Should your therapist tell you what to do?


By David Joel Miller.

Do therapists and counselors tell people what to do?

We can do it!

Telling you what to do
Photo courtesy of Flickr (marsmet545)

Most counselors and therapists will tell you that they do not, under any circumstances, tell clients what to do. Frankly, I think many of my colleagues are fooling themselves more than they are fooling their clients when they say that they do not tell clients what to do.

There are good reasons to tell someone to do things and there are also good reasons to not tell people what to do. This is especially true in something as close and confidential as the counseling relationship.

Clients have told me that they get very upset with their therapists either because the therapist keeps telling them to do something that is inconsistent with their goals and beliefs or because they ask the therapist what they should do and did not get an answer.

There are three questions to examine here. Why do therapists avoid telling clients what to do? Why after saying they would never do this do they then go ahead and try to influence client’s behavior in more subtle ways and lastly why counselors can and should tell clients what to do.

Two reasons why the therapist should avoid telling the client what to do.

The goal of counseling is to help clients learn to solve their own problems. Telling clients what to do “fosters dependence” meaning if we make the decisions for you then you do not learn to make them for yourself.

Rather than telling you what to do the counselor should be helping you learn about yourself, what are your values and goals, and then learn how to make the choices that are right for you, not the ones that are good for the therapist.

Second, it is your life, not ours. I do not want to tell someone to get married or divorced and then have to take the blame for things that turn out badly. We are not fortune tellers and do not know what the future holds. You need to pick the outcome that is best for you. While we may have opinions, they are our opinions.

How therapists try to tell you what to do anyway.

Therapists and counselors have opinions, often strong opinions about things. We see certain things as bad for you and other things as good. Not all professionals agree on which is which.

Some marriage therapists refer to themselves as “Gorilla divorce busters.” They believe that all marriages should be saved. So if you go to them for help, no matter how badly you feel in this relationship expect this professional to try to talk you into working on the relationship and out of getting a divorce.

Some therapists take a pro one gender stance. Lots of times this is a pro-feminist stance. They seem to always align with the woman. The message is the man is the problem, get rid of that guy and things will be better.

Personally, over time my position on these gender issues has changed. Most of the time it is neither person’s fault, and if they get divorced they will each be back with a new partner. Pick a partner and you pick a set of problems. So I encourage them to learn the skills they need for a good relationship and practice this with their current partner first.

I also recognize that sometimes even if both people change, the damage they did to each other may mean that they just can’t be together.

Personally, I have worked with so many people who have a substance use disorder that I tend to think most people need to give the drugs or alcohol up. If the couple has most of their fights while drinking I tend to think we need to talk about Alcohol abuse. If the client says they do not want to quit, I go with that. But next week when they get drunk and hit each other again I may ask about that drinking thing again.

I can think of a bunch of other issues that turn up in counseling that might prompt a counselor who has strong opinions to try to influence their client even after that professional says they never tell their clients what to do. Abortion, Homosexuality, and other sexual behaviors all may evoke that behavior in the therapist.

When should a counselor tell a client what to do?

I think, and I may well be in the minority on this, that there are times the counselor may need to tell the client what to do. I usually do this more in the way of providing information or making suggestions, but the point is clear that I think this is what the client should do.

When might a counselor do that? Mostly when I have some information that the client needs and the client does not have that information, some of this borders on social work. I do not do that but I do clinical counseling and there are similarities.

If the client does not have a job, I might do some testing, talk about their job history and which was their favorite job and then I might suggest some careers that would be good for the client. I might also suggest some websites to visit and some ways to revise their resume.

If the client is homeless I might suggest some places to go for housing. I might also revisit the drinking problems and suggest that if they stay sober their housing opportunities increase.

When doing Cognitive Behavioral therapy I may give homework. We sometimes call this “conducting behavioral experiments.” I ask the client to do something and then in the next session we talk about how that went. If they did not do the experiment we talk about what got in the way of doing this exercise.

Most of this “advice giving” is done when the client is trying to adjust to a change in their life and they just do not know where to go or what to do. This “telling” also works best when it is done in the form of suggestions and the client is free to do or not do these things. Either way, I am willing to keep seeing the client and together we work on finding the solution to their problems that work best for them.

Want to sign up for my mailing list?

Get the latest updates on my books, due out later this year by signing up for my newsletter. Newsletter subscribers will also be notified about live training opportunities and free or discounted books. Sign up here – Newsletter. I promise not to share your email or to send you spam and you can unsubscribe at any time.

For more about David Joel Miller and my work in the areas of mental health, substance abuse and Co-occurring disorders see the about the author page. For information about my other writing work beyond this blog check out my Google+ page or the Facebook author’s page, up under David Joel Miller. Posts to the “books, trainings, and classes” category will tell you about those activities. If you are in the Fresno California area, information about my private practice is at counselorfresno.com. A list of books I have read and can recommend is over at Recommended Books

Advertisements

5 thoughts on “Should your therapist tell you what to do?

  1. Hello, another good post. What do you think about “suggestion” that is outside of what you mention like offering information. I think therapists make subtle suggestions to clients that if asked, they’d say they never do. Can be a very harmful practice.

    Like

    • Yes I think it is hard not to make “suggestions” whether we mean to or not. This is something professionals need to be on the watch for. Rather than something subtle like “of course you are going to…” I think the best way is just to make the suggestion as something the client might consider and then tell the client that it is your life and up to you. Thanks for all the reads, reblogs and support.

      Like

  2. I was seeing a CSW years ago and to every question I asked she would ask back, “Well, what do you think?” We shared similar sensibilities and related to each other. But to be honest, I got nowhere. Now I’m seeing a psychologist who is much more open about his opinions, but not in a way that he is telling me what to do. He’s just constantly reflecting back at me my own questions.

    Like

  3. Counselor acted one too many times like a life coach…giving me advice as to what to do in a situation… and now I am done. I have noticed this person would be critical of my own plans which actually seemed to foster a sort of dependence I never wanted. Recently I decided to revise certain goals and reset with new priorities…and the counselor became almost a bully, giving unsolicited advice as to how I should stick with my original plans. This level of inflexibility woke me up. I think I am coping better and making decisions, and I and don’t need this pseudo life coach constantly throwing monkey wrenches into perfectly a perfectly appropriate goal refinement process.

    Like

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s