In last week’s blog, I invited my readers to consider attributes of ineffective, unhealthy and even unethical therapists. I focused on something many might consider to be innocuous: giving advice. This happens when therapists confuse their role with that of life coaches, advisors, educators, strategists or consultants. Advice givers ultimately want to direct clients to follow their advice rather than process their issues and needs in order to learn how to take charge of their emotional health and life choices. Advice-giving can be an insidious way to prevent healing and the building of emotional strength and as such can be highly unethical. It can keep a client dependent on their therapist, always seeking approval for following the therapist’s advice.
Let’s take a deeper dive and get even more specific.
Healthy Vs. Unhealthy Relationships
One reason a client may not recognize that their therapist is ineffective and possibly being unethical is that almost all therapists, including unethical ones, can be warm, engaging, nurturing. (Remember that advice-giving therapists may be unaware of how this behavior can be so unhealthy for their clients. A good supervisor should pick this up but not all therapists remain in supervision even though this is highly recommended by organizations like the American Counselors Association as stated in their Code of Ethics.)
Clients In both healthy therapeutic relationships and in those in which the therapist is unethical can feel that their therapist is genuinely interested in their well-being and is invested in facilitating their healing. In both cases, clients can feel connected, appreciated, and cared for by their therapist. In unhealthy, unethical therapeutic relationships clients typically are unaware that their therapist is not adhering to the basic ethics of a healthy therapeutic relationship or that their power to explore underlying issues and make their own decisions are being compromised. They seek the approval of their therapist, just as they would the parent or authority figure that the therapist may represent to them.
Questions To Ask
Questions to help you determine if a therapist falls under the unethical category. Do they:
- ask you to describe your beliefs, behaviors or relationships and then criticize them, letting you know what they believe needs to change?
- ask you to report back to them from a previous suggestion or directive?
- use a lot of “You should”, “You need to,” or “You must” messages or “You shouldn’t”, “You must not” messages? These could be disguised in messages like, “I’m only telling you this for your own good,” or “I have more life experience than you do so I am qualified to make suggestions, give directions like this.”
Do you often feel as if you:
- need to please the therapist, want their approval?
- worry if you didn’t do something they said you should do?
- are not confident in your abilities to make decisions and rely on your therapist to tell you what to do?
Examples Of Advice
The following are some examples of what an advice-giving therapist might say:
“You should steer clear of your latest love interest–they sound insecure and will only cause you problems. You can find someone more suitable for you if you free yourself from the this person. I can help you with specific ways to tell him your relationship is over.”
“You clearly are unhappy with your life right now. You need to think about changing careers. This one obviously is not using your gifts. What are other careers you have thought about? I can give you some helpful suggestions.”
“I don’t understand why you didn’t follow through with my suggestion that you…think about investing in a new home/get a pet to keep you company at night/make sure you record your thoughts and feelings in a journal that you write in at least twice a week.” [Said in a disapproving, critical voice.]
“Your friend is leaning too much on you for support. You should stop hearing about his problems and tell him he must go to a therapist.”
“Your ex is manipulating you and you are capitulating. You must stand up to their demands and not let them lessen your confidence in your rights as a parent.”
Why We Trust Our Therapist
Because clients often genuinely like their therapists and feel very comfortable fully trusting them, not realizing they are behaving in unethical ways, it can be essential for friends and family members to be on the lookout for how ethical the therapist really is. It can be very difficult to convince someone their “wonderful” therapist is doing harm to them. Clients may have developed strong loyalties to the therapist and may feel extremely dependent on them. Thoughts of breaking away can cause a lot of fear and anxiety.
Information from my previous blog and the examples in this one can be helpful in convincing someone – maybe even you – that your therapist may not be who you think they are. If a therapeutic relationship needs to end, they, or you, will need a lot of support. And you will need a new, trustworthy, and ethical therapist.
Showing Therapists Grace
We can all show some grace for therapists who struggle to avoid giving advice. Louis Cozolino reported sharing in this temptation: “… I often struggled to keep myself from directing my clients, giving advice, or pushing them to change. To my astonishment, I found that providing clients with a supportive relationship led to insights on their part that mirrored the interpretations I struggled to suppress. Clients often expressed a mixture of sadness and appreciation when they realized how much they longed to be listened to without fear of judgment and shame.”
I will end this blog with a little warning to therapists who are advice-givers. In addition to the fact that giving advice is not their job and can handicap their clients. Therapists can be sued if their advice does not work!
Invitation for Reflection
- In what ways are you clearer about why advice-giving therapists can do serious harm?
- If you are in a therapeutic relationship, can you objectively evaluate it to ensure that it is highly ethical?
- Do you have any concerns about friends or family members who are in therapy that this information now helps you to better assess? How can you use it to encourage them to be critical thinkers and careful consumers regarding the therapist they see?
Diane Wagenhals, Director, Lakeside Global Institute
Marcella Taylor says
What a great blog! I have questioned my daughter’s therpist many times around the ethics and even moral issues that have come up. Her therpist fit the bill to what you spoke about. It got to the point where her therpist was clearly crossing a lot of lines – telling my daughter that she can’t transfer to another therpist due to race, or because she really bonded with her, or because she doesn’t feel another therpist could do as good as a job as her, while at the same time, mandating that my daughter to do CBT when my daughter clearly stated that she wasn’t ready. It felt like my daughter was in a bad breakup, and the therpist refused to leave. I ended up emailing the director about it becasue I wanted her therpist to hopeful see these unhealthy lines that were being crossed, and maybe look at the reasonings behind it.