“Try This Instead” is self-help that doesn’t suck — it’s an advice column written by me, Sam Dylan Finch, a neurodivergent writer and lived experience advocate who’s passionate about sharing what I’ve learned.

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📌 Q: Hey Sam! I experienced a harmful therapy relationship a few years back. After taking some time, I’m ready to start therapy again… yet I can’t help but wonder if I missed an opportunity to ask more questions last time that would’ve protected me. What questions do you tend to ask new therapists or coaches, especially to identify red flags?

First of all, I want to say how incredibly sorry I am that you experienced harm in a therapeutic relationship.

If you aren’t familiar already, there’s some great work being done through the Therapy Harm Resistance Project, and its creator, Natalie Russ, has a list of therapy harm resources as well that might be worth exploring.

I’m wondering if there’s a hint of self-blame in the phrasing of this question — and I really get it, because I’ve experienced harm in these types of relationships, too, and my first instinct was to interrogate myself and try to figure out how I “missed it.”

The messy truth is, we can’t always prevent harm from happening.

We could be the most discerning, competent, and intuitive people… and still end up on the receiving end of someone’s unprocessed stuff.

We could ask all the “right” questions — about credentials, certifications, education, experience, or whatever else we believe will safeguard us — and still end up experiencing harm.

So I want to challenge the idea, which I think many of us still carry, that therapy harm (or any harm in a coaching or care relationship) could be prevented if we simply did our homework.

I know that’s really scary to reckon with, because when we seek out support, we’re already in a vulnerable position.

That doesn’t mean that we’re completely disempowered, though!

There are questions we can ask during a consultation, intake, or discovery call — whatever a practitioner is calling their first meeting with you — that can be helpful in both the short- and long-term.

That’s why I think it’s important to gently reframe the intention behind asking these sorts of questions.

Because we’re not asking questions to definitively prevent harm. Instead, we’re asking questions that can keep us safer throughout the relationship.

We do this not just by evaluating a practitioner in the moment when we first meet them, but by also supporting our future selves by establishing a precedent. You do this by asking how your practitioner plans to navigate things like feedback and repair in the future.

We may miss “red flags” in a first session for a variety of reasons, not the least of which is that there may not have been any to begin with!

That’s why it’s helpful to have “now and later questions,” to give your future self a point of healthy comparison — namely, to file away what the practitioner said would happen in certain situations, so you can compare it to what actually takes place once you’re working together.

Let’s unpack a few of those questions, and how they can be useful to ask any therapist (or coach, dietitian, or other adjacent practitioner) you’re considering working with.

1. What can I expect from our time together? What outcomes do you tend to see in your work?

Obviously a practitioner can’t know with certainty what the future looks like. But generally speaking, we can ask what to expect when working together, and assess if their response seems realistic, thoughtful, or just full of hot air.

The Red Flags

🚩 They promise amazing results, especially within an oddly short amount of time.

Why? Real change (or healing) often takes time! While sometimes life-changing care can produce unexpectedly speedy results, no practitioner can guarantee that for every single client they have, so it’s not appropriate to set that as an expectation from the outset.

🚩 They shift the responsibility exclusively onto the client, stressing that only clients who “weren’t ready” or “willing to do the work” have “failed.”

Why? Blaming clients for not “succeeding,” and framing it as the client’s failure alone, suggests a lack of accountability on the part of the practitioner.

🚩 They focus a lot on testimonials, or paraphrasing what other clients have said about them, rather than speaking directly to how they will support you.

Why? Hiding behind unverifiable reviews and testimonials (including on their website!) — while not really speaking to their specific approach or how they plan to help — doesn’t allow you to make an informed decision about whether or not the specific type of support they’re providing is appropriate for your needs and goals.

The Green Lights

💚 Their response seems nuanced, acknowledging that healing is rarely linear and that every client’s journey is unique, before unpacking possible outcomes.

Why? Viewing each client’s process as unique is a more realistic response, and suggests a level of patience and attentiveness to the specific needs of the client.

💚 They stress the importance of the relationship between you, acknowledging that you may discover that you aren’t a good fit, and that they’re prepared for that, too.

Why? Acknowledging that the relationship between you will impact the work is a more realistic response, and suggests a more appropriate level of accountability. It’s also good to normalize that not every practitioner is for everyone, and be ready to refer without taking it personally.

💚 They can generally speak to what types of support have been impactful for clients who have had similar challenges or goals to you.

Why? Being able to speak fluently to the types of support they offer and how that connects to relevant outcomes is important because it demonstrates competence — they can directly connect how their own interventions have supported specific types of clients, and why that is relevant to you.

If you choose to move forward…

Look for consistency. If you’re struggling to make progress, what happens when you raise your concerns to them?

Do their responses remain as nuanced, thoughtful, and “green” as they did when you first met?

Or do they start to mirror the red flags you were cautioned about before?

🚩 Delayed red flags sound like:

• Avoiding: I’ve walked thousands of clients through this very same issue. You just need to trust the process! You’re doing brilliantly.
• Deflecting: Hm. I’ve never had a patient bring this to me before. I wonder if this has something to do with the issue you mentioned having with your father?
• Blaming: I can’t work with someone who isn’t receptive to my teachings. If you can’t keep your heart open, nothing I offer will help you.

2. What’s the best way to offer you feedback?

Feedback is important for practitioners to adjust their approach based on what your unique needs are. After all, being responsive and attuned to you as a client is a big part of their job!

The Red Flags

🚩 They deflect, asking why you’re concerned about feedback, framing the question as odd or unreasonable.

Why? Practitioners should not feel threatened, confused, or worried about the idea of a client offering feedback to them.

🚩 They mention soliciting feedback at the end of your working relationship, but don’t seem available for feedback during your time together.

Why? Ideally, practitioners are available to discuss your concerns, needs, and feedback throughout the relationship, not just at the very end.

🚩 They overemphasize their education, supervisors and/or mentors, or other credentials as a subtle way of suggesting that they don’t need feedback at all.

Why? Supervisors, mentors, and education aren’t a substitute for feedback from clients, especially with respect to their lived experience. Emphasizing their education while dismissing the client experience could suggest a hierarchical approach that could leave clients feeling unheard or invalidated.

The Green Lights

💚 They discuss receiving feedback as an important part of what guides their work, and take your thoughts and feelings seriously.

Why? The strength of your relationship will ultimately dictate how impactful the work is. Trust and open communication are key parts of that.

💚 They express being open to receiving feedback in whatever format or way you feel most comfortable with.

Why? Not every client can advocate for themselves yet, and a practitioner who takes the time to accommodate clients who are still working on vocalizing their needs is a positive sign.

💚 They discuss consultation or supervision as a resource to better address client feedback, rather than as a way of replacing or ignoring client feedback.

Why? While not all practitioners have supervisors, most will be in community with other practitioners or have mentors to help ensure they’re taking client feedback seriously and doing the best work possible. Therapists especially may reach out for consultation if a client brings something to them that they need more education or guidance on.

If you choose to move forward…

Look for follow-through. They should ideally be behaving in ways that are aligned with what they shared at the outset of your work together.

Sometimes a practitioner tries to reconcile what they said in the beginning (“I am open to feedback”) by twisting it just a little, to sound more like, “I am open to feedback… if that feedback is something I believe or agree with.“

🚩 Delayed red flags sound like:

• Minimization: It sounds like you may be feeling a bit triggered or sensitive, and that is influencing your criticisms of me.
• Shutting down: If this is your way of telling me you don’t want to work together anymore, I’m happy to refer you out.
• Posturing: I have two decades of experience in this modality — I’ve taught at the university level! I think I would know if I were incompetent.

3. How do you navigate rupture or harm with your clients?

With this question, we’re trying to get a sense of how a provider feels about navigating conflict.

Even the best therapist or coach will sometimes misstep, maybe by saying something careless or making an assumption that doesn’t quite land.

It’s important that practitioners feel comfortable working with clients in ways that are safe and boundaried, and that includes having repair skills for when conflict, disagreement, or rupture happens in a relationship.

The Red Flags

🚩 They remark that they’ve never navigated any kind of conflict, rupture, or harm with clients, so they haven’t given it much thought.

Why? Even if a practitioner has not yet experienced rupture with a client, they should already know how they would handle it if it did occur. Rupture and conflict are a part of relational work, and practitioners should feel comfortable discussing it with you.

🚩 They try to “smooth over” or minimize your concerns by discussing how good they are at their role, so you don’t need to worry.

Why? If a practitioner’s plan for rupture is to assume it won’t happen, it’s more likely that they’ll harm clients by improvising when harm occurs, and suggests they haven’t intentionally worked on their repair skills.

🚩 They ask if you struggle to trust authority, have a trauma history, or otherwise imply that your question reveals something problematic about you.

Why? Pathologizing a potential client for simply asking a question about a normal part of relational work is an inappropriately defensive reaction.

The Green Lights

💚 They normalize rupture and recognize that sometimes practitioners can make mistakes or even harm clients.

Why? Practitioners are not infallible — they’re still human. Recognizing their own capacity for harm demonstrates a crucial level of self-awareness and humility.

💚 They do not appear threatened by the mention of rupture or conflict, but instead, recognize its value when handled skillfully and with care.

Why? Rupture or conflict can actually be a growth opportunity, and can strengthen the relationship when a practitioner handles it with intention!

💚 They can name in general terms how they view rupture and how they support clients, while remaining curious about what that means for you.

Why? This demonstrates that the provider has done some amount of thinking and practicing around rupture, because in reality, most practitioners will step on a client’s toes or miss the mark from time to time.

Their curiosity about what’s underneath the question is reasonable so long as it feels validating of your concern in the end, rather than dismissive.

If you choose to move forward…

Look for patience. They should not be threatened by rupture with a client, and instead, remain open, grounded, caring, respectful, and engaged.

In fact, they may see this as an opportunity to engage in healthy repair, and strengthen the relationship between you.

🚩 Delayed red flags sound like:

• Withdrawing: Perhaps I misjudged the situation. I thought you were ready to do the deeper work. But maybe it’s best that we reevaluate our work together.
• Personalizing: You know I didn’t mean it like that! I would’ve thought you knew me better than to assume ill intentions.
• Pathologizing: I was waiting for the right time to tell you this, but I’ve been thinking that perhaps you have what’s called Borderline Personality Disorder, or BPD. Are you familiar with the concept of “splitting”? I suspect that’s why you’re treating me this way.

Remember: These questions are designed to help us feel safer, but they can’t guarantee our safety.

What happened to you in your last therapy relationship was not your fault.

And while I hope it never happens again, please know that if it does, it wouldn’t be anymore your fault the next time than it was the time before.

That’s because, when someone takes advantage of their role as a clinician or care provider, the only person responsible for that misuse of power is the practitioner.

Asking the right questions can increase our discernment, both in choosing to work with someone and in strengthening our self-trust later if they start to behave out of alignment.

But ultimately, we can only control what we can control!

So be gentle with yourself as you navigate this process, and try not to psych yourself out — you may need time to trust someone new, but you absolutely can trust yourself no matter what happens.

This is a courageous next step, my friend, and I’m manifesting a gentle and supportive practitioner for this next season of growth in your life.

All the best,

Sam Dylan Finch

⚠️ A note about safety: This article does not constitute medical or treatment advice. These are just my opinions! If you believe that a provider may be engaging in unethical or harmful practices, or is making you feel unsafe in any way, please get an informed perspective from someone more qualified to support you directly. You might also explore these therapy harm resources.