Should you tell that to a friend or a therapist? – Part 2

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Therapist

Therapist.
Photo courtesy of Pixabay.com

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 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 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 behavioural problem.

Hope that clarified the issue from the therapist’s perspective.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – 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 my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.

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Why pay a therapist when you can just talk to a friend?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.

Therapist

Therapist.
Photo courtesy of Pixabay.com

Therapist or friend – what is the difference?

1. Friends may keep your secrets; therapists are required to keep them.

Some friends are so close you can tell them anything. Well, almost anything. Most of us have secrets which we were sure we could never tell anyone. Friends are usually friends because we have things in common. If you tell them everything can they, will they, keep the secret? What effect might their knowing the secret have on your friendship? What if you two have a falling out? Some things are just too embarrassing to tell a friend.

There are two concepts that keep a therapist from revealing secrets. Confidentiality, which means that they can’t talk about what you say unless it fits those very few exceptions like you are suicidal or talk about abuse of a child. Other than that what you say there stays there.

Also, there is what is called patient-provider privilege. That means some things may be protected even if police or lawyers come around asking questions. Friends don’t get legal protection to keep your secrets.

You are only as sick as your secrets – Friends shouldn’t have to carry some secrets

2. Friends can help you solve today’s problem – counselors can help you learn to solve your own problems.

Counselors often work with clients to help them learn skills to solve life’s problems. Friends may tell you what to do in a given situation but that does not help you with the next problem.

You want help that will help you become more independent not more dependent. Therapists are taught they should help you be independent not foster dependency.

3. Friends may not want to hurt you but sometimes you need to hear the truth.

A profession person can give you their honest opinion. You paid for it and you deserve it. Friends may be afraid to tell you the truth for fear of losing a friend.

4. Friends get tired of listening to your problems, therapists do this for a living.

Ever meet someone who was really needy. Every time you talked to them it was all about their problem of the day? When you are going through something difficult you need to talk about it. Friends can get talked out. Don’t burn out friends and damage friendships by asking friends to become very involved in your problems.

5. Friends have a good heart. They want to help with your problems. That doesn’t mean they always known how.

Therapists have many years of schooling and specific training in how to help people like you with problems. They study not only diagnosis and treatment but how to help with particular problems.
It is that kind of expertise that you need in your corner when that problem overwhelms you.

6. Friends can play the game with you, but counselors and coaches can help you improve your game.

When the team is losing all the players are going to talk to each other. They know what it feels like to lose. What they don’t always know is how to change that losing streak. That is where a new coach can come in and help turn a team around. Counselors, therapists and professional coaches can do that for your life problems.

That does not mean you should avoid friends or peer support groups. Both are vital parts of your support system. Millions have recovered from alcoholism in A.A. But if you find that when you talk to your friends about your problem, that they don’t know how to help you or that the solutions they offer are not helping, consider that you may have a second problem, a mental health problem and seek professional help.

Those are some reasons that you might decide to see a therapist rather than talk with a friend. What if your friend is a therapist? What if you are a counselor? In the next post, I want to talk about reasons to keep that friendship and that professional relationship separate.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

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.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

Want the latest blog posts as they publish? Subscribe to this blog.

Want the latest on news from recoveryland, the field of counseling, my writing projects, speaking and teaching? Please sign up for my newsletter at – 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 my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at counselorfresno.com.