I am an adult. My therapists treat me with adult respect. They may discuss natural consequences of my actions with me -- for instance, if I am not minding my sleep hygiene, they will remind me that the natural consequence of that for me is that lack of sleep can throw me into hypomania which can start an episode that, in my case, almost inevitably leads to a crash into serious depression. That isn't punishment. That's just an adult conversation about actions and natural consequences. They might encourage me to call my pdoc for sleep meds to cut the cycle off before it gets set in motion, but there is no punishment involved. I can't think of an instance where they "punished" me for something that I did or didn't do. I wouldn't have continued to see them if they did; I'm not a child.