I talk to a lot of people that are looking for a therapist. I even run focus groups on what’s the most important thing client’s consider when looking for a new therapist. All the data that I have collected and continue to collect influences TherapyDen’s therapist directory. That's why, if you have filled out a profile with TherapyDen, you’ll notice the slight push towards authenticity. I ask therapists to be more honest about who they really are because clients want to know. I ask therapists to define who their ideal client is so that clients can really see themselves in your office.
Along with talking to people who are seeking counseling, I also have regular conversations with folks who go to therapy consistently and have found a good fit. And there are two things that these clients are not bringing up in therapy. Let’s discuss.
Thing 1: They want to change the subject but don’t know how
I’d like to think that if a client wanted to change the subject, no matter what it was, they’d speak up. I know I certainly would! But it’s pretty naive of me to think that clients would have the same reaction in therapy that I would. I know this. And I think about this every time I’m being a therapist. And when I talk to people that are in therapy, who report a strong rapport with their counselor, the topic of wanting to change the subject, but not being able to, comes up over and over again. So it makes me think that even though I am heading into my sessions with clients with complete awareness that they may not want to talk about something, there still must be times that I am missing it and inadvertently making a client talk about something that they have no interest in talking about.
And when I say that clients report wanting to change the topic, they typically are not talking about changing the subject when something feels uncomfortable or they are being therapeutically challenged by their counselor. They are talking about how they feel bored talking about their family history. Or they have no interest in doing a visualization. Or talking about a fractured work relationship really doesn’t matter to them. Clients report that they talk about things that they think are therapeutically not relevant but they feel, for some reason, that they can’t change the subject. Or that they have tried to change the subject but don’t feel heard so they just kinda go along with it.
It’s painful to hear that clients leave a session thinking that what they talked about was totally irrelevant. As therapists, I think we need to do a better job checking in with our clients, possibly on a weekly basis, about what they want to talk about. They need to know that they can speak up at any time during a session and ask why we are focusing on a certain issue or treatment intervention. We can explain why we are focusing on it and we can also give them the option to change the direction. Because for many reasons, clients may not think that it’s okay to influence where the conversation is going to go.
Thing 2: They want to ask you a personal question but don’t know if they should
Where ever you land personally on the spectrum of self-disclosure in therapy is irrelevant for this one. It’s 100% up to you whether or not you want to self-disclose certain things when talking to a client. But I hear it over and over again. Clients want to ask you personal questions. And the fact that they think they can’t, is getting in the way of your connection with them.
A friend of mine texted me last week and asked if it was okay to ask her therapist if they are liberal or conservative. She said it’s been really on her mind and it matters a lot when it comes to trusting her therapist. And I think we all know how important trust is when developing a relationship with a client. My friend was saying that she probably couldn’t trust her therapist if she’s wasn’t liberal. I encouraged her to bring it up in her next session and be direct in asking. If the therapist is liberal and tells her so, then great! The trust isn’t broken. And if the therapist isn’t liberal, then okay, my friend should run for the hills! Kidding. Sorta ;)
If the therapist self-discloses that she isn’t liberal then it’s a wonderful opportunity for my friend to address the automatic mistrust that she has for non-liberals. It could be a real growth opportunity for her to trust someone that’s on the other end of the political spectrum.
Or maybe as a therapist you wouldn’t answer the question at all because you don’t think it’s relevant. Okay fine. But I still think you’d agree that it should be something that your client asks if they think it’s getting in the way.
My advice to therapists is to tell clients in the first session that they should feel okay asking anything they want. And if you, as a therapist, feel like it’s okay to answer, then you’ll answer. And if you don’t want to answer, then you’ll talk about why. But bringing it up in the first session isn’t good enough. We should be bringing it up monthly at the very least. Because clients should be told repeatedly it’s okay for them to say anything they want in session.
What does all of this mean?
From what I’ve collected, it seems as though some clients are not feeling empowered in session. They may think some topics are off limits or that they should just trust whatever direction the therapist is moving the conversation. That could lead to a less than optimal connection and eventually get in the way of progress, possibly resulting in a client ending therapy too soon. So don’t be afraid to educate your clients on the power and agency they have as clients. It will lead to a better outcome.
Jeff Guenther, LPC, is a therapist in Portland, OR. He has been in private practice since 2005. Jeff is the creator and owner of Portland Therapy Center, a highly ranked therapist directory. Jeff, and his team, have launched a new progressive therapist directory, TherapyDen.
