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The tipping etiquette lists are in holiday circulation, alerting the conscientious to tasteful appreciation of their postal workers (Starbucks card), garbage collectors ($15-$30) and dog walkers (gift certificate for a pedicure). But what about your therapist? How much should you spend on her holiday bonus?
Nothing.
The doorman gets a Benjamin, the stylist is tipped cost of a haircut and you slip the paperboy $30. The person who knows your deepest pain and secrets? Zilch. Why not?
It's not customary. Tips reward good service for jobs that rely on extra income to earn a living (food service, taxis, barbers, etc.). Therapists and physicians may groan about managed care trimming our profit, but we don't rely on tips and may even be hassled by the IRS if we receive them.
It's not our language. Therapy is called the "talking cure" because we use words—not gifts or gestures—to convey our thoughts and feelings. We're often looking to put words to the meaning behind a behavior ("I smoke pot to fit in....") or token ("my father's watch meant everything to me..."). Words are our commodity. A gift introduces another symbol that will need to be explored in words ("This necktie is like my grandfather, you remind me of him because..."). You can skip the tie and just talk about your grandfather if you'd like.
It's not your job. Therapy is a real relationship, but one that is intentionally skewed toward the client. Your needs, opinions, behaviors and feelings are the reason for our season. Affirming the therapist and letting him know he's loved and cared for is the job of the therapist, his friends, his family and his therapist. Part of our job is making sure these needs are met elsewhere and never fall upon the client. Certainly feedback (see below) is welcomed, but ego-stroking affirmations of value and worth are not necessary. We want this room to be one place in your life where the only person you need to focus on and care for is you.
But go ahead. We're not Scrooge. As I've said many times before, it's your time and your dime, you can do or say practically anything during your hour, including giving gifts and singing praises. It's certainly not offensive, just know that neither are expected of you. And most therapists won't just politely accept it with a thank you, they'll want to talk about it: "So, how does it feel to give me a Chia Pet today?" There's a chance they won't accept it, especially if it's expensive. And they're not getting you anything.
Therapists don't require a gift, a tip or even acknowledgment of the holiday season from you. The relationship doesn't call for small talk or other pleasantries, and holidays are no exception. We don't go home feeling sad no one remembered us with a bottle of scotch or a fruitcake or a sausage and cheese basket. If therapists feel unappreciated it's probably due to therapist burnout, not ungrateful clients.
If you still want to give a gift, here's one that's right in line with therapy: Tell your therapist how you feel about your work together. Tell her what you do and don't appreciate and how working together has impacted your life. A Starbucks card enables a habit for a couple weeks, but honest feedback can help her be a better therapist which is good for her, you and her other clients. Many people seek therapy to figure out honest, direct communication. This gift helps you grow and helps her, too.
Still not enough? How about a referral? In this financial climate everyone can use a business boost. If the therapist works for someone, a nice note to the boss would be a kind gesture. If you've just got to get rid of some cash, perhaps you could donate to a community mental health center so someone less fortunate can benefit from therapy.
Honestly, if you're grateful for all the hard work and effort your therapist has given, the best gift is your own continued effort to grow and change. More so than any trinket or tip, our biggest gift comes when we see change and improvement in your life.
