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Therapy

What Therapists Can Do When a Client Wants Advice

Feelings pressured and stressed when pushed for direct advice? Here are options.

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Source: self

I spend a few hours every week supervising new therapists working on their Master's degrees. Challenges around giving clients advice have continually emerged in supervision over the last few years.

Clients often think therapy is about direct advice about what to do in a complex situation (whether to stay in a challenged relationship, or move, or change jobs), but it's usually more about helping clients find their own way based on their own intuition, values, and needs. This empowers clients and helps avoid therapist liability. When therapists perceive their client still, seemingly relentlessly, pressuring for direct advice, therapists may also worry they're not helping enough or failing. Here are some pointers on dealing with this common issue:

1. Use "present process" from emotionally focused therapy. An option, as you're explaining these points to your client, is processing from an emotionally focused therapy (EFT) lens: "What is it like for you to realize that therapy may not be what you expected, and how are you doing with that gap between what you’ve expected, and what you're getting, at this stage in our therapy?” This commonly used therapist intervention is called "present process" in EFT.

Consequently, therapists, together with their client as a team, may explore requests in this way: "You just asked me for direct advice on what action to take, and I told you that therapists don’t usually do direct advice and I empathized and explained why. What was that like for you? Your face looked a little disappointed, if I read you correctly. Is that what it was?"

Being sensitive to this possible letdown — expecting direct therapist advice and not getting it — may help a client stomach the unanticipated nature of therapy and later set them up for success. Then, after validating the client's request, you can use similar points from this post and hopefully resolve the confusion, strengthen and clarify the therapeutic relationship, and decide how to proceed collaboratively.

2. Play it out with the persistent client from a solution-focused lens. Another option is asking, “If I did give you really good advice, what do you think would be different? How do you think my ‘good advice,’ if it landed, would be most helpful and change your feelings, your behavior, and your beliefs about yourself?” Then, as a team, you can foster confidence, autonomy, and success with perceived or imagined direct advice, ironically, without actually providing the direct advice your client may have thought they needed. This way they can give it to themselves with your emotional support.

3. What if your client still insists on you providing direct advice? After clarifying that therapy doesn't usually work that way, a client may still insist. In some cases, it may be possible to give your clients some direct advice (hopefully sparingly), and see how it goes. You probably have a helpful opinion and this may be the time to share it, as long as the client knows that it's their choice. This would help see if it is uniquely helpful to them, or if it would show what I'd predict: that direct advice isn’t often that helpful, as we’ve found with most (not all) other clients and situations.

So, if you try refusing, but your client still pushes for direct advice, you can present it as a experiment and see how it goes together, after educating them on its risks (as outlined here) and the likelihood of it not working as well as they may have expected. This approach can be thought of as a "warning label" or "try at your own risk."

Conclusion

It's most important to stay with your client and clarify the confusion about usually not being able to tell them exactly what to do, and then process that interaction with them. Hopefully, it would ultimately empower them, strengthen the therapy alliance, and make you feel more helpful and comfortable with them as therapist.

Direct advice usually, albeit unintentionally, sets up a lose-lose situation for most therapists and their clients: client disempowerment, dependence, and/or anger, and therapist liability, along with potential burnout and overall feelings of ineffectiveness. On the other hand, I've found that helping clients get unstuck, and find their own way, is usually the best option. This builds resilience and self-reliance, which are, I believe, the most profound gifts therapy can produce. After all, do you want your clients to learn how to channel their own inner-therapist, or do you want to resolve all their problems for them?

Using my own therapy experience as a client to help me figure out things for myself was one of the most empowering and confidence-boosting endeavors I have ever experienced. All clients also

deserve that opportunity.

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