountability
The Cognisance Therapeutic Principle places the client’s awareness, participation and freedom at the centre of the work.
The therapist may bring training, experience and another perspective. The client remains the person living the life.
This does not mean the therapist agrees with everything or avoids challenge. It means challenge does not become ownership.
The client should not have to hand over their judgement in order to receive help.
Trust has to be earned through behaviour. Accountability is part of how that trust is protected.
You can read more on The Cognizance Therapeutic Principle.
What you can do when something feels wrong
Write down what happened
Use plain language. Record what was said or done, when it happened, what you understood at the time, how it affected you and what followed.
Separate the original concern from the response
Sometimes the therapist’s response becomes as important as the first event. Did they listen, explain and reflect, or did they shame, threaten, minimise or close the conversation?
Ask one clear question if it feels safe
You might ask, “Can you explain why you did that?” or “What do you think your responsibility is here?”
You do not owe the therapist this conversation. It is one option.
Seek an independent view
Speak with somebody who is not connected to the therapist. This may be another practitioner, GP, advocate, safeguarding lead, professional organisation, regulator, employer, platform or legal adviser.
Check the therapist’s current status
Do not rely only on letters after a name or a logo on a website. Search the relevant current register and read the organisation’s complaint process.
Decide what you need now
You may want an explanation, an apology, corrected records, a refund, changed practice, a referral, a complaint, distance, or simply an end to contact.
The therapist may not agree to everything you request. Naming what you need can still help you decide your next step.
Questions that may help you assess the response
- Did the therapist allow me to describe what happened without interrupting or diagnosing my reaction?
- Did they acknowledge the power attached to their role?
- Did they explain their reasoning without presenting it as the only possible truth?
- Did they recognise impact as well as intention?
- Did they apologise clearly where an apology was appropriate?
- Did they take any practical action to reduce further harm?
- Did they seek supervision, management or independent advice where needed?
- Did I remain free to pause, leave or complain?
- Do I feel clearer after the conversation, or more frightened and confused?
Complaints are one route, not an obligation
A formal complaint may create a record, lead to investigation, identify a breach of standards or protect other people.
It can also be slow, demanding and emotionally difficult.
Some people feel strongly that they need to complain. Others decide they cannot carry the process, do not have enough evidence, or need to focus on recovery.
Not making a complaint does not prove that nothing happened.
Making a complaint does not guarantee the outcome you hope for.
Before beginning, check who has authority over the therapist. The route may be through a professional body, statutory regulator, employer, NHS service, charity, university, clinic, online platform or safeguarding process.
Different organisations have different time limits, evidence requirements and possible outcomes.
Professional standards and complaint routes
BACP’s Ethical Framework includes accountability and candour. It says members should be open and honest when something in their work has placed a client at risk or caused harm, take action to prevent or limit harm, repair harm where possible, offer an appropriate apology, and discuss what happened in supervision or with a manager.
UKCP describes accountability and candour as transparency about therapy and responsibility for acting in the client’s best interests. Its guidance also expects clients to be told about the complaints process.
HCPC standards apply to regulated professions such as practitioner psychologists. They require professionals to work in partnership with service users, recognise positions of power and trust, maintain boundaries and respond appropriately to concerns.
Useful official starting points:
- BACP accountability and candour guidance
- How to complain about a BACP member
- UKCP complaints information
- Raising a concern with the HCPC
- Professional Standards Authority register finder
Not all therapists fall under the same system. Some counselling and psychotherapy registers are voluntary rather than statutory. Identify the practitioner’s exact current membership before relying on a particular process.
If therapy has already harmed you
Harmful therapy can leave people doubting their memory, judgement and right to be angry.
It can also make future offers of help feel dangerous.
You do not have to rush into another therapeutic relationship to prove that you still believe in therapy.
You may need information, distance, practical support, friendship, medical care, advocacy, legal advice, a complaints route, or time to understand what happened.
A new therapist is not automatically the right first step.
If you do seek one, you are allowed to move slowly, ask direct questions, limit what you disclose and leave if the relationship does not feel right.
The previous therapist’s title or professional position does not make your experience less real.
A final thought
Therapy only works when there is enough safety for honesty.
Safety does not come from the therapist being perfect.
It comes partly from knowing that difficulty can be spoken about, mistakes can be examined, and professional power does not place somebody beyond question.
A good therapist may not agree with everything you say.
They may sometimes challenge you.
But they should not punish you for having a voice.
You are allowed to ask questions.
You are allowed to give feedback.
You are allowed to slow down.
You are allowed to walk away.
Between Paths provides general information and reflection, not a formal judgement about a therapist, legal advice, safeguarding advice or emergency support. Professional standards, time limits and complaint procedures vary, so check the current information from the relevant organisation.
A therapist’s authority should never place them beyond question.
Accountability is part of care.
