[atisketatasket]

This is something that has crossed my mind periodically since I started therapy two years ago. It was brought to my attention again with a hard smack in the face yesterday.

Clients are told that they need to be able to trust the therapist to get something out of therapy. I don't think that is true for all clients - depends on what you go to therapy for.

There are oodles of professional articles and blogs and therapeutic truisms about that need for trust. But is the reverse true as well? Does a therapist need to be able to trust a client to build the sacred "therapeutic relationship"?

By trust I don't think I mean just things like trusting a client to say when they feel self-destructive. My example from yesterday is that my current therapist told me she doesn't trust me (quite a bit, apparently, because it's why she writes down everything I say) not to file a complaint against her, since I filed a complaint against my former psychiatrist (for wrongful termination, violating my rights as a patient, possible fraud, negligence, etc.). I've got all kinds of problems with that statement, but for the purposes of this thread, how can she then talk about or even expect our building a therapeutic relationship based on trust when she feels she has to be wary? It would be like entering a romantic relationship worrying all the time your partner will cheat on you, so you behave accordingly.

I'm sure there are plenty of examples - what if a therapist doesn't trust a client to tell the truth? Or to keep appointments? And so on.

Despite the example, there's a theoretical question here - does a therapist need to trust a client for therapy to work? If so, in what areas? (Elaborate in the comments section.)

[stopdog]

Trust clients to do or not do what?
Not to Shoot them? Not to Physically and with mal-intent stalk them? Pay the agreed upon fee?- then Yes.
Anything else? - then no - that is the therapist's problem

[Pennster]

I had a therapist once who told me he had been worried I might sue him. This caused a lot of problems in the already troubled therapy, and was such a misreading of the situation that I still wonder at it.

I am not sure if a therapist needs to trust a client for the therapy to work, but it's likely that if the therapist doesn't trust the client it's likely to cause some trouble. My ex-therapist seemed to spend a lot of time being angry at me, and he was really off his game a lot of the time. But I think we resolved a lot of it by the time I stopped seeing him- I would imagine it's totally possible for therapists to learn to trust clients they at first don't trust, as I'm pretty sure mine did.

[laxer12]

I think there does need to be a certain level of trust but that it varies with every relationship. I told my T recently that I want her to push me. She then talked about how there needs to be trust from both of us in order for her to be able to push me. I need to trust that she thinks it would be helpful for me and she needs to trust me to tell her if she's pushing me too hard.

I think you also bring up a good point about trusting a client to keep an appointment. If a client is constantly cancelling last-minute or not showing up, that takes up a time slot that could be given to someone else and the T is losing money (it is a business after all).

T's also need to trust that the client is telling them the things they need to know in order to help them. Again, this is different for everyone depending on what they are going to therapy for. Some things the T needs to know, and other things aren't as important.

I think with your example of your T being worried about you filing a complaint is an interesting example. She needs to have trust in herself to not do anything that would lead you to file a complaint but I also think she has to trust you to an extent to bring up issues as they happen so that you two can work through them. If a client is afraid to talk to their T about something that they are doing that bothers them, and they have filed a complaint in the past, I could see where there would be a lack of trust. In no ways am I saying this is the case with you, I'm just using it as an example.

In order to build a relationship, both parties need to trust each other but again, it varies depending on the nature of the relationship.

[atisketatasket]

Originally Posted by stopdog

Trust clients to do or not do what?
Not to Shoot them? Not to Physically and with mal-intent stalk them? Pay the agreed upon fee?- then Yes.
Anything else? - then no - that is the therapist's problem

Is it really just the therapist's problem, though? Seems to me it's going to affect their job performance...making it also the client's problem.

[stopdog]

I mean it is the therapist's problem to deal with. If the therapist cannot deal with it - then it does become the job of the client to find a less wimpy therapist

I can totally appreciate CW being brutally honest, but if that was me I probably would've told her I'm unable to work with her if she's so concerned about the fact that you reported Smaug. I mean-it's not like you reported every therapist you've ever come across and you had a legitimate reason to report Smaug. The fact that CW feels the need to keep her guard up makes it seem like (to me) she lacks confidence in her profession. I wouldn't be able to see a T whom I didn't personally think were confident in their work.

If your therapist doesn't trust you then I don't see how you can work together. A certain amount of trust is best but it does work both ways. I mean if you reported a previous therapist for valid reasons, then why would a new therapist be afraid to treat you? Unless they had in mind to violate you too? Trust is so basic in therapy imo. Both individuals should be thinking the best of each other from the get go.

[InnerPeace111]

I think that therapists need to trust that clients have a personal sense of inner wisdom as well as the necessary resources within themselves to create positive change and healing in their lives.

[atisketatasket]

Originally Posted by InnerPeace111

I think that therapists need to trust that clients have a personal sense of inner wisdom as well as the necessary resources within themselves to create positive change and healing in their lives.

What does that mean?

And if they have those things why do they need a therapist?

[stopdog]

I can see possibly having a use for a therapist even with those things. I cannot see those things as a requirement = a good number of people do see a therapist because they are bereft of such.

Originally Posted by InnerPeace111

I think that therapists need to trust that clients have a personal sense of inner wisdom as well as the necessary resources within themselves to create positive change and healing in their lives.

^ yes ^ aren't therapists taught to bring out the good qualities of the individual that have been lost in the depths of drug abuse, self-loathing, depression, prejudice, economical oppression, and the like. Since when is it so hard to see the good in someone and why should anyone have to tell a therapist that? If a therapist is a heartless, shallow, human being then I wouldn't want one.

[InnerPeace111]

Originally Posted by RaisingKay

^ yes ^ aren't therapists taught to bring out the good qualities of the individual that have been lost in the depths of drug abuse, self-loathing, depression, prejudice, economical oppression, and the like. Since when is it so hard to see the good in someone and why should anyone have to tell a therapist that? If a therapist is a heartless, shallow, human being then I wouldn't want one.

That's an excellent point you bring up --- that clients are inherently good. A lot of times that inherent goodness just gets buried. It's easy for it to get buried. But it's there. So trusting that clients are not inherently flawed. And, also, trusting and appreciating human potential. It's powerful stuff for sure.

[stopdog]

That sounds more like a therapist trusting in humanity or something. Humans are basically good sort of thing -rather than specifically trusting a client. And that trust around a specific client and belief about human beings are getting a bit blurred

[nottrustin]

I believe there needs to be a mutual trust on some level. A couple of areas T and I have discussed is if I have thoughts is SU she needs to know however she has learned that she can trust me when I tell her the thoughts are there but I would never act in it. A few years ago I took to many sleeping pills. She trusted me when I told her it was not a SU attempt but an attempt to get some sleep when my regular does was ineffective. She had me go to the hospital and talked to the Dr. about what was going on and advocated against hospitalization. Had we not had that trust I would have likely been admitted.

Another area is I am dealing with a difficult situation and am not honest with her she can't help me. For example if I stop taking my meds and my mood tanks and she is unaware of the stopping of meds she may handle the situation a lot differently....the same is the case with my alcohol consumption.

As far as a lawsuit that seems such a basic requirement. If based on one extreme situation a therapist can't trust a client isn't going to sue them I can't imagine the therapy would be effective. I would suspect the therapist being afraid of litigation would cause them filter what they would normally do.

I voted "in some areas" and basically think what stopdog said in post #2. I don't think they need to trust clients more than any other professional that works with clients in a way that they spend one-on-one time with them in an office. Physical safety, not stalking them or their associates physically, timely payment. Maybe to show up at appointments with a reasonable reliability, but that is not in control of the therapist at all, max they can do is to require payment for missed sessions.

I have a therapist friend who says clients lie all the time, and when he was at the beginning of his career, he tried to figure that out and address it when possible, but stopped doing that and even caring as ultimately it's not truth they can work with but what's being presented. Even if they see clear signs of not being truthful, it's inappropriate to question the client on it too much. I do think that being overly suspicious is not only the T's problem though but the client's as well.

Basically, my view is that trust is like faith. One can have it or not have it. And if one has it, it can still be either validated or disappointed. Very much outside of individual control how it unfolds.

One thing from my personal experience: my second therapist seemed to really trust me about payment. He asked that I pay cash each time and sometimes when I was traveling or just otherwise did not want to go to the office and we had phone sessions, sometimes even 3-4 weeks in a row, he did not want me to transfer the money, pay with credit card, or even mail a check. Just waited for weeks to receive the payments for all the sessions when I went to see him next. Of course there was likely a strong personal interest in getting cash vs other forms of payment, but he did provide the service for weeks in advance.

[Sarmas]

I think that developing trust should revolve around the client and not the therapist. The emphasis shouldn't be on the therapist trusting the client as much as the client trusting the therapist. It shouldn't be expected for the client to walk into their first session and developing an immediate trust. Trust is something that is developed throughout the course of therapy and that's contingent on the therapist's behaviors and actions. I think most importantly the clients trust in their therapist can affect the therpeutic work.

I know for myself whenever I doubt my therapist or I feel like she has pulled away or is not in tune with me then I tend to retrieve as well. Therefore I don't share things that could help me move ahead and instead I create a wall. Clients are already walking through the door with a variety of issues including trust issues.

I think therapists should expect to hit bumps along the road with certain clients. It's the nature of the work. Clients refuse to disclose certain things but it should be expected. The therapist should help the client with disclosure and trust issue in order to better help the client.

when it comes to payment and scheduling many therapists already have rules and guidelines in place. Many have set boundaries from the beginning of the therpeutic work. Therapy shouldn't revolve around the therapist anyway. The focus should be on the client and the therapist gaining that trust.

[Sarmas]

in addition to what I have discussed before there was a time I remember that I needed fot my T to trust me. Again it revolved around me and not her. It seemed to me that Once she diagnosed me with bpd that she seemed scared of me. She kept at a distance and I clearly made her uneasy. That seemed to bother me. I felt labeled and placed in a category that I don't think I quite fit into. Then she predicted what my behaviors might be based on my diagnosis. I had an issue with my boys T and copay. I always pay their copay the day of their session. My son forgot to hand him the copay while we were still there and I was unaware he freaked out. Again I was upset because I felt like we were placed in a certain category. I'm thinking that if our family scenario and circumstances was different and we lived in the best neighborhood in the area or if I was a lawyer or Doctor maybe that wouldn't have been the case. When I have lied or kept things from my T I have told her. I tell her that I keep things from her. She only pushes so far. I disclose things when I feel it's appropriate and wait to see her response. Based on her response that's where my trust factor comes and how much I disclose later.

[Moment]

I think a therapist can work with a client even if there's not much trust. For example, maybe the therapist could teach the client some new skills. But I don't think the work will be transformative for either person.

I think for more in-depth therapy that leads to substantial change, there has to be an emotional interaction/entanglement between therapist and client that requires vulnerability on both sides. The therapist has to be open to the client affecting them and changing them, in order to create a reciprocal change in the client.

I don't think a therapist can do that without a basic sense of trust and I think it has to be earned by the client during the therapy process. I remember once my therapist said to me, in response to something I said, "Yeah, but I trust you." I was very surprised.

Yes, I think a T needs to trust the client. I see therapy as relational, I think there needs to be some connection between the T and the client. It sounds good that your T has told you that she feels this way. Does she acknowledge that your previous complaint was valid? If so, what does she worry about? That you will make a valid complaint about her? That she will make a mistake and you will complain about that? Or that you will make an unreasonable complaint?

[atisketatasket]

I don't think the onus is solely on the client to earn the trust. We're going to put another burden on the client? And there's a huge possibility there of the client being manipulated by an unethical therapist to jump through ever more hoops to gain the therapist's trust.

Also, how would it apply to my situation? Seems to me that all she she has to do is do her ****ing job and not break the law or her ethics code if she doesn't want a complaint made. She knows very well my complaint against the former psychiatrist was more than justified and not frivolous. And I have no idea how a client in my position would go about earning her trust. This is her problem to deal with. I doubt she will.

[1stepatatime]

Originally Posted by stopdog

Trust clients to do or not do what?
Not to Shoot them? Not to Physically and with mal-intent stalk them? Pay the agreed upon fee?- then Yes.
Anything else? - then no - that is the therapist's problem

I have to respond to this , SD.. so several month ago my therapist and I were having a conversation about guns. So I asked her if I could bring one of mine to show her and she said sure. The next week I brought it in.. unloaded, magazine out,the chamber empty. She was very cool about it.. looked at it, took it apart and put it back together.. lol. So I guess I could say she trusts me not to shoot her! ( which I NEVER would harm anyone unless I feared for my life)

[atisketatasket]

Originally Posted by 1stepatatime

I have to respond to this , SD.. so several month ago my therapist and I were having a conversation about guns. So I asked her if I could bring one of mine to show her and she said sure. The next week I brought it in.. unloaded, magazine out,the chamber empty. She was very cool about it.. looked at it, took it apart and put it back together.. lol. So I guess I could say she trusts me not to shoot her! ( which I NEVER would harm anyone unless I feared for my life)

I think you have an awesome therapist.

I don't own a gun, but sometimes I go to a shooting range and target practice with one of their guns to relieve stress. This is not something one reveals to people lightly in a seriously blue state.

[feileacan]

I think I couldn't work with a therapist who wouldn't trust me in some sense. And my T does trust me. He has adapted his therapy frame considerably according to my needs and he has trusted me when I've expressed those things I've felt I've needed.

He trusts me to pay him - he always gives me the bill in the end of the month for the whole month which in my case is typically a payment for 16-19 sessions, which is quite a lot.

He doesn't fully trust me when I'm presenting one of my child parts, the one who is very angry and has violent fantasies about him. The last time I told him about those fantasies I complained that he doesn't take me seriously. He said he takes me very seriously. I said that if you take me seriously then you should be scared. He said that he is not scared but he is watching me very closely so that I couldn't accidentally start acting out those fantasies. But that's just one part of me.

I don't know about "need", but they should. However, if a therapist can't trust ANYBODY, then they shouldn't be a therapist. I'm not saying a therapist has to trust someone with their life, but there has to be some level of trust in general.

At the same time, I think it's okay for a therapist to not trust one or a few of their clients. I mean, if these people are pathological liars, maybe there is something going on that causes them to lie. Fear of judgment? Fear of getting caught? Fear of doing something they shouldn't do? In that case, therapy can help with the compulsive lying, and therefore the therapy can be effective for the client.