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Two Misconceptions About Doing Psychotherapy
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by Mitchell M. Handelsman, PhD - University of Colorado Denver
It takes lots of training and a long time to become a competent therapist
(Orlinsky & Rønnestad, 2005). Why is psychotherapy so difficult to learn? One
reason is that the therapeutic relationship is private. Students have
experienced many teachers and professors; thus, plenty of good models exist for
students who aspire to jobs in academia. However, few students have experienced
more than one or two therapists in their lives, and The Sopranos and
old reruns of The Bob Newhart Show at 2:00 a.m. don’t really count.
Another reason psychotherapy is difficult to learn is that it is unique.
Students begin therapy training with ideas about relationships based largely on
their interactions with family members, friends, physicians, and others—ideally,
not including parole officers. But these relationships, although similar in
superficial ways, are not at all like psychotherapy in several very important
ways. Thus, many students need to correct some misconceptions about therapy. As
Grater (1985) put it, “To a significant extent the trainee learns to replace
social patterns of interacting with therapeutic responses” (p. 606).
Give Up Giving Advice
The first misconception: Psychotherapy involves clients who relate problems and
therapists who tell clients how to solve those problems. This is what I call the
financial planning model of helping: “I know the best investments for you, and I
don’t really need to know much about you to offer advice.” Physicians and
attorneys use a similar model. These relationships involve high levels of expert
knowledge—about diseases, finances, law—and a lot of specific advice.
Students are often surprised that psychotherapy does not involve the same kind
of advice, because therapists actually know very little about how clients should
live their lives. Think about it: In an hour a week, you will never have enough
information about your clients to make decisions or offer specific advice about
their lives. The expertise of psychotherapy is about the properties of a
growth-producing (therapeutic) relationship and about methods to help clients
use therapy to make their own decisions.
It might be useful to distinguish between process and substantive advice.
“Process advice consists of suggestions for how to go about solving problems, or
how to make the most of therapy,” whereas “substantive advice consists of
suggestions for specific solutions to the problems, or for how to live”
(Anderson & Handelsman, 2010, p. 102). Process advice is great; too much
substantive advice may indicate that therapists are taking too much
responsibility for clients’ lives.
Some advice sounds substantive, but is actually so general that it can be given
to anybody: For example, “I think you two, as partners, should learn to
communicate better.” Beyond these generalities, how do we know what’s best for a
Personal Experiences Don’t Count as Much as You’d Think
Many beginning (and veteran!) therapists believe that having endured and solved
some life problem gives them a built-in advantage with clients who have similar
problems. I disagree. Such experience may give therapists a way to empathize.
However, expertise in therapy comes from the integration of theory,
researchbased skills, and personality—not simply from personal experience. Thus,
therapists may be less effective with clients who have similar issues because
therapists may: (a) miss important client information because they assume
clients are just like them, (b) be too quick to give only advice they found
useful, and (c) rely too heavily on their experience—which may be atypical—and
not enough on what the research says. As a professional, the only person you are
qualified to help based only on your own experience is … you!
The bottom line: Too much advice and too much self-disclosure by therapists may
constitute, or lead to, unethical behavior. These behaviors are examples of
“boundary issues” (Gutheil & Gabbard, 1993), which I shall discuss in future
Anderson, S. K., & Handelsman, M. M. (2010). Ethics for psychotherapists and
counselors: A proactive approach. Malden, MA: Wiley-Blackwell.
Grater, H. A. (1985). Stages in psychotherapy supervision: From therapy skills
to skilled therapist. Professional Psychology: Research and Practice,
Gutheil, T. G., & Gabbard, G. O. (1993). The concept of boundaries in clinical
practice: Theoretical and riskmanagement dimensions. American Journal of
Psychiatry, 150, 188-196.
Orlinsky, D. E., & Rønnestad, M. H. (2005). How psychotherapists develop: A
study of therapeutic work and professional growth. Washington, DC: American
Mitch Handelsman received his BA in psychology from Haverford College and his PhD
in clinical psychology from the University of Kansas. He is currently professor
of psychology and a CU President’s Teaching Scholar at the University of Colorado
Denver, where he has been on the faculty since 1982. He served for a year (1989-1990)
in Washington DC as an APA Congressional Science Fellow. In 2003-04, he was president
of the Rocky Mountain Psychological Association. He is a licensed psychologist and
a fellow of the American Psychological Association.
Mitch won the 1992 CASE (Council
for the Advancement and Support of Education) Colorado Professor of the Year Award,
and the Excellence in Teaching Award from the Society for the Teaching of Psychology
(APA Division 2) in 1995. He has published several book chapters and over 50 articles
in journals ranging from the Professional Psychology: Research and Practice to the
Journal of Polymorphous Perversity. His major research area is professional ethics;
he is the coauthor (with Sharon K. Anderson) of a text on ethics in psychotherapy
(Ethics for Psychotherapists and Counselors: A Proactive Approach) from Wiley- Blackwell.
His ethics blog, “The Ethical Professor,” can be found at
Summer 2011 issue of Eye on Psi Chi (Vol. 15, No. 4, p. 16), published
by Psi Chi, The International Honor Society in Psychology (Chattanooga, TN). Copyright,
2011, Psi Chi, The International Honor Society in Psychology. All rights reserved.