There are many aspects to undergoing psychotherapy that most people do not understand, and there are many misconceptions as to what to expect from this unusual and incredibly special relationship. In this unfamiliar association between two strangers, a special bond is formed as a therapist attempts to help their client overcome emotional difficulties using their training as their guide. The expectations of the client can, however, be a hindrance to this working relationship. In this article, I will attempt to address a few of these beliefs from the point of view of a client.
The Therapist is wise and all-knowing
Clients often enter therapy with the idea that because a therapist is trained in helping people to navigate the maze of emotion that is inherent in most people who seek their help, they are a reservoir of information. They think their therapist can understand their problems without any explanation on their part. The expectation is that the therapist should know what the client is thinking. As a client, I had to learn that therapists are people with human flaws, emotions, and biases. My expecting my therapist to know what I was thinking and how to help me regardless of the complexities of my thought processes was unjustified and caused a great deal of distress for both she and I. It was only after she helped me to a more realistic understanding that she was only a woman, not an all-knowing seer that we were able to connect on a human level and move forward in my treatment.
Therapists should always be available
Healthy boundaries as to what a therapist will and will not accept in the way of communication between themselves and their emotionally charged client’s are important. It is something that should be spoken of at the very first appointment and reiterated throughout treatment. Such boundaries are significant to the therapist maintaining their own mental health, and to keeping the client from crossing the line from needing help to dependency. When I entered treatment, my therapist made sure I knew where she stood on personal phone calls and her privacy. She explained that while I could call her home, she would prefer that I call the clinic where she worked and allow them to relay my need to speak with her. In this way, she explained, there would be fewer chances of a mishap, as at the time she had small children. I tried to cross this boundary a few times but was reminded kindly but firmly that to do so was unwise. I also had to understand that my therapist time away from her duties was vital to her emotional health and her ability to help myself and others. Without her private time, she would have become greatly limited in her capacity as a therapist. This time included her need for vacations, which at first, I viewed with stress-filled apprehension, but later understood that those weeks were vital to my overall recovery.
My therapist will fix everything for me
This is perhaps the most pervasive error many clients make in their beliefs about a therapist. The idea that a trained mental health professional, i.e. a therapist, will know all there is to know about their client’s condition and will give them step by step instructions on how to heal, is very prevalent among clients. Setting up a therapist to be an all-seeing, all-knowing person, causes many clients to drop out of therapy when they come to the sudden realization that their therapist is not fulfilling their expectations. I have spoken to many client’s, other than myself, and have heard many of them complain about how their therapists would not give them the answers to the problems they have brought into their office. It is hard to understand that this expectation is unreasonable, as therapists, while well-trained and well-prepared, will not hand out advice to their clients. It takes time for clients to understand that the role of a therapist is not to give their opinions on how their clients should run their lives, but help their patients to seek their own answers. I can remember, in my own experience in therapy, how I thought my therapist would tell me how to heal and the disappointment I felt when she did not. After she explained to me that she did not have all the answers and that the way she lived her life might not be the way I needed to live mine, I was better prepared to allow her to help me find my own answers within myself.
Therapists are perfect people with perfect lives
Clients often live under the illusion that because their therapist has a successful career that they have quiet lives with no distractions or problems. This is a common misconception which can lead to clients not empathizing when their therapist must call in sick or has a personal crisis. This lack of understanding causes the client to feel resentful and may even cause them to leave treatment, believing they have been unfairly treated. I can remember feeling upset when my therapist suddenly was unavailable for my appointments for a month, I felt slighted and upset. I lacked the understanding and empathy that she was a human being who had a life and family. After I discovered, sometime later, that her mother had died and that was why she had been absent for so long, I was able to look back at my feelings and see they were unfounded. She and I discussed my reaction in-depth, and I could put into perspective the fact that she had needs too
My therapist will never leave me
This expectation is perhaps, the most unrealistic of them all. Therapists are first and foremost people. They sometimes need to move to a different state, retire, or sometimes they die. These are the facts of life that many clients, because of their understandable self-reflection in the psychotherapeutic inspection forget. My therapist decided to retire after we had worked together for many years. I took the news hard, but I realized, because of our discussions on the subject, that she needed to move on with her life. She gave me a year to adjust, and we spent many hours preparing for her departure. At the end of our last hour together, we parted company with a hug and with mutual respect and admiration.
It is important to remember that clients often have unrealistic expectations when entering a therapeutic alliance with a therapist. There are actions a therapist can do to help dispel these anticipations.
- Speak frankly and freely with the client about what they can and cannot expect to receive from their visits from the beginning and often.
- Set firm boundaries with explanations as to why they are important.
- A therapist should never assume that their client understands the rules of therapy, even after dealing with the same client for months or even years. Repeating to the client their expectations of their client’s conduct should be repeated as often as possible to avoid misunderstandings.
- Therapists should allow the client to see their humanity. They need to understand that you have a life outside of the office, and real problems to solve daily, just like all other humans. This does not include self-disclosure that is inappropriate or unethical.
- Give clients plenty of preparation for upcoming events such as vacations or retirement.
With open and honest discussions about these faulty yet common expectations, many of the pitfalls that clients fall into can be avoided.
Part of the healing process is sharing with other people who care. ~ Jerry Cantrell
Davis SJ. The expectations of therapists: a client’s point of view. MOJ Addict Med Ther. 2017;4(1):209–210. DOI: 10.15406/mojamt.2017.04.00068