Does Your Therapist Have to Like You?

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"What population do you enjoy working with?" is a question that often induces mild anxiety in me.

There is no specific population I enjoy over others. In my practice, I see clients ranging in age from five to 82 with struggles across the mental health spectrum. However, there are some people that I enjoy working with over others.

I recall being a new therapist and feeling a sense of guilt and shame. Out of a caseload of roughly 60 clients, there were six that I really enjoyed working with. I appreciated working with most of my clients but these six were different. I found myself slightly more invested in them. This felt horrible as I reflected on sessions afterward. Wasn't I supposed to care about everyone the same?

I eventually learned that my feelings were normal and useful. They gave me insight into qualities that made people more effective at relating with others. Further—since therapy can be considered a social microcosm—I started using my reactions to clients as a tool for helping them connect with others. If clients did something to push me away, I would gently let them know. If they did something that made me feel closer to them, I would also let them know.

Do Therapists Like Some Clients More Than Others?

In a book called Psychotherapy: The Purchase of Friendship, Schofield (1964) suggests that there are certain traits that make clients more appealing to therapists: youthful, attractive, verbal, intelligent, and successful (referred to as “YAVIS”). Some of these qualities might be seen as controversial. For instance, who gets to define what "attractive" or "successful" is? Does this mean that clients of lower socioeconomic statuses are viewed less favorably by therapists? It has been found that clients from impoverished backgrounds do receive less quality mental health services (Hodgkinson, Godoy, Beers, & Lewin, 2017). These disparities should not be ignored.

Research suggests that some of these biases may still be prevalent amongst therapists (Teasdale & Hill 2006; Tyron, 1986). Some clinicians debate whether they have any relevance today. However, it may be tough to prove. Therapists may not be willing to admit them or they may not be aware of them. However, I raise this issue because I believe that reflecting on these qualities can help you enhance your interpersonal skills. All people can improve in one way or another.

Let’s look closer at YAVIS and how you might consider applying it to your life:

• Youthful. This should not be misinterpreted as young. While age can play a role, it also has to do with how you relate with others. Youthfulness is more about openness to new ideas and experiences. We have all encountered people of advanced age who come across as enthusiastic and vivacious (my grandmother is one) and young people who do not.
• Attractive. Unfortunately, stereotypically attractive people are often treated better than those who are considered unattractive. Dossinger, Wanberg, Choi, and Leslie (2019) assert that people who are perceived as more attractive have more career privileges than those who are not. However, physical attractiveness is not the whole picture. People come across as much more attractive and appealing when they are real, meaning honest and authentic. Practice expressing your thoughts and feelings in an honest way in order to be more real.
• Verbal. I have used this word to maintain the integrity of the author’s points. However, I believe a better word to use is expressive. The latter is more inclusive as certain disabilities prevent people from being verbal. There are many ways to express yourself. The main idea is that we tend to like people who express themselves as opposed to being closed off. It repels people when they have to work hard to get you to communicate.
• Intelligent. Schofield mentioned education levels as it pertains to this point. However, I think it is more important for people to be able to think critically about themselves and the world around them. Self-awareness is important in developing and maintaining relationships. It is also helpful if you can learn more about the world around you so that you can connect with the experiences of others.
• Successful. Money and status are often the first things that come to mind when considering success in America. However, I think motivation is more important. It is stimulating to be around people who come across as motivated and self-started. This is somewhat similar to youthfulness.

Therapists are human. As mentioned earlier, there are certain people that therapists enjoy working with as opposed to others. This is the same dynamic that is often present in other relationships. These biases may present an ethical dilemma if clinicians aren't willing to challenge themselves on an ongoing basis via therapy and/or supervision.

I do not agree with everything that Schofield suggested. However, his findings highlight both an interesting and difficult truth among mental health practitioners.

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As a client, the goal is not to make yourself more appealing to therapists. Therapy is a safe space to present yourself however you like. It is the job of an honest therapist to provide feedback on how you relate with them that may be helpful or detrimental to other relationships in your life. And at the end of the day, it's normal to wonder if your therapist likes you or not.

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