social skills for therapists

An opinion is still an opinion if you put a question mark at the end

Therapists usually see themselves as facilitators rather than advice-givers or problem-solvers. They generally believe things like:

  • “We never tell people what to do”
  • “We create space to support them through figuring it out.”
  • “We raise questions.”
  • “We don’t give advice, we let them come up with solutions.”

Thing is: “raising questions” in practice amounts to expressing a lot of opinions. An opinion is still an opinion when it is phrased as a question. It’s *especially* still an opinion when it is phrased as a series of leading questions and pregnant pauses.

It matters what therapists of any kind believe about their clients; they can’t help very much without understanding what’s going on. That’s a reason why psychologists and other types of therapists spend years in school learning psychological theories and practical methods. One of the major ways in which therapists are sometimes able to help people is by having well-informed opinions and understanding things that others don’t.

It’s ok for therapists to have opinions — but they need to be well-informed, and they need to be able to modify them in response to new information. (Eg: Sometimes the patient knows something you don’t, sometimes there’s social or cultural context that changes the meaning, etc.)

I think that it is much easier to have a worthwhile opinion if you can admit to yourself and others that you have opinions and that your opinions affect other people.

tl;dr Therapists tend to express their opinions to clients phrased as a series of questions. They think that this means they’re not expressing an opinion, but rather just asking and creating space for the client to think. It matters that this is not true. Therapists have opinions (and should have opinions), and being honest about that makes it much easier to learn new things and make your opinions needed. An opinion is still an opinion if you put a question mark at the end.

boundary violations in therapy

all-women-kick-ass asked realsocialskills:

 

do you know what particular boundary violations in therapy AREN’T considered unethical? because i am also studying to be a therapist and would very much like to avoid said boundary violations with future clients.

Boundary violations that aren’t considered unethical:

  • Teaching people not to trust their own judgment
  • Telling people their reservations about therapy are just a symptom of their disease
  • Equating wanting to stop therapy with wanting to give up on improving one’s life. Those things are different.
  • Insisting that people speak verbally or make eye contact as a precondition for working with them
  • Insisting that someone repeat details of sexual abuse over and over, even when they are coming to you for help with something largely unrelated
  • Threatening to have someone institutionalized if they stop taking medication
  • Ignoring someone’s concerns about medication side effects
  • Asking questions in a way that makes it impossible for someone to refuse to answer

Any others y'all know of?

More about respectful therapy

This applies to both adults and children. Respect is really important.

Some of what this means is:

Understand that people who need therapy are going to have trouble with it sometimes:

  • People who have therapy have it because some things are hard for them. This is normal and should be expected in a therapy context.
  • Being in therapy doesn’t make things easy. It just means someone is getting help learning something
  • Expect that it’s going to be hard for the person you’re teaching to learn the things you are teaching them
  • And sometimes they will have trouble in ways you didn’t anticipate
  • When they are having more trouble than you expect, don’t get angry
  • And don’t make fun of them
  • And don’t accuse them of being lazy or wasting your time
  • And especially, don’t tell them that if they’d just *try*, they’d be able to do it
  • Help them find a way to figure out how to do the thing.
  • This means sometimes you might have to spend an hour or hours searching for a way to successfully explain something you think of as simple or obvious
  • This is part of your job. You’re there to help people figure out how to do things, and sometimes that’s hard.
  • It’s not ok to get angry at or frustrated with someone when they’re having trouble understanding something. If you’re feeling that way, it’s your problem and not theirs, and you need to find help dealing with it.
  • Treat people with consistent respect. That makes a huge difference.

Respect your client’s priorities:

  • Adults in therapy get to decide which things they want to work on
  • If they want help with one thing, and you think something else would be more helpful, it’s their call and not yours
  • It’s ok to tell them what you’d advise and why
  • It’s not ok to coerce them into doing what you want
  • It’s also not ok to treat them as less-than-human or unworthy of help if their priorities are different from yours
  • For instance, someone might care about reducing pain but not especially care about walking
  • Or someone might care about nutrition for cognitive functioning but not especially care about weight loss
  • And they get to decide that

Kids in therapy also have agency

  • Kids don’t get to decide everything the way adults do, but what they want still matters
  • It’s important to acknowledge that they have opinions and priorities
  • And it’s important to listen seriously. Sometimes they know something you don’t, and sometimes listening will change your opinion of what they should be doing in therapy
  • And sometimes, their opinions and priorities should be respected even if you think they are making a mistake
  • This is especially true of teenagers
  • Don’t equate kids with their parents. Sometimes kids and parents disagree. Listening to the parents isn’t enough
  • Do listen to the parents, though. They probably know relevant things about your child that you don’t know. Not always, but usually.