This post was written by Joel Schmidt, Licensed Mental Health Counselor and Owner of Float On Counseling. If you would like to schedule an appointment with Joel, please visit our "Contact Us" page.
Therapy can be weird. As a therapist, there are things that I would like to say to some of my clients - but I probably never will. If you’ve read any of my blog posts before, you’d know that I talk a lot about the therapy process, interesting therapy dynamics, and the unique nature of the therapeutic relationship that makes it different from all other relationships.
Because of its nature, there are certain boundaries that should generally be adhered to by a therapist to protect the sanctity of the relationship…things like keeping contact between sessions to a minimum, pretending like you don’t know your clients if you see them in public (to protect their confidentiality), and not talking too much about yourself (unless you think it will be beneficial in some way to the client).
If you’ve ever done any research on what sort of things are essential in order for therapy to be successful, you’d know that your therapist’s level of education, credentials, and specialized training are among some of the least important factors that predict success with therapy outcomes. Those things are important, sure. You need a therapist competent and knowledgeable in working with the kinds of issues they’re treating…but the thing that stands above all else turns out to be the quality of the relationship. Even though there is a transactional element to therapy (therapist provides the service and client pays for the service), there are still 2 human beings involved. Two human beings that have feelings and who in most cases have a good level of care and concern for one another.
As a therapist, this sometimes causes a feeling of having to hold back to a certain degree. I generally consider myself to be a pretty transparent therapist. I’m open, honest, and will often share aspects of my life with the people I work with. That said, there are sometimes things I’d like to say, but that I probably won’t ever…either because it wouldn’t contribute to the therapy, it’s not relevant, it wouldn’t be considered ethical, or it would have the potential to be harmful in some way - even if well-intended and helpful on the surface.
Since I can’t (and probably won’t) ever tell my clients any of these things, there’s gotta be some kind of an outlet, right? Here are a few things I often wish I could say as a therapist.
“Let’s be friends” - At one point in my therapist journey, I would work with just about anyone. This was either because I didn’t have a choice (when working at an agency) or because I just wasn’t yet sure what type of work I wanted to do. This meant clients weren’t always the best fit - even if they were perfectly wonderful people. I’ve become much more clear over the years on the types of issues and people I love working with. This means I like my clients…and in many cases, I’m confident that if I had met them in the real world that we probably would have been friends. Although it’s sometimes disappointing that we can’t be, I’m thankful to have the opportunity to have some kind of a relationship with really cool people that I would likely have never met under other circumstances.
“You should definitely do this”: fill in the blank. As therapists, we have to be very careful about giving advice. Sure, we might help identify options, carefully suggest what “we might do” in a given situation, or provide useful tips on how to cope in certain situations - but we should absolutely never direct people or tell them what they should do or need to do. It sometimes feels SO obvious what someone should do, but ultimately the client needs to figure these sorts of things out on their own as the director of their own life. Making decisions for people takes away autonomy and diminishes the ability to make healthy and effective decisions for themselves outside of the therapy room. Oh yeah, and what if what we tell them to do turns out to be a really bad idea?!
“I thought about you when…”. Honestly, I’m not afraid to tell my clients if something came up that made me think of our work together between sessions. No harm in that - and it’s probably helpful for clients to know that you don’t just turn them off for the 167 hours between sessions…but what a lot of clients probably don’t know is how often we actually do think about them. In these often long-term relationships, we as therapists spend a lot of time with and learn a lot about the people we work with. We share stories and laugh with our clients. We witness heartache, loss, love, change, and growth. We participate in the journey…and being a part of these journeys becomes a part of our life. We wonder how current clients are doing between sessions and how past clients are doing. That’s without even mentioning that thinking about our clients between sessions is often a crucial part of the work. We reflect on sessions, develop plans, wonder if what we said was as helpful as we intended, and think about what we might say next time we meet.
“It’s been a while since we last met. How have you been?”. This one might sound a bit odd. What could possibly be wrong with reaching out to an old client to see how they’re doing? Although there might be certain situations where this WOULD be appropriate - especially if some sort of check-in has been agreed upon - reaching out after therapy ends would be an exception.
Like I’ve already mentioned, the therapeutic relationship one is unique and structured with certain boundaries and expectations that differ from all other relationships. When the therapeutic relationship ends, contact usually ends as well - at least until someone reaches out to schedule an appointment again to re-establish the relationship. This is for a few reasons but essentially boils down to confidentiality and respecting a client’s autonomy. Things change in people’s lives and we can’t be sure that a message will be welcome, if it will bring up any uncomfortable feelings, or whether or not it might compromise the privacy surrounding the work they did in therapy in the past. Imagine someone feeling like they had to explain to a significant other or friend who just called or texted them, if the role therapy had played in their life was something they wanted to keep to themselves. When it comes to the autonomy piece, the client gets to decide when and if they have contact with their past therapist.
Aside from all of that, we are carefully warned to avoid “dual relationships” in the law and in ethical standards of practice. We are to maintain only one role with clients…the role of therapist. Reaching out, outside of the context of therapy, might be perceived as the initiation of a friendly relationship which is different from the professional and essentially contractual one that comes along with the therapist/client dynamic.
This blog post was written by Joel Schmidt, a Licensed Mental Health Counselor and Owner of Float On Counseling. Joel's specialties include Anxiety Disorders, such as panic attacks and phobias, but he also helps his clients with Moderation, Low Motivation, Depression, Religious Deconstruction, and more. If you would like to schedule a virtual counseling appointment with Joel, you can click here to schedule online, email him at joel@floatoncounseling.com, or call 813-515-9602.