By David Joel Miller.
Do therapists and counselors tell people what to do?
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 client 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 persons 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 web sites 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.
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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