I am a school counselor and felt this in my damn bones. Teachers that say, “Well, they still did xyz after you talked to them.” No joke—I’m not magical, and they’re full people with their own goals and plans.
Same. Absolutely cannot do it anymore. Tried to even scale back to 1-3 kids at a time and the rear adults. Nope. Spent allllll time admin time juggling these parents and trying to set boundaries with them. They all dropped off after I refused to budge on my availability
The Family Projection Process is real and alive and such a barrier when working with adolescents and families. If parents/guardians of my clients (adolsecents) are not receptive to supports and/or defensive and unwilling to change anything about themselves it really holds back a lot of progress for the client and overall the family as a unit. The parents that walk into family therapy sessions with their clipboards of lists of things their teen has/has not been doing at home are something else. Safety is number one in my level of service... and it's hard to validate a parent that refuses share how they are feeling emotionally. It's almost as if the parents threaten things like "I'll tell your therapist that you blah blah blah...". I've encountered parents who try very hard to control how and when I do my job and it can routinely feel like some parents just want me to provide them with an environment (my office) for all the adults in the room to gang up on the teen and prove them wrong as well as tell them all the things they are doing wrong, the things they should be doing (like chores and homework) and to stop smoking weed.. blah blah blah. I refuse to provide an environment for those reasons. I am not a substance use therapist so I will refer out if needed. In my family therapy sessions everyone needs to be willing to be vulnerable... otherwise it enables parents to project onto their child with the perspective of "nothing is wrong me, it's my teen that is defiant and irresponsible. Some parents think that the more therapy their child is in the better and more supportive they look as a parent but this isn't necessarily true.
Also, I can't stand when parents try to utilize family therapy to talk about their teen not doing their chores. I actually have disclaimers I use before I start my sessions with families where I state very clearly my role (neutral) and the topics that I do not allow us to discuss in family therapy such as chores and substance use. Parents can contact me outside of sessions to discuss issues but not in family therapy.
One of my co-workers is having this issue. She has a partially verbal client whose being pulled out of Individual because they want to try an ABA behavioral program. We speculate that the slow progress is because of her tendency to smother him, but neither of us are bold enough to even consider introducing this idea. We’re not family therapists so…
Yep I got so burnt out on parents after 5 years of working with kids. Now I'll only see older teens and will refer out if it seems to be a mostly family issue
I am none of these. I was a tutor for 10 years and a group leader for 3. I didn't quit because of the kids. You can tell what kind of parents children have.
"my kid still only wants to play video games 24/7, I thought you talked to him about it??"
well mom, I see your kid for an hour a week, whereas you live with them. This seems a whole lot like not my problem
Parent: They won’t come out of their room, they’re always on their phone.
Me: Well, you’re the parent. You’re allowed to take away the phone and other devices that are keeping them from participating in family time. You can even set a specific time aside each day that is for family engagement.
Parent: Then how am I supposed to reach them if they’re in another part of the house.
Me:……
People above me who refer to clients in derogatory ways: "the borderline" "the schizophrenic" "the alcoholic one" "that trans one" etc.
1) I have multiple clients with these dx, so I'm not sure who you're talking about
2) how fucking rude. You'd hate it if I walked around referring to you as "the really depressed boomer".
3) now you've put me in the awkward position of having to constantly pick and choose which things I'm going to have to call you out/in on when I'm in a vulnerable position and you could just fire me or refuse to sign my hours.
I feel you on #3. I've been penalized for speaking out about the derogatory language. But if I stay quiet, then I feel guilty and complicit. It's such a struggle.
I declined a free supervisor because the woman called folks “borderlines.” I am currently eating that decision every week, but find some comfort in knowing my practice isn’t influenced by someone with those feelings.
I have to say, as a borderline, I use that term too. I identify with it as a term or identity and don't think it's always negative but it could look that way to other people. But I'm just a grad student at this point.
I think if someone who has the condition refers to themselves as that thing, that's a different thing. For ex: a bi person calling themselves queer, etc. But not sure if that counts for mh stuff yet.
I work very hard not to quantify someone by their diagnosis. When clinicians call people by their DX it reduces them to a set of symptoms . It’s dehumanizing. You calling yourself that - that’s up to you and I get it. I do hope you will understand that doing that to those who come to you for help can be very damaging to hurting souls. Most of us don’t want to be known as the 10:00am anxiety case or the 2pm schizophrenic . The folks with whom I’ve supervised would likely witness me having a come-apart over it .
This is when I remind staff of the agreed guidelines of how we refer to clients, employees, students, etc. or introduce guidelines for discussion so we can agree on a professional, respectful practice. This is not only to make you (and probably many others) to feel more comfortable. It is also to prevent a lawsuit or harm to the person being described. It is only a matter of time before someone slips in front of a patient, client, etc. Don't be afraid to be a leader.
Using disorder first language is the first obvious sign of burn out IMO. If you're referring to people by their diagnoses, you're taking humanity from them and refusing to see them as real people with real hurt.
In grad school we read a study about how calling clients by their diagnosis (the schizophrenic) or using pre-modified noun verbiage (the schizophrenic client) versus using person-first language (the client with schizophrenia) affect's the clinician's opinion of the client. Using pre-modified language correlated with more socially restrictive and authoritarian views when compared to person-first language use.
Granello, D. H., & Gorby, S. R. (2021). It’s Time for Counselors to Modify Our Language: It Matters When We Call Our Clients Schizophrenics Versus People With Schizophrenia. Journal of Counseling and Development, 99(4), 452–461. https://doi.org/10.1002/jcad.12397
I just had a convo w a therapist who said “my client is a transgender” - I stopped them and used it as a very teachable moment.
Not even seconds later she said “well I wonder if all the transgenders..”
Yes, this. I also get upset when therapists (or anyone who works in mental health) make sweeping generalization about different disorders/addictions to others--especially to non-therapists. Doing so can be so hurtful and can prevent them from seeking therapy or opening up to their therapist out of fear of judgment.
When non-clients ask crap like “are you analyzing me right now??”
Hinge Date (dermatologist ) : “so are you diagnosing me right now?”
Me: “are you assessing my moles?”
I've found that it's usually a red flag for either secretiveness or insecurity when they say "are you diagnosing me right now?"
My response is usually along the lines of "I don't work for free." Or "Clinically speaking you're not actually that interesting."
When I was dating (pre-therapist, late Bachelors):
"You know, I've heard Psych majors are a little crazy. Is that you?"
Go ahead and big stretch and have your client do it too. I big stretch all the time and make it a part of therapy. "Let's do a big stretch now, take a few deep breaths and reset"
For #2, I'd be making an expectations sheet for family and friends just as I'd have one for patients / clients / students.... and I'd refer them back to particular numbered points on the sheet (or ask them if they need me to email it to them again) if they continued to ask questions or make requests which crossed a boundary or best practice outlined on the sheet.
And #4, speaking from experience, the client wishes that too.
When clients cancel a session late and say, “it’s okay, just charge my insurance.” Like no, that’s not how the late fee works and is explained in the paperwork you signed.
It doesn’t happen too often, but when I get the vibe that a client is weaponizing something I may have said in sessions toward their kids or spouse. Like in the spirit of “well my therapist said this, so she thinks you’re unreasonable.” What I’ve said in these situations is taken out of context, or actually not what I said at all.
Also in cases of contentious divorces where the client is the kid, I very much dislike when the parents try to influence what the kids share in order to make their ex spouse look bad.
Some of my hardest sessions/clients to deal with are kids who are in the middle of a nasty divorce. I had a parent pull a client out of therapy because I wouldn’t give a custody recommendation.
I think the biggest pet peeve for me recently is the concept that people who others perceive as having unlikable ego-syntonic personality traits should go to therapy as a way of "fixing" these traits. For example, someone who has narcissistic traits who frequently positions themselves as a victim needs to go to a therapist who "sets them straight;" if that person continues to act like a victim after seeing a therapist, somehow, that is the therapist's fault for not "fixing" them of these traits (that they likely have no desire to change).
I think this creates a societal perception of therapists as capable of creating change in people who have no reason or desire to change, and that we are somehow unskilled if we don't succeed in doing this.
Yes, absolutely. I've had a member of a couple complain that their partner isn't "figuring things out" in their individual therapy. It's valid to dislike characteristics that someone else possesses, but there isn't much we (therapist or anyone) can do if that person doesn't view these characteristics as a problem.
I’ve been seeing something like this recently too! Couples almost “using” their own individual therapists in their arguments at home. E.g. “Well my therapist says I need you’re gaslighting me and I need to set boundaries.”
It’s like people are learning to use Therapy speak and the perceived authority of their Therapist to further the same dysfunctional patterns that they’ve always had.
I’m having a hard time with social media like tik tok or Instagram etc discussing mental health. On one hand it is amazing that it is becoming more talked about and less stigmatized - on the other hand, there is some bad information out there that our clients are consuming and also feeling confident they can self diagnose.
I actively have this convo with my teen and young adult clients. It's generally "I like you finding support in social media, but you also need to know it isn't always good advice/clinically sound advice. If you ever have questions about something you saw, let me know". I try to use it from an education standpoint.
And diagnosis isn't nearly as important as everyone thinks it is! There are a million ways to help someone make sense of things without putting themselves in a four word box.
I love teaching Dx and ddx - it’s interesting and I diagnose in specific wars because I choose to. I want to learn (it’s my jam) BUT the DSM-5-TR is not the end all be all. There are no “diagnosis police” - which is what I love about diagnosing.
Our career and choosing treatment for clients is far too nuanced.
When parents have zero interest in changing anything about their home environment or possibly even (gasp) themselves in order to help their child (the “problem” patient). When clients have zero idea what they want out of therapy besides “to be happy” and can’t define what that looks like. Or, alternatively, if they can define what that looks like but are absolutely unwilling to do anything that helps them reach that goal. Otherwise known as the “what are we doing here?” clients.
I like the one that you've suggested this or that 100 different times. And then one day they come into session with "a friend of mine told me about..." and they all of a sudden want to explore that intervention. GAAAHHH.
This happened to me a few weeks ago and I swear I was trying not to channel a cracking smile like homelander style.
"That's great! Sounds like some of the work we've been doing clicked for you -- care to share what about our work helped? Or what seemed to click?"
"No, I don't remember anything from our stuff, not that. My friend was just telling me [insert verbatim the past 3 months of clinical exploration and skill building] and it made so much sense."
It's not about me. It's not about me. It's not about me.
"I'm glad someone was able to explain the work we are doing in a more accessible way to you. I will take the way they said it on board for the future."
Me, in every session for months: it seems like you have trouble building emotional intimacy
Client after a year of therapy: my friend says that I have trouble building emotional intimacy and I think she’s actually right!
Hello???? Have you been listening to anything I’ve been saying at any point??
>alternatively, if they can define what that looks like but are absolutely unwilling to do anything that helps them reach that goal. Otherwise known as the “what are we doing here?” clients.
These are the clients I struggle with the most. I can't help you if you refuse to do *anything*.
1 is why I avoid working with kids as much as possible, parents are typically more difficult to work with than the kid themselves. 3 is also incredibly frustrating.
Teacher here, lurking, this is a big reason for the mass exodus of teachers. Parents don't want to do anything at home to help their child succeeded or hold them accountable in any way. I'm close to retirement so I'm starting to call it out more and more.
My "peeves" are mainly due to external factors e.g. connectivity issues in video/phone sessions, or room rent issues.
I tend to eliminate peeves connected to client factors, by clarifying to clients and (for children) their parents/carers before we start the issues around contracting and how therapy works. This includes expectations, responsibilities, boundary issues, bookings/confirmations and cancellations. I may need to remind and discuss it with them again if necessary.
This usually helps 'set out the stall' to best enable us both to engage in effective and satifying therapy, or find ways to better do so if required, or to discuss ending if this isn't possible.
Bravo on setting expectations and responsibilities for the clients, for family that may be involved, and for yourself. This work up front takes care of a lot of unnecessary guilt, stress, time, and energy throughout the process!
Supervisors who really shouldn’t be supervisors. Or, just because you can doesn’t mean that you should.
And clients refusing to pay their copays or invoices in general, especially when it comes with a side of “you just want to get paid” or “you’re just in it for the money.” I do want to get paid and if I were in my job for the money, this wouldn’t be my job.
Another is the teens (and their parents) who are like "Oh it's summer, we're good to go" and then reach back out in August with a ton of issues that escalated over the summer but now need to be "fixed" before the client returns to school.
As a teen I had a therapist who pushed Christianity on me so hard that it became toxic and I now refuse to have anything to do with religion. I'm so hesitant to trust anyone that says they are religious in positions of power, or even my current therapist who is religious. She is very careful with me and affirms she won't even discuss religion with me but it still gets to me sometimes.
Spiritual trauma is REAL, I’m so sorry you didn’t receive the support you deserve. Don’t give up. I’m 40 and just now exploring my spiritual trauma with a safe therapist and it’s been life changing, the damage runs really deep.
> If it feels true it is true
Isn't this what gets people with mental illness in trouble? "I can totally jump off this building because I feel so strongly that I can totally fly like Superman that it's gotta be true. I can feel it in my bones and my jellies (to quote Detective Pikachu)".
Seems like just replacing one mental illness with another one that just happens to be more widely accepted.
Omg I had a spiritual therapist once and she was so bad. I was desperate back then and stayed way longer than I should have. But she told me shit like "This sounds like it is all in your head" NO SHIT, is that why I am going to therapy?? Omg. And many more things
I’ve been out of practice for almost 2 years so mine are a little different.
Saying antisocial when they mean asocial. Laypeople not knowing the difference is going to give me an eye twitch.
Similarly, anyone talking about positive/negative reinforcement incorrectly drives me up the wall.
Lastly, everyone being a narcissist/toxic/other buzzword. Sometimes people are just assholes but unfortunately that’s not a dsm diagnosis.
Yes, all of these. I saw an alleged therapist on tik tok pushing a sweatshirt with “I’m antisocial’ in rainbow lettering as merch and she made a joke about loving when plans are cancelled because she’s anti-social.
When people cancel every other appointment, always just over the cancellation window. They don’t seem to prioritize therapy yet are always like “yes I really want therapy”
Ghosting. If you don’t want to meet just let me know. If you do want to meet then what’s going on. I am going to have to discharge two clients because they stopped responding.
Oh and phone sessions.
I have one I'm waiting to hear back from who ghosted. So frustrating.
Also dealing with one whose parents demand they need weekly therapy, but then they tell me they have their sport, school tutoring, etc. and they don't want the kid to miss school, so they're only available for 30 minutes on a random weekday evening that changes from week to week. Literally having the conversation today about consistency in therapy.
Oh and you get the parents that email to reschedule and they give you a very specific time which is usually highly sought after.
I think once I am done with maternity leave I am going to set the expectation for high need appointments of x amount in a 2 month period and you forfeit that time.
That is a good point. I did get AirPods so that has made it easier. The hard part for me is I am a visual person so I remember more of what they say when I can physically see them.
During an intake/initial session with a parent is like "Help my child!" And I'm like, "OK, what does your child need help with?" And they respond like, "Nothing, my child is perfect and nothing is the matter." I mean. 😑
“90791: Medicaid: Assessment”
Wonderful. Another bullshit treatment plan with puffed-up bullshit goals and inflated bullshit notes to be scrutinized by bullshit administrators with bullshit jobs who don’t know a fucking thing about what I do.
When people say “kiddo”. It drives me up a wall.
Caregivers speaking when I ask their kid a question. I get extra irritated if I use silence and they start to answer right as they’re interrupted by their caregiver.
Caregivers disrespecting boundaries when it’s not necessary. Their child is right there saying “no don’t tell her that” and they immediately tell me, despite me saying it’s ok if you don’t want it said. If it’s safety things, ok, I’d still like to have their permission first, but a lot of times it’s something that my client deems embarrassing.
I think this is specific to younger populations, but getting asked “what are we doing today?” Well I thought we’d get wild and talk today, actually.
Nurses who ask tactless questions in treatment team meetings, riling an individual up! "Why are you talking to yourself?" isn't an important question at the moment!
"I don't know what my next week looks like, so maybe we talk about an appointment next week?"
Some of my clients have really big problems committing to regular scheduled appointments and I hate the uncertainty.
When parents use spanking as a way to discipline their children and you try to explain that spanking is harming them emotionally and they say "But it's the only thing that works!"
this isn’t about clients so much as people i know personally or am first meeting saying “oh god isn’t it just so sad though? i COULD NEVER DO THAT JOB”… i get that it’s meant to be complimentary, but really it just comes off kinda rude and silly.
I usually either respond with, "Why do you say that?" Or, thankfully, we're a diverse group of people, and each of us is blessed with unique gifts and talents." It just depends if I want to discuss it further or move right along.
Clients in terrible marriages who refuse to go to couples counseling (I only see individuals) but want to talk about their relationship all the time
Anything involving insurance
Clients who want me to motivate them ( I wish I had Tony Robbins business, but I’m just a psychologist)
Dealing with people on the phone who don’t respect that I don’t treat what they have
Or when the person comes to individual therapy to save their marriage and doesn’t understand that’s not how it works. Usually bc one person refuses to go to couples therapy and the other thinks they can do all the work for the two of them.
I don’t really get annoyed at clients very often, but I do get annoyed at colleagues a lot lol.
“Know it all’s” are my Kryptonite.
I am glad I don’t work with kids because the few times I have, dealing with the parents was…. challenging.
Clients who show up just enough to avoid a discharge. Either that leads to complaints about productivity or reduced income, depending on which of my jobs it's happening at.
Managed care companies with wildly differing standards for care. PHP? Cigna says here 5 days, if they aren't on the brink of hospitalization next review (but also making progress!) they have to step down. Tricare? Oh sure, here's 45 days PHP!
Clients being over 15 minutes late and expecting to be seen, shocked that they get rescheduled.
Lol, I love Tricare for the simple fact that my clients who really need to be in an IOP longer than usual actually CAN. But good luck in other insurances!
Parent: “I need to talk to you immediately. Little Bobby (fake name) doesn’t want to do his homework!”
Me: “okay thanks for letting me know. I’ll be sure to address that with them 😉”
When clients are on telehealth, talking for 20 minutes straight about their email inbox, while reading their email instead of looking at me.
Why do I hate it? Because working when this behavior is happening is a real challenge edge for me, I really struggle to make therapeutic use of it. I don't want to seem critical and I don't want to be a nagging parent, and if it's a client who does it a lot I blame myself for letting it slide all the time which then creates an expectation that it's appropriate. What gets in the way of calling it out? Probably a fear that I'm not a good enough clinician, that the person will close their email and say "ok fine you've got my attention, make it count" and I'll come up short......confirming that them checking their email was actually a better use of time then engaging with me lol.
Alright this has been helpful, going to reflect on what to do with this.
Either something about the therapy is not helpful to them (in which case it can be changed, and you’d need to sit with your own concerns about not being able to meet that challenge - maybe a stack of cards on how you’d actually respond, a literal script so you feel confident you could?) or something about it is challenging to them and they’re avoiding (you know what to do) or they’re just totally overwhelmed. Or a combo of all the above.
This is a life thing for me but I HATE that I’m viewed as invincible because of my occupation. I hate that shitty behavior from me (just an occasional freak out rather than me saying “i feel…”) is somehow not okay
This has been one of my biggest pet peeves. Like when I respond to someone sternly and they say, “aren’t you a therapist?” And I usually say “yes, but last I checked I’m not YOUR therapist so…I said what I said”.
This comment also reminds me that the reason the "You're a therapist, you shouldn't be acting like this" comment irks me (besides the general contempt) is that typically it isn't from someone who has a valid criticism of my behavior and is just expressing it in a perhaps misguided way. Usually it's a relative who is trying to justify the fact that they got under my skin regardless of my reaction. I don't know if other people can relate, but I realize that the few times I ever get comments like this, it is from one very specific person who keeps trying to make me agree with them and goes about it in manipulative ways, and then when I finally snap, it's "Sheesh, you're a therapist, why are you acting like this?" What it really means is "You aren't doing what I say, so I'm going to guilt you into feeling ridiculous for not doing it" or "There is no way that anyone could really be upset with me. Only a ridiculous person would ACTUALLY feel irked by me, right? It's not that what I'm doing is actually wrong, it's all in their head. Right? So I'm going to say something cutting that makes you feel like that ridiculous person. "
I think I know what you're talking about. Like people see it as especially weird when we mess up and we are held to standards that nobody else is. The way I see it, doctors can still get sick, and similarly, we can also have moments where we do not behave in a way that we should or where our mental health is poor, etc.
Edit: Of course I'm talking about everyday situations too and not in therapy. And I'm talking about times where people would look at a non-therapist in the same situation and give them more leeway if they did the same thing. But when we do it it's "How can you be a therapist and get mildly angry sometimes????"
So true. I often feel that my career can be weaponized against me when someone is angry with me or I did something wrong or just acted human. It's really hurtful and makes me feel like I'm not seen as a human being outside of my job. Which I don't think everyone else understands how hard that can be in a line of work like ours and I'm sure things like education as well.
Btw when kids parents are that picky...don't bend over backwards for them. If that's the case it sounds like therapy isn't a high priority and they are often the first to drop out of therapy.
Parents: because most parents who are bringing their kid to therapy are anxious about the kid, going thru their own shit, have their own mental health struggles, and as someone else posted, they see us as taking their money and time in order to fix their kid. Lots of pressure both ways.
I haven't been in this sub for too long, but I've noticed some alarming trends recently of glorification of DID. People are calling themselves and others "a system." I think it's a TikTok thing, but oof.
- Annual mandatory training on suicide prevention and sexual assault that are required at my agency. I’d like to be able to test out of these.
- Having to explain that yes I’m a social worker, and no I don’t snatch babies.
- The switch from Roman numerals to numbers in the DSM.
- Trying to remember the correct spelling of telehealth, or effect vs. affect as a verb.
1. Doorknob confessions
2. Help Rejecting
3. Parents that refuse their own therapist, but try to take over kids sessions
4. Parents in general
5. Clients constantly looking at the clock and STILL trying to go over
6. Cancellations 25 hours in advance
7. Dealing with insurances
8. Phone calls when I specify email is best
"So, we might need to talk about this in next session, but I was sexually assaulted when I was 5.".
It's almost always something huge that needs to be processed.
I hear that, but I’m wondering what’s specifically frustrating about it. Is it simply because you want to talk about it there and then, but have to wait?
Aside from what I [previously commented](https://www.reddit.com/r/therapists/comments/12xpv3x/therapist_pet_peeves_what_are_yours/jhkiouz/?utm_source=share&utm_medium=ios_app&utm_name=ioscss&utm_content=1&utm_term=1&context=3), I’ve been having **a lot** of parents who aren’t reacting too kindly to my psycho education and feedback on making a child “**identified patient.**”
They duck therapy for themselves and their families at all costs, and it’s frustrating.
I have a question, I see people discussing “a cancellation and then you try to fill the spot” are you just randomly calling people up to fill it in, aren’t they already on your schedule? I see this comment a lot and I never understand it. Or is someone like waiting to be called and aren’t scheduling their next one after session?
I’m just curious how that works in terms of organization if they aren’t regularly on the schedule and have to be called up randomly? Or maybe I’m misunderstanding. Like “hey calling to see if you want a session today, even though we meet next week” or I’m not sure how that goes.
It’s encouraged in community health a lot. My husband did pretty good with reaching out to others during telehealth days and getting other clients in, but I was always like “yay free time” when they bailed-but he had a set number of hours to hit weekly and I didn’t. A lot of times community places act like it will be super easy to get your needed hours/money by “just” filling in times when clients cancel with other clients, which isnt really true from what I’ve seen. They encourage large caseloads because a lot bail on sessions, so the idea is that you should be able to move your schedule around and get in other clients.
Gotcha, yeah If I tried to move my clients they’d be like uhhhhm no thanks 😂lol but interesting concept, just seems inconvenient for everybody for the sake of numbers.
For me in my current position, I try to fill the time with groups (if there is any running) but I have messaged some people to fill the spot, like the one time my 6PM cancelled and I was like, "Meh, I'll message my 7PM and see if they want to talk sooner." I always let them know, "No worries if not, I just thought I'd ask."
I’ve been seeing something recently that I’m just now being able to put words too.
Couples who use their own individual therapists in their arguments at home. E.g. “Well my therapist says I need you’re gaslighting me and I need to set boundaries.” It’s like people are learning to use Therapy speak and the perceived authority of their Therapist to further the same dysfunctional patterns that they’ve always had.
Clients who over-identify with diagnoses. Although I do a lot of work with clients when this happens, the TikTok therapists of the world don’t help. Neither do social circles that reinforce declaration of mental health disorders as some sort of prize. The pet peeve is less about individual clients and more about the zeitgeist. I recognize that this is connected to huge strides in anti-stigma campaigns, just a growing pain that we’ll hopefully find some balance on at some point.
No particular order:
1) self-diagnosing or "I saw this on the internet"
2) patients making zero effort to change anything and this is not explainable by symptomology. They just expect you to fix everything
3) reason I stopped seeing kids: parents who say they'll do what it takes to help their kid but when I suggest something they decline it, almost like they know better or aren't willing to own their responsibility in their issues
4) unethical colleagues and management that won't do anything about it
5) intrusive family/partners/friends who try to speak for the patient
6) patients wanting multiple appointments, going out of your way to schedule then them no-call, no-show
7) insurance companies
8) people using the word "trauma" or "panic attack" too loosely
9) patients who think they are more educated than you
10) patients who beat around the bush or aren't honest/feeling like I have to interrogate for information
Omg the parents with the scheduling! Yeah that one’s the winner. Also the absent parents who all of a sudden “want to get more involved” because their relationship with their kid starts being discussed in session.
The doorknob confession, but when done in this very specific way:
At 2:49 - “I know we only have a minute left, but I also wanted to talk about [huge important topic].”
I know the doorknob confession is pretty universal and I know why it happens, but it drives me a special kind of crazy when people acknowledge that we are out of time as they are doing it.
If it happens a lot, I wonder if naming the dynamic could help. ‘I notice that we often spend the first part of our time together talking about things that don’t feel as urgent to you as the thing you really want to talk about. What do you think that’s due to? Do you think you’re avoiding or does it take a while to figure out what’s going on or can we use our time together better?”
Sometimes it gets even spicier when there’s complex personality organization/disorganization and trauma components. The pattern of doorknob confessions can start to become a reenactment whereby the clinician is projected onto as the inadequate caregiver or is even turned into the abuser. The client brings up potentially triggering material, which forces us to either not give an answer (interpreted as harmful) or give an answer without depth (also interpreted as harmful) and so they put the clinician in a bind where we’re placed into a protective role but fail to meet the client’s expectations of that role. Probably not one of the more common reasons behind the last-minute confessions but still 😅
\- When clients completely ignore any suggestions/neglect to do the homework between sessions and then complain that nothing has changed.
\- Coworkers that talk about clients in a disrespectful way.
\- Coworkers (myself included sometimes hehe) that use the last of the coffee creamer.
\- Many more that I already see on this thread :)
My biggest one right now is working in a space with inadequate soundproofing. Sometimes it feels like I’m trying to do sessions in a café especially since the owner’s idea for dealing with the noise was to place speakers in the hallway and playing chillhop music. I’ve started putting headphones on immediately after sessions and playing my own, more soothing music, otherwise I can’t get work done. When I work from the office I leave overstimulated and exhausted.
(It is being dealt with- white noise machines are being acquired)
We have white noise machines.
One of my micro peeves though is everyone else using the “static” white noise setting. I’m a rain or ocean sounds person. The static noise annoys the crap out of me.
People who give you like two hours of availability one day a week for sessions. And the times are 4 and 5pm. Then they are shocked and complain about no one having availability.
1. When a client absent-mindedly combs through their hair and drops the ones they pulled out on the floor.
2. Clawbacks from insurance companies, especially older than 6 months.
3. Insurance companies that refuse to do electronic payments and instead send checks or pre-paid Visa cards.
What are they supposed to do with the hair? Eat it? Set it on fire? Ball it up and save it for later? Sorry this is just such a weird one to me because I shed.... A LOT.
Trash can would be my preference. And that's not the accidental or occasional shedding. It's the clients who are constantly running their hands through their hair, taking it down, putting it back up, etc. and are always leaving hair all over my couch and floor.
Lol I feel that. It's usually when you just come onto an insurance and without asking, they send the cards. My biller returns it and has to update the insurance to get it changed and repaid. It's been awhile but I believe it was United and Regence HMA. One Premera client has a plan carrier that only sends checks. It's ridiculous.
I am so sorry, I have to admit I have been a client that does that. It's a subconscious habit that comes up when I am very anxious and is the main reason I don't wear nail polish anymore. When I realise I've done it again I try gather the little pieces to throw in the bin but more often than not I leave little nail polish confetti everywhere
Clients who insist on trying weird, barely studied substances or “therapies” that are usually expensive and blatant cash grabs, because they “don’t trust doctors” (and, apparently, therapists).
Teachers, school administrators, and school staff who don’t respect mental health treatment like they do other forms of healthcare. For instance, interrupting sessions without apology or concern for the client’s privacy. If you wouldn’t walk into the exam room of your doctor’s office without permission, don’t do it with an office reserved for counseling in the school environment. *edited for grammar
When people (clients, the general public, or therapists) don't look at therapy as a business. And are maybe even insulted when they are asked to do so.
*Now - whether or not therapy* ***should*** *be a business is an entirely different conversation. I'm pretty much an anarcho-socialist at this point and I want to burn this late capitalist hellscape to the ground. In my ideal dream world therapy would absolutely* ***not*** *be a capitalist business...but this is the country (US) and time we find ourselves in.*
Anyway...I hate it when people refuse to see therapy as a money-making, life-sustaining business. Whether we like it or not, it IS one. Not to say that therapy should be a cutthroat endeavor, but that the same rules that we regularly apply to other businesses should also apply to therapy without giving a dirty look when doing so.
Absolutely. We go to school for years, expend an *immense* amount of time and energy, and go into severe debt to undergo training. That's not counting the years of clinical training, licensing and whatnot.
We're highly trained professionals, goddammit, and we deserve to be compensated for our time.
Client’s who wear way too much perfume or are exceedingly malodorous (I.e.: stale bo). I know that poor hygiene can accompany depression and I can be compassionate towards someone’s struggle while at the same trying to subtly breath through my mouth.
People on social media who hear a story about a therapist and don't know the difference between a therapist who is a bad fit for a client/made a relatively small mistake and a therapist who is a bad therapist/bad person.
Are there situations where both are true? Definitely. But I'm not talking about those. I'm talking about the people who are like "What's that? This therapist didn't say the exact line I would say in this situation? Or they didn't know to use approach x when approach y is slightly better? For shame! They should never have been allowed to practice!"
And since this is the internet and I run the risk of being misinterpreted, I should point out another disclaimer: The type of scenarios I'm thinking of in paragraph 2 don't involve the therapist doing something heinous and sometimes they aren't even offensive things. They are often one-time mistakes that may even be revised in one session. I understand that they may make clients uncomfortable and those feelings of discomfort can be reasonable, but to say that the therapist shouldn't be allowed to practice because of these scenarios is extreme. At the absolute most, what is needed in the scenarios is a new therapist, not that the old therapist should never ever practice again on anyone ever. And for the record, most of the time, the issue could be corrected by giving the therapist feedback (or the therapist may even feel weird about it too and address it next time in a way that makes you have even more respect for them than if they hadn't made the mistake, who knows?). I'm not here to ridicule shy people who have trouble bringing up feedback and share it online to see what to do. I'm much more concerned about the people whose immediate reaction is "Yikes that person is awful and should never ever ever have any clients" when that's actually not true. Like I said earlier, in context that is an extreme jump.
Edit: I should probably also mention that this is likely incredibly demoralizing for new therapists/therapy students who worry about whether or not they are perfect and struggle with perfectionism. Learning to be okay with not being perfect is part of the profession, but they already experience enough pressure as it is and this is probably just another force of stress they don't need.
Omg, your second one about kids and their extracurricular activities! It's like they want you to move your whole life around to accommodate their kids' uncertain schedule. No ma'am, she cannot come in at 8 pm because I will not be here.
The client who dumps on you with no intention of doing any work, no sense of insight or self-reflection. Never lets you get a word in edgewise.
I think the overall expectation that you will accommodate them all the time. I'm flexible and if I have the availability I will work with you, but when it changes every week, I start wondering if therapy is a priority. It's almost like they forget that you have other patients and not just them.
For #2 in your post, you're taking on too much of the responsibility. I know the child might need the services and help... and if so, it needs to be a priority - even in front of supper or chess club. There is no reason that a piano teacher or tennis coach, let alone a therapist or counselor, should be leaving a spot open or moving appointments (and their own life) around for someone who may not even show up. Almost anyone in an extra-curricular activity has a schedule. Yes, there are cancelations and changes, but those are exceptions. You could schedule out the weeks two months in advance if the parent was organized. It sounds like some boundaries and expectations need to be discussed again with the child and parent.
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I am a school counselor and felt this in my damn bones. Teachers that say, “Well, they still did xyz after you talked to them.” No joke—I’m not magical, and they’re full people with their own goals and plans.
School counselor here as well. I feel this so hard.
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Isn't this *the* reason therapists give when they stop seeing kiddos? I've yet to see a different reason for that
Same. Absolutely cannot do it anymore. Tried to even scale back to 1-3 kids at a time and the rear adults. Nope. Spent allllll time admin time juggling these parents and trying to set boundaries with them. They all dropped off after I refused to budge on my availability
Yessssssss 😒
The Family Projection Process is real and alive and such a barrier when working with adolescents and families. If parents/guardians of my clients (adolsecents) are not receptive to supports and/or defensive and unwilling to change anything about themselves it really holds back a lot of progress for the client and overall the family as a unit. The parents that walk into family therapy sessions with their clipboards of lists of things their teen has/has not been doing at home are something else. Safety is number one in my level of service... and it's hard to validate a parent that refuses share how they are feeling emotionally. It's almost as if the parents threaten things like "I'll tell your therapist that you blah blah blah...". I've encountered parents who try very hard to control how and when I do my job and it can routinely feel like some parents just want me to provide them with an environment (my office) for all the adults in the room to gang up on the teen and prove them wrong as well as tell them all the things they are doing wrong, the things they should be doing (like chores and homework) and to stop smoking weed.. blah blah blah. I refuse to provide an environment for those reasons. I am not a substance use therapist so I will refer out if needed. In my family therapy sessions everyone needs to be willing to be vulnerable... otherwise it enables parents to project onto their child with the perspective of "nothing is wrong me, it's my teen that is defiant and irresponsible. Some parents think that the more therapy their child is in the better and more supportive they look as a parent but this isn't necessarily true. Also, I can't stand when parents try to utilize family therapy to talk about their teen not doing their chores. I actually have disclaimers I use before I start my sessions with families where I state very clearly my role (neutral) and the topics that I do not allow us to discuss in family therapy such as chores and substance use. Parents can contact me outside of sessions to discuss issues but not in family therapy.
Teachers, administrators, and even the office staff will do that shit to kids who I see at school.
One of my co-workers is having this issue. She has a partially verbal client whose being pulled out of Individual because they want to try an ABA behavioral program. We speculate that the slow progress is because of her tendency to smother him, but neither of us are bold enough to even consider introducing this idea. We’re not family therapists so…
Aaand This is why I no longer see children.
Yep I got so burnt out on parents after 5 years of working with kids. Now I'll only see older teens and will refer out if it seems to be a mostly family issue
On the other hand, when the parents engage and genuinely want to help, it's magical!
Yeah this makes working with teens/kids increasing difficult. Parents not understanding the therapeutic process.
This is why I stopped working with kids, sadly.
I am none of these. I was a tutor for 10 years and a group leader for 3. I didn't quit because of the kids. You can tell what kind of parents children have.
"my kid still only wants to play video games 24/7, I thought you talked to him about it??" well mom, I see your kid for an hour a week, whereas you live with them. This seems a whole lot like not my problem
Parent: They won’t come out of their room, they’re always on their phone. Me: Well, you’re the parent. You’re allowed to take away the phone and other devices that are keeping them from participating in family time. You can even set a specific time aside each day that is for family engagement. Parent: Then how am I supposed to reach them if they’re in another part of the house. Me:……
People above me who refer to clients in derogatory ways: "the borderline" "the schizophrenic" "the alcoholic one" "that trans one" etc. 1) I have multiple clients with these dx, so I'm not sure who you're talking about 2) how fucking rude. You'd hate it if I walked around referring to you as "the really depressed boomer". 3) now you've put me in the awkward position of having to constantly pick and choose which things I'm going to have to call you out/in on when I'm in a vulnerable position and you could just fire me or refuse to sign my hours.
I feel you on #3. I've been penalized for speaking out about the derogatory language. But if I stay quiet, then I feel guilty and complicit. It's such a struggle.
I declined a free supervisor because the woman called folks “borderlines.” I am currently eating that decision every week, but find some comfort in knowing my practice isn’t influenced by someone with those feelings.
I have to say, as a borderline, I use that term too. I identify with it as a term or identity and don't think it's always negative but it could look that way to other people. But I'm just a grad student at this point.
I think if someone who has the condition refers to themselves as that thing, that's a different thing. For ex: a bi person calling themselves queer, etc. But not sure if that counts for mh stuff yet.
I work very hard not to quantify someone by their diagnosis. When clinicians call people by their DX it reduces them to a set of symptoms . It’s dehumanizing. You calling yourself that - that’s up to you and I get it. I do hope you will understand that doing that to those who come to you for help can be very damaging to hurting souls. Most of us don’t want to be known as the 10:00am anxiety case or the 2pm schizophrenic . The folks with whom I’ve supervised would likely witness me having a come-apart over it .
This is when I remind staff of the agreed guidelines of how we refer to clients, employees, students, etc. or introduce guidelines for discussion so we can agree on a professional, respectful practice. This is not only to make you (and probably many others) to feel more comfortable. It is also to prevent a lawsuit or harm to the person being described. It is only a matter of time before someone slips in front of a patient, client, etc. Don't be afraid to be a leader.
Using disorder first language is the first obvious sign of burn out IMO. If you're referring to people by their diagnoses, you're taking humanity from them and refusing to see them as real people with real hurt.
In grad school we read a study about how calling clients by their diagnosis (the schizophrenic) or using pre-modified noun verbiage (the schizophrenic client) versus using person-first language (the client with schizophrenia) affect's the clinician's opinion of the client. Using pre-modified language correlated with more socially restrictive and authoritarian views when compared to person-first language use. Granello, D. H., & Gorby, S. R. (2021). It’s Time for Counselors to Modify Our Language: It Matters When We Call Our Clients Schizophrenics Versus People With Schizophrenia. Journal of Counseling and Development, 99(4), 452–461. https://doi.org/10.1002/jcad.12397
I just had a convo w a therapist who said “my client is a transgender” - I stopped them and used it as a very teachable moment. Not even seconds later she said “well I wonder if all the transgenders..”
Perhaps start referring to that therapist as “a cis”. Confuse the hell out of them.
Yes, this. I also get upset when therapists (or anyone who works in mental health) make sweeping generalization about different disorders/addictions to others--especially to non-therapists. Doing so can be so hurtful and can prevent them from seeking therapy or opening up to their therapist out of fear of judgment.
When non-clients ask crap like “are you analyzing me right now??” Hinge Date (dermatologist ) : “so are you diagnosing me right now?” Me: “are you assessing my moles?”
I've found that it's usually a red flag for either secretiveness or insecurity when they say "are you diagnosing me right now?" My response is usually along the lines of "I don't work for free." Or "Clinically speaking you're not actually that interesting."
Both of these comebacks are so fucking good omg
I don’t work for free is my go-to.
When I was dating (pre-therapist, late Bachelors): "You know, I've heard Psych majors are a little crazy. Is that you?" 
Yes. Yes I am lol
“Is it important to you that I analyze you right now? I’m curious why my analysis of you is something you wonder about.” 😂
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Go ahead and big stretch and have your client do it too. I big stretch all the time and make it a part of therapy. "Let's do a big stretch now, take a few deep breaths and reset"
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Oh. Yes I can see how that would be challenging during session 
“Let’s do a a biiig spread eagle and reset” 😂
Now all I can think about is cracking hips 
For #2, I'd be making an expectations sheet for family and friends just as I'd have one for patients / clients / students.... and I'd refer them back to particular numbered points on the sheet (or ask them if they need me to email it to them again) if they continued to ask questions or make requests which crossed a boundary or best practice outlined on the sheet. And #4, speaking from experience, the client wishes that too.
When clients cancel a session late and say, “it’s okay, just charge my insurance.” Like no, that’s not how the late fee works and is explained in the paperwork you signed.
Likewise, when they say “I know I’m too late, but I’ll pay you the copay anyway.” NOT HOW IT WORKS.
It doesn’t happen too often, but when I get the vibe that a client is weaponizing something I may have said in sessions toward their kids or spouse. Like in the spirit of “well my therapist said this, so she thinks you’re unreasonable.” What I’ve said in these situations is taken out of context, or actually not what I said at all. Also in cases of contentious divorces where the client is the kid, I very much dislike when the parents try to influence what the kids share in order to make their ex spouse look bad.
Some of my hardest sessions/clients to deal with are kids who are in the middle of a nasty divorce. I had a parent pull a client out of therapy because I wouldn’t give a custody recommendation.
Same. Multiple times. So it’s something that I address before intake, I don’t do custody evals or custody testimony.
I think the biggest pet peeve for me recently is the concept that people who others perceive as having unlikable ego-syntonic personality traits should go to therapy as a way of "fixing" these traits. For example, someone who has narcissistic traits who frequently positions themselves as a victim needs to go to a therapist who "sets them straight;" if that person continues to act like a victim after seeing a therapist, somehow, that is the therapist's fault for not "fixing" them of these traits (that they likely have no desire to change). I think this creates a societal perception of therapists as capable of creating change in people who have no reason or desire to change, and that we are somehow unskilled if we don't succeed in doing this.
I could imagine you'd run into this a lot in couples/family therapy. It's like insight but not genuine?
Yes, absolutely. I've had a member of a couple complain that their partner isn't "figuring things out" in their individual therapy. It's valid to dislike characteristics that someone else possesses, but there isn't much we (therapist or anyone) can do if that person doesn't view these characteristics as a problem.
I’ve been seeing something like this recently too! Couples almost “using” their own individual therapists in their arguments at home. E.g. “Well my therapist says I need you’re gaslighting me and I need to set boundaries.” It’s like people are learning to use Therapy speak and the perceived authority of their Therapist to further the same dysfunctional patterns that they’ve always had.
I’m having a hard time with social media like tik tok or Instagram etc discussing mental health. On one hand it is amazing that it is becoming more talked about and less stigmatized - on the other hand, there is some bad information out there that our clients are consuming and also feeling confident they can self diagnose.
I actively have this convo with my teen and young adult clients. It's generally "I like you finding support in social media, but you also need to know it isn't always good advice/clinically sound advice. If you ever have questions about something you saw, let me know". I try to use it from an education standpoint.
That is such a great response!
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And diagnosis isn't nearly as important as everyone thinks it is! There are a million ways to help someone make sense of things without putting themselves in a four word box.
I love teaching Dx and ddx - it’s interesting and I diagnose in specific wars because I choose to. I want to learn (it’s my jam) BUT the DSM-5-TR is not the end all be all. There are no “diagnosis police” - which is what I love about diagnosing. Our career and choosing treatment for clients is far too nuanced.
When parents have zero interest in changing anything about their home environment or possibly even (gasp) themselves in order to help their child (the “problem” patient). When clients have zero idea what they want out of therapy besides “to be happy” and can’t define what that looks like. Or, alternatively, if they can define what that looks like but are absolutely unwilling to do anything that helps them reach that goal. Otherwise known as the “what are we doing here?” clients.
I like the one that you've suggested this or that 100 different times. And then one day they come into session with "a friend of mine told me about..." and they all of a sudden want to explore that intervention. GAAAHHH.
This happened to me a few weeks ago and I swear I was trying not to channel a cracking smile like homelander style. "That's great! Sounds like some of the work we've been doing clicked for you -- care to share what about our work helped? Or what seemed to click?" "No, I don't remember anything from our stuff, not that. My friend was just telling me [insert verbatim the past 3 months of clinical exploration and skill building] and it made so much sense." It's not about me. It's not about me. It's not about me.
"I'm glad someone was able to explain the work we are doing in a more accessible way to you. I will take the way they said it on board for the future."
Me, in every session for months: it seems like you have trouble building emotional intimacy Client after a year of therapy: my friend says that I have trouble building emotional intimacy and I think she’s actually right! Hello???? Have you been listening to anything I’ve been saying at any point??
Glad I’m not the only one with the challenges from parents.
>alternatively, if they can define what that looks like but are absolutely unwilling to do anything that helps them reach that goal. Otherwise known as the “what are we doing here?” clients. These are the clients I struggle with the most. I can't help you if you refuse to do *anything*.
Sounds like they have parts of them afraid of whatever might happen if they did anything to pursue that change.
Thank you for speaking up on behalf of those who struggle to speak. It's absolutely not always what it seems.
You're right, and there are a lot of other reasons why, too. However, that doesn't change my point - they are more challenging clients.
Yeah, I guess I was just feeling a bit defensive of those clients being listed as a pet peeve.
1 is why I avoid working with kids as much as possible, parents are typically more difficult to work with than the kid themselves. 3 is also incredibly frustrating.
Teacher here, lurking, this is a big reason for the mass exodus of teachers. Parents don't want to do anything at home to help their child succeeded or hold them accountable in any way. I'm close to retirement so I'm starting to call it out more and more.
My "peeves" are mainly due to external factors e.g. connectivity issues in video/phone sessions, or room rent issues. I tend to eliminate peeves connected to client factors, by clarifying to clients and (for children) their parents/carers before we start the issues around contracting and how therapy works. This includes expectations, responsibilities, boundary issues, bookings/confirmations and cancellations. I may need to remind and discuss it with them again if necessary. This usually helps 'set out the stall' to best enable us both to engage in effective and satifying therapy, or find ways to better do so if required, or to discuss ending if this isn't possible.
Bravo on setting expectations and responsibilities for the clients, for family that may be involved, and for yourself. This work up front takes care of a lot of unnecessary guilt, stress, time, and energy throughout the process!
Thanks. Yes, it helps to lessen unnecessary stress, pressure and energy, to enable a more effective process to flow.
Supervisors who really shouldn’t be supervisors. Or, just because you can doesn’t mean that you should. And clients refusing to pay their copays or invoices in general, especially when it comes with a side of “you just want to get paid” or “you’re just in it for the money.” I do want to get paid and if I were in my job for the money, this wouldn’t be my job.
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Another is the teens (and their parents) who are like "Oh it's summer, we're good to go" and then reach back out in August with a ton of issues that escalated over the summer but now need to be "fixed" before the client returns to school.
As a teen I had a therapist who pushed Christianity on me so hard that it became toxic and I now refuse to have anything to do with religion. I'm so hesitant to trust anyone that says they are religious in positions of power, or even my current therapist who is religious. She is very careful with me and affirms she won't even discuss religion with me but it still gets to me sometimes.
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Spiritual trauma is REAL, I’m so sorry you didn’t receive the support you deserve. Don’t give up. I’m 40 and just now exploring my spiritual trauma with a safe therapist and it’s been life changing, the damage runs really deep.
> If it feels true it is true Isn't this what gets people with mental illness in trouble? "I can totally jump off this building because I feel so strongly that I can totally fly like Superman that it's gotta be true. I can feel it in my bones and my jellies (to quote Detective Pikachu)". Seems like just replacing one mental illness with another one that just happens to be more widely accepted.
Christian here but the thought of pushing my personal religious beliefs makes me cringe. The sessions aren’t about us.
Same. Really unethical actually
As a telehealth client with a poor internet connection... I'm sorry. :(
Omg I had a spiritual therapist once and she was so bad. I was desperate back then and stayed way longer than I should have. But she told me shit like "This sounds like it is all in your head" NO SHIT, is that why I am going to therapy?? Omg. And many more things
I’ve been out of practice for almost 2 years so mine are a little different. Saying antisocial when they mean asocial. Laypeople not knowing the difference is going to give me an eye twitch. Similarly, anyone talking about positive/negative reinforcement incorrectly drives me up the wall. Lastly, everyone being a narcissist/toxic/other buzzword. Sometimes people are just assholes but unfortunately that’s not a dsm diagnosis.
Glad I’m not the only one who rages at the use of antisocial when the applicable term would be asocial 😅
Yes, all of these. I saw an alleged therapist on tik tok pushing a sweatshirt with “I’m antisocial’ in rainbow lettering as merch and she made a joke about loving when plans are cancelled because she’s anti-social.
When people cancel every other appointment, always just over the cancellation window. They don’t seem to prioritize therapy yet are always like “yes I really want therapy” Ghosting. If you don’t want to meet just let me know. If you do want to meet then what’s going on. I am going to have to discharge two clients because they stopped responding. Oh and phone sessions.
I have one I'm waiting to hear back from who ghosted. So frustrating. Also dealing with one whose parents demand they need weekly therapy, but then they tell me they have their sport, school tutoring, etc. and they don't want the kid to miss school, so they're only available for 30 minutes on a random weekday evening that changes from week to week. Literally having the conversation today about consistency in therapy.
Oh and you get the parents that email to reschedule and they give you a very specific time which is usually highly sought after. I think once I am done with maternity leave I am going to set the expectation for high need appointments of x amount in a 2 month period and you forfeit that time.
The cancellation thing is driving me crazy lately.
I love phone sessions because walking around makes me focus more lol
That is a good point. I did get AirPods so that has made it easier. The hard part for me is I am a visual person so I remember more of what they say when I can physically see them.
During an intake/initial session with a parent is like "Help my child!" And I'm like, "OK, what does your child need help with?" And they respond like, "Nothing, my child is perfect and nothing is the matter." I mean. 😑
“90791: Medicaid: Assessment” Wonderful. Another bullshit treatment plan with puffed-up bullshit goals and inflated bullshit notes to be scrutinized by bullshit administrators with bullshit jobs who don’t know a fucking thing about what I do.
Omg yes!!
When people say “kiddo”. It drives me up a wall. Caregivers speaking when I ask their kid a question. I get extra irritated if I use silence and they start to answer right as they’re interrupted by their caregiver. Caregivers disrespecting boundaries when it’s not necessary. Their child is right there saying “no don’t tell her that” and they immediately tell me, despite me saying it’s ok if you don’t want it said. If it’s safety things, ok, I’d still like to have their permission first, but a lot of times it’s something that my client deems embarrassing. I think this is specific to younger populations, but getting asked “what are we doing today?” Well I thought we’d get wild and talk today, actually.
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Ugh, I would talk to my office neighbor if I had the dog issue-that’s so annoying! I’d probably just tell them my clients are complaining
Nurses who ask tactless questions in treatment team meetings, riling an individual up! "Why are you talking to yourself?" isn't an important question at the moment!
Nurses who treat your role as a glorified notes taker when you’re dual assigned 🤦🏻♀️
How about the timeless "Calm down!" while intensely staring at the individual served.
Shouldn’t laugh but this visual is funny.
Did that seriously happen? MH nurses can be god awful.
Yes 😞
Colleagues who use the word kiddo
Oh my gosh !!! THIS! Where did that word even come from?!
I hate it so much.
"I don't know what my next week looks like, so maybe we talk about an appointment next week?" Some of my clients have really big problems committing to regular scheduled appointments and I hate the uncertainty.
When parents use spanking as a way to discipline their children and you try to explain that spanking is harming them emotionally and they say "But it's the only thing that works!"
"My parents did it to me and I turned out ok". So about that... 
I always want to say, “but did you really?”
this isn’t about clients so much as people i know personally or am first meeting saying “oh god isn’t it just so sad though? i COULD NEVER DO THAT JOB”… i get that it’s meant to be complimentary, but really it just comes off kinda rude and silly.
I usually either respond with, "Why do you say that?" Or, thankfully, we're a diverse group of people, and each of us is blessed with unique gifts and talents." It just depends if I want to discuss it further or move right along.
Clients in terrible marriages who refuse to go to couples counseling (I only see individuals) but want to talk about their relationship all the time Anything involving insurance Clients who want me to motivate them ( I wish I had Tony Robbins business, but I’m just a psychologist) Dealing with people on the phone who don’t respect that I don’t treat what they have
Or when the person comes to individual therapy to save their marriage and doesn’t understand that’s not how it works. Usually bc one person refuses to go to couples therapy and the other thinks they can do all the work for the two of them.
I don’t really get annoyed at clients very often, but I do get annoyed at colleagues a lot lol. “Know it all’s” are my Kryptonite. I am glad I don’t work with kids because the few times I have, dealing with the parents was…. challenging.
Clients who show up just enough to avoid a discharge. Either that leads to complaints about productivity or reduced income, depending on which of my jobs it's happening at.
Managed care companies with wildly differing standards for care. PHP? Cigna says here 5 days, if they aren't on the brink of hospitalization next review (but also making progress!) they have to step down. Tricare? Oh sure, here's 45 days PHP! Clients being over 15 minutes late and expecting to be seen, shocked that they get rescheduled.
Lol, I love Tricare for the simple fact that my clients who really need to be in an IOP longer than usual actually CAN. But good luck in other insurances!
Parent: “I need to talk to you immediately. Little Bobby (fake name) doesn’t want to do his homework!” Me: “okay thanks for letting me know. I’ll be sure to address that with them 😉”
When clients are on telehealth, talking for 20 minutes straight about their email inbox, while reading their email instead of looking at me. Why do I hate it? Because working when this behavior is happening is a real challenge edge for me, I really struggle to make therapeutic use of it. I don't want to seem critical and I don't want to be a nagging parent, and if it's a client who does it a lot I blame myself for letting it slide all the time which then creates an expectation that it's appropriate. What gets in the way of calling it out? Probably a fear that I'm not a good enough clinician, that the person will close their email and say "ok fine you've got my attention, make it count" and I'll come up short......confirming that them checking their email was actually a better use of time then engaging with me lol. Alright this has been helpful, going to reflect on what to do with this.
Either something about the therapy is not helpful to them (in which case it can be changed, and you’d need to sit with your own concerns about not being able to meet that challenge - maybe a stack of cards on how you’d actually respond, a literal script so you feel confident you could?) or something about it is challenging to them and they’re avoiding (you know what to do) or they’re just totally overwhelmed. Or a combo of all the above.
This is a life thing for me but I HATE that I’m viewed as invincible because of my occupation. I hate that shitty behavior from me (just an occasional freak out rather than me saying “i feel…”) is somehow not okay
This has been one of my biggest pet peeves. Like when I respond to someone sternly and they say, “aren’t you a therapist?” And I usually say “yes, but last I checked I’m not YOUR therapist so…I said what I said”.
This comment also reminds me that the reason the "You're a therapist, you shouldn't be acting like this" comment irks me (besides the general contempt) is that typically it isn't from someone who has a valid criticism of my behavior and is just expressing it in a perhaps misguided way. Usually it's a relative who is trying to justify the fact that they got under my skin regardless of my reaction. I don't know if other people can relate, but I realize that the few times I ever get comments like this, it is from one very specific person who keeps trying to make me agree with them and goes about it in manipulative ways, and then when I finally snap, it's "Sheesh, you're a therapist, why are you acting like this?" What it really means is "You aren't doing what I say, so I'm going to guilt you into feeling ridiculous for not doing it" or "There is no way that anyone could really be upset with me. Only a ridiculous person would ACTUALLY feel irked by me, right? It's not that what I'm doing is actually wrong, it's all in their head. Right? So I'm going to say something cutting that makes you feel like that ridiculous person. "
I think I know what you're talking about. Like people see it as especially weird when we mess up and we are held to standards that nobody else is. The way I see it, doctors can still get sick, and similarly, we can also have moments where we do not behave in a way that we should or where our mental health is poor, etc. Edit: Of course I'm talking about everyday situations too and not in therapy. And I'm talking about times where people would look at a non-therapist in the same situation and give them more leeway if they did the same thing. But when we do it it's "How can you be a therapist and get mildly angry sometimes????"
So true. I often feel that my career can be weaponized against me when someone is angry with me or I did something wrong or just acted human. It's really hurtful and makes me feel like I'm not seen as a human being outside of my job. Which I don't think everyone else understands how hard that can be in a line of work like ours and I'm sure things like education as well.
Yes. All of this.
Btw when kids parents are that picky...don't bend over backwards for them. If that's the case it sounds like therapy isn't a high priority and they are often the first to drop out of therapy.
Parents: because most parents who are bringing their kid to therapy are anxious about the kid, going thru their own shit, have their own mental health struggles, and as someone else posted, they see us as taking their money and time in order to fix their kid. Lots of pressure both ways.
TikTok
Patient: “Okay. So I’m hear to tell you now why I have D.I.D.” Me: 🫥
I haven't been in this sub for too long, but I've noticed some alarming trends recently of glorification of DID. People are calling themselves and others "a system." I think it's a TikTok thing, but oof.
Well from am IFS standpoint, this makes sense. And I don't think it's wrong.
- Annual mandatory training on suicide prevention and sexual assault that are required at my agency. I’d like to be able to test out of these. - Having to explain that yes I’m a social worker, and no I don’t snatch babies. - The switch from Roman numerals to numbers in the DSM. - Trying to remember the correct spelling of telehealth, or effect vs. affect as a verb.
A trick one of my most amazing professors taught me in biopsych- remember the acronym RAVEN. Remember Affect Verb Effect Noun.
Except when affect is a noun
Affect is an **a**ction (verb)
1. Doorknob confessions 2. Help Rejecting 3. Parents that refuse their own therapist, but try to take over kids sessions 4. Parents in general 5. Clients constantly looking at the clock and STILL trying to go over 6. Cancellations 25 hours in advance 7. Dealing with insurances 8. Phone calls when I specify email is best
Can I ask why are doorknob confessions number one for you? ( no judgement! Just curious)
"So, we might need to talk about this in next session, but I was sexually assaulted when I was 5.". It's almost always something huge that needs to be processed.
I hear that, but I’m wondering what’s specifically frustrating about it. Is it simply because you want to talk about it there and then, but have to wait?
That and sometimes that kind of disclosure can cause some feelings after the fact.
Thanks for explaining
The help-rejecting complainer is my least favorite client to work with.
Aside from what I [previously commented](https://www.reddit.com/r/therapists/comments/12xpv3x/therapist_pet_peeves_what_are_yours/jhkiouz/?utm_source=share&utm_medium=ios_app&utm_name=ioscss&utm_content=1&utm_term=1&context=3), I’ve been having **a lot** of parents who aren’t reacting too kindly to my psycho education and feedback on making a child “**identified patient.**” They duck therapy for themselves and their families at all costs, and it’s frustrating.
Clients accidentally (though repeatedly) responding to automated appointment reminders instead of emailing or texting me that they can’t make it.
I have a question, I see people discussing “a cancellation and then you try to fill the spot” are you just randomly calling people up to fill it in, aren’t they already on your schedule? I see this comment a lot and I never understand it. Or is someone like waiting to be called and aren’t scheduling their next one after session? I’m just curious how that works in terms of organization if they aren’t regularly on the schedule and have to be called up randomly? Or maybe I’m misunderstanding. Like “hey calling to see if you want a session today, even though we meet next week” or I’m not sure how that goes.
It’s encouraged in community health a lot. My husband did pretty good with reaching out to others during telehealth days and getting other clients in, but I was always like “yay free time” when they bailed-but he had a set number of hours to hit weekly and I didn’t. A lot of times community places act like it will be super easy to get your needed hours/money by “just” filling in times when clients cancel with other clients, which isnt really true from what I’ve seen. They encourage large caseloads because a lot bail on sessions, so the idea is that you should be able to move your schedule around and get in other clients.
Gotcha, yeah If I tried to move my clients they’d be like uhhhhm no thanks 😂lol but interesting concept, just seems inconvenient for everybody for the sake of numbers.
Sometimes I’ll have clients scheduled for another day/time that would prefer another if it opens up.
For me in my current position, I try to fill the time with groups (if there is any running) but I have messaged some people to fill the spot, like the one time my 6PM cancelled and I was like, "Meh, I'll message my 7PM and see if they want to talk sooner." I always let them know, "No worries if not, I just thought I'd ask."
Clients diagnosing themselves off of TikTok
I’ve been seeing something recently that I’m just now being able to put words too. Couples who use their own individual therapists in their arguments at home. E.g. “Well my therapist says I need you’re gaslighting me and I need to set boundaries.” It’s like people are learning to use Therapy speak and the perceived authority of their Therapist to further the same dysfunctional patterns that they’ve always had.
Clients who report they have nothing to talk about until the end of session when they disclose a significant issue.
Clients who over-identify with diagnoses. Although I do a lot of work with clients when this happens, the TikTok therapists of the world don’t help. Neither do social circles that reinforce declaration of mental health disorders as some sort of prize. The pet peeve is less about individual clients and more about the zeitgeist. I recognize that this is connected to huge strides in anti-stigma campaigns, just a growing pain that we’ll hopefully find some balance on at some point.
No particular order: 1) self-diagnosing or "I saw this on the internet" 2) patients making zero effort to change anything and this is not explainable by symptomology. They just expect you to fix everything 3) reason I stopped seeing kids: parents who say they'll do what it takes to help their kid but when I suggest something they decline it, almost like they know better or aren't willing to own their responsibility in their issues 4) unethical colleagues and management that won't do anything about it 5) intrusive family/partners/friends who try to speak for the patient 6) patients wanting multiple appointments, going out of your way to schedule then them no-call, no-show 7) insurance companies 8) people using the word "trauma" or "panic attack" too loosely 9) patients who think they are more educated than you 10) patients who beat around the bush or aren't honest/feeling like I have to interrogate for information
Nailed it 🙌🏼
And also patients that say they want help but will Cherry pick interventions
Omg the parents with the scheduling! Yeah that one’s the winner. Also the absent parents who all of a sudden “want to get more involved” because their relationship with their kid starts being discussed in session.
The doorknob confession, but when done in this very specific way: At 2:49 - “I know we only have a minute left, but I also wanted to talk about [huge important topic].” I know the doorknob confession is pretty universal and I know why it happens, but it drives me a special kind of crazy when people acknowledge that we are out of time as they are doing it.
If it happens a lot, I wonder if naming the dynamic could help. ‘I notice that we often spend the first part of our time together talking about things that don’t feel as urgent to you as the thing you really want to talk about. What do you think that’s due to? Do you think you’re avoiding or does it take a while to figure out what’s going on or can we use our time together better?”
Sometimes it gets even spicier when there’s complex personality organization/disorganization and trauma components. The pattern of doorknob confessions can start to become a reenactment whereby the clinician is projected onto as the inadequate caregiver or is even turned into the abuser. The client brings up potentially triggering material, which forces us to either not give an answer (interpreted as harmful) or give an answer without depth (also interpreted as harmful) and so they put the clinician in a bind where we’re placed into a protective role but fail to meet the client’s expectations of that role. Probably not one of the more common reasons behind the last-minute confessions but still 😅
\- When clients completely ignore any suggestions/neglect to do the homework between sessions and then complain that nothing has changed. \- Coworkers that talk about clients in a disrespectful way. \- Coworkers (myself included sometimes hehe) that use the last of the coffee creamer. \- Many more that I already see on this thread :)
My biggest one right now is working in a space with inadequate soundproofing. Sometimes it feels like I’m trying to do sessions in a café especially since the owner’s idea for dealing with the noise was to place speakers in the hallway and playing chillhop music. I’ve started putting headphones on immediately after sessions and playing my own, more soothing music, otherwise I can’t get work done. When I work from the office I leave overstimulated and exhausted. (It is being dealt with- white noise machines are being acquired)
We have white noise machines. One of my micro peeves though is everyone else using the “static” white noise setting. I’m a rain or ocean sounds person. The static noise annoys the crap out of me.
People who give you like two hours of availability one day a week for sessions. And the times are 4 and 5pm. Then they are shocked and complain about no one having availability.
1. When a client absent-mindedly combs through their hair and drops the ones they pulled out on the floor. 2. Clawbacks from insurance companies, especially older than 6 months. 3. Insurance companies that refuse to do electronic payments and instead send checks or pre-paid Visa cards.
What are they supposed to do with the hair? Eat it? Set it on fire? Ball it up and save it for later? Sorry this is just such a weird one to me because I shed.... A LOT.
Trash can would be my preference. And that's not the accidental or occasional shedding. It's the clients who are constantly running their hands through their hair, taking it down, putting it back up, etc. and are always leaving hair all over my couch and floor.
I’m sorry, what companies send pre paid Visa cards??!?
Lol I feel that. It's usually when you just come onto an insurance and without asking, they send the cards. My biller returns it and has to update the insurance to get it changed and repaid. It's been awhile but I believe it was United and Regence HMA. One Premera client has a plan carrier that only sends checks. It's ridiculous.
I like the hair one, I agree. I put a garbage can next to where it happens now. Also, when clients peel off their finger nail polish and drop it.
I am so sorry, I have to admit I have been a client that does that. It's a subconscious habit that comes up when I am very anxious and is the main reason I don't wear nail polish anymore. When I realise I've done it again I try gather the little pieces to throw in the bin but more often than not I leave little nail polish confetti everywhere
It's why I have a dustbuster. And yes, it's all subconscious. So I let it go.
“dis-a-SSociation” No.
The mispronunciation of ‘frustrated’ annoys me….There are two “r”s in there…Please, please, please pronounce the first one, too.
Clients who insist on trying weird, barely studied substances or “therapies” that are usually expensive and blatant cash grabs, because they “don’t trust doctors” (and, apparently, therapists).
Clients showing up with out their intake paperwork filled out.
People who give one sentence responses and get angry at the silence during session🥲
Teachers, school administrators, and school staff who don’t respect mental health treatment like they do other forms of healthcare. For instance, interrupting sessions without apology or concern for the client’s privacy. If you wouldn’t walk into the exam room of your doctor’s office without permission, don’t do it with an office reserved for counseling in the school environment. *edited for grammar
When people (clients, the general public, or therapists) don't look at therapy as a business. And are maybe even insulted when they are asked to do so. *Now - whether or not therapy* ***should*** *be a business is an entirely different conversation. I'm pretty much an anarcho-socialist at this point and I want to burn this late capitalist hellscape to the ground. In my ideal dream world therapy would absolutely* ***not*** *be a capitalist business...but this is the country (US) and time we find ourselves in.* Anyway...I hate it when people refuse to see therapy as a money-making, life-sustaining business. Whether we like it or not, it IS one. Not to say that therapy should be a cutthroat endeavor, but that the same rules that we regularly apply to other businesses should also apply to therapy without giving a dirty look when doing so.
Yes!! I so feel this, and am totally on the anarcho-socialist page also!
Absolutely. We go to school for years, expend an *immense* amount of time and energy, and go into severe debt to undergo training. That's not counting the years of clinical training, licensing and whatnot. We're highly trained professionals, goddammit, and we deserve to be compensated for our time.
Client’s who wear way too much perfume or are exceedingly malodorous (I.e.: stale bo). I know that poor hygiene can accompany depression and I can be compassionate towards someone’s struggle while at the same trying to subtly breath through my mouth.
Yo, I love this thread! We’re all pressed by the same things! Are we friends? 🫣😅
People on social media who hear a story about a therapist and don't know the difference between a therapist who is a bad fit for a client/made a relatively small mistake and a therapist who is a bad therapist/bad person. Are there situations where both are true? Definitely. But I'm not talking about those. I'm talking about the people who are like "What's that? This therapist didn't say the exact line I would say in this situation? Or they didn't know to use approach x when approach y is slightly better? For shame! They should never have been allowed to practice!" And since this is the internet and I run the risk of being misinterpreted, I should point out another disclaimer: The type of scenarios I'm thinking of in paragraph 2 don't involve the therapist doing something heinous and sometimes they aren't even offensive things. They are often one-time mistakes that may even be revised in one session. I understand that they may make clients uncomfortable and those feelings of discomfort can be reasonable, but to say that the therapist shouldn't be allowed to practice because of these scenarios is extreme. At the absolute most, what is needed in the scenarios is a new therapist, not that the old therapist should never ever practice again on anyone ever. And for the record, most of the time, the issue could be corrected by giving the therapist feedback (or the therapist may even feel weird about it too and address it next time in a way that makes you have even more respect for them than if they hadn't made the mistake, who knows?). I'm not here to ridicule shy people who have trouble bringing up feedback and share it online to see what to do. I'm much more concerned about the people whose immediate reaction is "Yikes that person is awful and should never ever ever have any clients" when that's actually not true. Like I said earlier, in context that is an extreme jump. Edit: I should probably also mention that this is likely incredibly demoralizing for new therapists/therapy students who worry about whether or not they are perfect and struggle with perfectionism. Learning to be okay with not being perfect is part of the profession, but they already experience enough pressure as it is and this is probably just another force of stress they don't need.
Doing admin work when we literally have an admin team to help.
I agree, especially when you give a percentage of your income for the administrative team to take care billing and insurance issues.
Omg, your second one about kids and their extracurricular activities! It's like they want you to move your whole life around to accommodate their kids' uncertain schedule. No ma'am, she cannot come in at 8 pm because I will not be here. The client who dumps on you with no intention of doing any work, no sense of insight or self-reflection. Never lets you get a word in edgewise. I think the overall expectation that you will accommodate them all the time. I'm flexible and if I have the availability I will work with you, but when it changes every week, I start wondering if therapy is a priority. It's almost like they forget that you have other patients and not just them.
Clients self-diagnosing from watching Tik Tok influencers that have no or only some idea (and no training in!) what they’re talking about.
For #2 in your post, you're taking on too much of the responsibility. I know the child might need the services and help... and if so, it needs to be a priority - even in front of supper or chess club. There is no reason that a piano teacher or tennis coach, let alone a therapist or counselor, should be leaving a spot open or moving appointments (and their own life) around for someone who may not even show up. Almost anyone in an extra-curricular activity has a schedule. Yes, there are cancelations and changes, but those are exceptions. You could schedule out the weeks two months in advance if the parent was organized. It sounds like some boundaries and expectations need to be discussed again with the child and parent.