By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.
Talking to a Friend or therapist – part 2.
I think I misread this question the first time. My first thought after reading the question was:
“Why should a client go to a therapist they have to pay rather than just talking to a friend?” That is from the client’s point of view and describes why a client would be better off getting a professional therapist rather than relying on a friend.
I wrote a blog post about “Therapist of Friend” which is up at counselorssoapbox.com. That post got some really good comments from readers and they suggested some additional reasons they found going to a professional therapist helpful.
After rereading the question I think they were asking:
“What if your friend is also a therapist? Or as a therapist what do I say, to my friend. Do I set boundaries and keep my roles as friend and therapist separate?”
Remember some of the readers of this blog are consumers but some of the readers are professionals or aspiring professionals.
Here is my opinion of what an ethical therapist should do.
The law’s that created LMFT’s and some other therapist and counselor professions defined what professionals do as “applied psychotherapy.” We are able to bill for services provided to a client’s medical insurance. We have to keep the practice of our medical specialty separate from what we do on a non-professional friend basis.
Consider a doctor and his wife, a therapist; who go to dinner at the house of a couple who are casual friends. The friends proceed to describe some chest pains the husband has been having.
The doctor could ask a couple of follow-up questions, make a diagnosis, and whip out his prescription pad and write out a prescription. But should he? Most likely he will tell his friend you should see a doctor. That needs to be checked out and you need some tests and lab work.
Now the wife changes the subject and tells this couple all about the problems they have been having with their teenage son. What should the therapist do? Listen empathically? Ask more questions to define a diagnosis? Suggest some interventions that the parents could try? Or should this therapist, for the same reasons as the doctor, suggest politely that lots of kids these days have problems and the family might want to consider getting him some counseling? Counseling doesn’t mean he is crazy, just he may need help with some of the growing up tasks that he needs to do. And often it is hard to listen to suggestions from family members whom you want to please and you have a history with.
But wait a minute, aren’t those also reasons why the couple may not be totally honest with their therapist friend? And could you make things worse if you suggested interventions or treatment and you had an incomplete diagnosis because your “friend” left out some embarrassing details in front of their spouse and guests?
Once you learn a skill it is hard to unlearn it or know when to put it aside. If the friend had a heart attack the doctor would most likely intervene and do some emergency procedure or he might call an ambulance. The therapist would do the same if the person was suicidal. But beyond emergency situations, therapists need to put their therapist hats by the door and just be friends.
Remember no one likes a car salesman who comes to your house for dinner and spends the whole meal trying to sell them a car. No one likes a psychotherapist who is trying to psychoanalyze everyone they meet.
The difference in the relationship between a friend and a professional therapist lies in the professional’s ability to diagnose or define the problem and then institute interventions to make a change. Even professional coaches are allowed to make criticisms of the client that a friend would not be permitted.
In a past blog post, I wrote about reasons a client might want to see a professional for therapy rather than just talk to a friend. Now, look at those same reasons from the therapist’s point of view. Your liability insurance won’t cover you. They get no confidentiality or privilege. You may need to make a child protective service report on your friend. And most importantly because of dual relationships, you lose a friend.
Here is what I suggest you tell your friends who bring up problems that are in a therapist’s scope of practice.
1. This sounds like something that a counselor could help you with.
2 I make it a rule not to do therapy with friends.
3. We are not supposed to have a second relationship like a friend, with our clients and I would hate to lose you as a friend.
4. I can give you the names of some therapists who could see you if you like.
If you do other things such as coaching or teaching there is no problem in having a friend attend your class or coaching them on more effective communication but be sure that this is a separate activity from your therapy or counseling practice. And remember, in coaching or teaching you never ever give a diagnosis or conduct an intervention designed to treat a mental, emotional, or behavioral problem.
Hope that clarified the issue from the therapist’s perspective.
Staying connected with David Joel Miller
Seven David Joel Miller Books are available now!
My newest book is now available. It was my opportunity to try on a new genre. I’ve been working on this book for several years, but now seem like the right time to publish it.
Story Bureau is a thrilling Dystopian Post-Apocalyptic adventure in the Surviving the Apocalypse series.
Baldwin struggles to survive life in a post-apocalyptic world where the government controls everything.
As society collapses and his family gets plunged into poverty, Baldwin takes a job in the capital city, working for a government agency called the Story Bureau. He discovers the Story Bureau is not a benign news outlet but a sinister government plot to manipulate society.
Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.
Dark Family Secrets: Doris wants to get her life back, but small-town prejudice could shatter her dreams.
Casino Robbery Arthur Mitchell escapes the trauma of watching his girlfriend die. But the killers know he’s a witness and want him dead.
Planned Accidents The second Arthur Mitchell and Plutus mystery.
Letters from the Dead: The third in the Arthur Mitchell mystery series.
What would you do if you found a letter to a detective describing a crime and you knew the writer and detective were dead, and you could be next?
Sasquatch. Three things about us, you should know. One, we have seen the past. Two, we’re trapped there. Three, I don’t know if we’ll ever get back to our own time.
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