Monday, August 28, 2017

Should Your Therapist Give You advice?



Freud
Sigmund Freud, Wikipedia
If you’ve never been to see someone about a mental health issue before this may seem a weird question.  However, there are two broad approaches to our kind of work.

In the old days, clients would pitch up, describe what was going on, and receive an expert opinion.  Possibly this came about because many of the first modern generation of mental health providers were psychiatrists, medical doctors specializing in mental health.   
 
So they’d act like traditional doctors, dispensing wise counsel to their patients.

Rogers
But in the 1940s, the idea of a client centered approach became popular. It was championed by Carl Rogers, a psychologist (not a medical doctor!) who believed that we are each our own best expert. He advocated that mental health workers should listen to and work with the client to set goals and find solutions.

Today mental health providers who give advice are called Directive and those who are client centered approach are called Non-Directive.

Generally speaking, people in the West lean towards wanting Non-Directive practitioners because it generally falls in line better with our individualistic, egalitarian cultural approaches while people in South East Asia lean towards wanting Directive practitioners because it falls in line better with their group oriented, strong hierarchical cultural approaches.

I say generally and am making sweeping statements because this is just a casual blog post. If you want to debate this, we can talk about it.  For now the question is, if you are looking for help and a bit uncertain about what you want, what should you know?

Here are some thoughts:

A big pro of the Directive approach is that you don’t have to make any decisions. You pay someone to do it for you. If you get someone good, who thinks like you, that can work very well. 
 
The big drawback is that what works for me, may not work for you. If you are not totally in sync, the advice may not work - or make things worse.

A big pro of the Non-Directive is that you are involved in every stage of the process, and so you are much more likely to develop good approaches that suit your unique person and situation. 
 
The big drawback is that it takes a lot of work, and it can be tiring.

Me, I suggest it’s best to work with someone like me who does a bit of both. You see, there are times when something is clear to me because of my training and experience.

For example, I’m very happy to say things like, “There are three ways of doing this, A, B and C. From what I know of you, I’d go with approach B as it’s most likely to suit you best.”

I’m also not shy about giving opinions. For example, “I think you should consider looking into your relationship with your MIL, because it sounds toxic and I think it may cause you trouble if you don’t address it.”

But I also check with you that this is what you want. And if you disagree, that’s okay. Because I’m someone you work with; I’m not your nanny. In the end, you decide what's good for you.