As you might guess, we have some advice about advice giving. Specifically, you should become aware of when and why you want to give a client advice. Review and contemplate the following questions. When you feel like giving advice, is it . . .
1. just to be helpful?
2. to prove you're a competent therapist?
3. because you've had the same problem and so you think you know how the client can be helped?
4. because you think you have better ideas than your client will ever come up with?
5. because you think your client will never come up with any constructive ideas?
Your responses to these questions can help determine whether your advice giving motives are pure or not. As you may have guessed, we're not strong advocates of giving advice. On the other hand, we also believe that advice, when well-timed and received from the proper person, can be tremendously powerful. When it comes to giving advice, our advice to you is: (a) be aware of why you're giving it, (b) wait for the appropriate time to deliver it, (c) avoid giving advice in a moralistic or pedantic manner, and (d) avoid giving redundant advice (i.e., advice that the client has already received from someone else).
Fourth, agreement can reduce client exploration (i.e., "Why explore my beliefs any longer; after all, my therapist agrees with me.").
Wherever there is agreement, there can also be disagreement. It is simple, rewarding, and somewhat natural to express when you are in agreement with someone else. On the other hand, disagreement is often socially unacceptable or socially undesirable. People sometimes muffle their disagreement, either because they are unassertive or because they fear conflict or rejection.
In a clinical interview, however, interviewers are in a position of power and authority. Consequently, interviewers sometimes lose their inhibition and disagree openly with clients. Depending on the issue, the result can be devastating to clients, disruptive to therapy, and may involve abuse of power and authority. Imagine, for example, a client and therapist having the following interaction about U.S. foreign policy not long after the September 11, 2001, terrorist attacks:
Client: "I am so angry about what happened in New York. I think we need a quick and decisive military action. We need to bomb Afghanistan to its knees."
Interviewer: "I'm uncomfortable with what you're saying. You're focusing solely on retaliation and I don't think that's very constructive."
Client: "Well, those Arabs started it and I think we need to finish it."
Interviewer: "Do you use this same philosophy in your personal relationships? Maybe you need to look a little closer at the implications of what you're saying."
As you can see from this interaction, when emotionally laden political and social issues are raised, it is possible for an interviewer to lose his or her therapeutic focus and deteriorate into sociopolitical positioning. In this case, the interviewer uses disagreement and disapproval to express his or her political-social agenda and leads the interaction into a destructive arena. Further, the therapist subsequently begins to link the client's political views to his or her personal life in a premature and inappropriate way. This sort of approach can become a clear abuse of interviewer power and status.
Disagreement may also be subtle. Sometimes, silence, lack of head nodding, or therapist neutrality is interpreted as disagreement. It is important to monitor your reactions to clients so you know if you tend to nonverbally and inadvertently communicate disagreement (or disapproval) to clients.
The purpose of disagreement is to change client opinion. The problem with disagreement is that countering one opinion with another opinion may deteriorate into a personal argument, resulting in increased defensiveness by interviewer and client. Therefore, interviewers generally should not use personal disagreement as a basis for their therapeutic intervention. The cost is too high, and the potential benefit can be achieved through other means. Two basic guidelines apply when you feel compelled to disagree with clients:
• If you have an opinion different from a client regarding a philosophical issue (e.g., abortion, mixed-race marriage, sexual practices), remember it's not your job to change your client's opinion; it's your job to help him or her with maladaptive thoughts, feelings, and/or behaviors.
• If, in your professional judgment, the client's belief or opinion is maladaptive (e.g., is causing stress, is ineffective), then you may choose to confront the client and provide him or her with factual information designed to facilitate client change toward more adaptive beliefs. (In such a case, you provide information or explanation rather than disagreement.)
A good example of when an interviewer should employ explanation instead of disagreement is in the area of child rearing. Clients often use ineffective or inappropriate child-rearing techniques and then support such techniques by citing their opinion or experience. Interviewers should avoid bluntly rushing in and telling clients that their opinion is "wrong." Instead, clients should be encouraged to examine whether they are consistently accomplishing their discipline goals by using a particular strategy:
Client: "I know some people say spanking isn't good. Well, I was spanked when I was young and I turned out fine."
Interviewer: "So, you feel like being spanked as a child didn't have any negative affect on you."
Client: "Right. I'm doing okay."
Interviewer: "It's true that many parents spank and many parents don't. Maybe, instead of looking at whether you or I think spanking is okay, we should look at your goals for parenting your son. Then, we can talk about what strategies, including spanking, might best help you accomplish your parenting goals."
In this case, empirical evidence indicates that the behavior discussed (spanking) may produce undesirable consequences (Bauman & Friedman, 1998; Sheline, Skipper, & Broadhead, 1994; Straus, Sugarman, & Giles-Sims, 1997). Additionally, numerous professional groups (e.g., the American Psychological Association, American Academy of Pediatrics) recommend that parents develop alternatives to physical punishment for managing children (American Academy of Pediatrics, 1998; Hyman, 1997). Therefore, eventually, the interviewer may discuss with the client the potential undesirable consequences of physical punishment. Generally, this discussion should focus on the client's child-rearing goals and objectives, rather than whether the interviewer does or doesn't "believe in spanking." An exception to this guideline occurs when a therapist suspects the client is physically abusing a child. However, even in cases when child abuse is suspected and reported to the department of family services, the decision is based on violation of a legal standard, rather than therapist-client philosophical disagreements.
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