There’s an oft-cited trope that therapists shouldn’t give advice. At least, it’s oft-cited in the world of therapists and their clients, especially serial clients. While there’s some degree of wisdom in this to be sure, it’s far too opaque a statement. What constitutes advice and what is considered giving it? Are there really no circumstances under which it might be a good idea to prod someone in a given direction?
Perhaps a better rule of thumb is that therapists shouldn’t give advice that doesn’t fit with clients’ values. Value judgment conversations should always be a give and take in therapy, with the therapist regularly checking in to make sure that he or she and the client are on the same page.
The first and most essential premise of therapy is that the world is to be approached from the client’s reality. It’s not the therapist (hopefully) who is seeing tigers that aren’t there or is petrified by the idea of going outside; rather these perceptions are brought to the table by clients and need to be met as they are. Now, this is not to say that therapists should affirm the existence of hallucinatory tigers or encourage clients to indefinitely cower in place, but merely to accept these as starting points of clients’ worlds. By treating hallucinations or anxiety, therapists help clients to update their understanding of the world, in a way that is more adaptive for successful living.
Expanding this principle helps to understand how client values are best approached generally. Just as a therapist likely doesn’t share a client’s psychosis or anxiety, he may well also have all different ideas about life, religion, or politics. What matters in therapy is not what the therapist’s beliefs are, but those of the client. It’s the therapist’s job to distinguish between beliefs or values that are commonplace and therefore more likely to be adaptive, versus those that are entirely unique or odd, which might signify pathology. Something that is very helpful here is cultural competency, as it provides some degree of familiarity with what beliefs or ideas are to be considered normal and which are not.
Ideally, when a therapist encounters a client belief or value that seems to her to be strange, the first order of business is to flush it out through questioning. Doing so allows clients to clarify what is meant and possibly explain why something that was initially interpreted in a negative light, may in fact be positive. More importantly, in the event that a client’s idea or perception is maladaptive, the therapist’s challenge provides the client with an opportunity to reassess his ideas and possibly reach a new conclusion on his own.
So, should therapists give advice? The best answer is yes and no. Telling clients to do something is almost never a good idea, outside of an emergency. Whether advice is offered at all really depends on having an accurate understanding of and respect for clients’ values and a willingness to enter their worlds. When the decision to offer advice is made, it is imperative to work step by step with clients to ensure that potentially taking advice occurs through their own volition and not blind reliance on the therapist.
Elliott Blitenthal is a clinical social worker who works with adolescents and adults with anxiety, depression, interpersonal and career issues, or who feel that things aren’t the way they should be. Elliott works with individuals, couples, and families via telehealth or in-person. He can be contacted at 952-393-6415 (call/text) or This email address is being protected from spambots. You need JavaScript enabled to view it.. For more information including about insurance, visit www.elliottblitenthal.wixsite.com/website.
