To be sure, psychotherapy is a relationship. Personal and relational growth and healing takes place within the context of a relationship. Apps for anxiety, PTSD and other emotional struggles can be quite helpful. But they rarely take the place of a relationship, nor does research indicate that they have the same efficacy. It is relationships, especially in childhood when we are all dependent on our caregivers, that frequently cause emotional suffering and disorders. It should then not be surprising that it is relationships that help people recover and heal.

Psychotherapy is something of a unique kind of relationship, however. It is a professional relationship. A person or family seeks out a therapist and pays them for services. Beyond that, the therapeutic relationship is not reciprocal. The therapist is responsible for making sure that the relationship is about the client, his or her needs and growth, and only about the client. If the conversations begin to go off course and include the needs or interests of the therapist, it is generally subtle. If this happens, professional boundaries are not being respected or maintained, and this is considered a violation of the therapist’s Code of Ethics.  It is up to the therapist to recognize this, address the issue immediately, and, if the relationship has been damaged, help the client transition to another therapist.

If a client should take notice if they begin to feel they (1) can’t bring up certain topics as it might upset the therapist, (2) begin to worry about the therapist, (3) find that the therapist is talking frequently about him or herself, (4) notices the therapist seems distracted, (5) or just generally feels uneasy or uncomfortable. It is most important that the client raise these issues with the therapist, asking that they be addressed. If they are not, a client may want to seriously consider ending their work with that particular therapist.

A client should never feel they should continue working with a therapist out of any sort of obligation.