Why your psychologist won't give you advice

Sometimes we enter therapy and find it very frustrating when our psychologists won’t just tell us what to do. Especially if we are used to being seen in other medical settings, we might expect to go to a counselor and have them apply some treatment that will make us feel better. While it is your psychologist’s job to provide direction (even if that sense of direction is simply to take a moment and let an answer emerge naturally), most experienced psychologists are not big fans of offering advice. Below are the three primary reasons I don’t offer advice as a general rule of thumb.

1. It invalidates the significance of your concerns

To give someone advice is to assume many things. First, it assumes you are not already aware of the idea I have or have not tried the suggestion already. For example, suppose you come in noting that you have been feeling “just kind of blah” on and off for the past 3-5 years. Now I may happen to know from some random article that exercise is nearly as effective as therapy or medication for your moderate, persistent depression (Hallgren et al., 2016). Yet, imagine I said something like “Sounds like you’ve been feeling pretty down. Have you tried going to an intermediate aerobics class 4 to 5 times per week?” It’s about 100% likely that you already have some sense that exercise helps with mood. Hearing this from me doesn’t make you any more likely to want to do it. Instead, especially if we were just getting to know each other, you may now feel less likely to want to do it because you’ve been passively shamed by me for not exercising. The message being something like “What are you talking to me for? You could be at a Zumba class!” Further, you may have already tried exercise and either it was not sufficient or it was hard to maintain on your own (likely because you have persistent depression!). Offering you advice minimizes the complexity of your concerns and invalidates the efforts you have already tried. You wouldn’t be coming to see me if your problems could be solved easily on your own.

Let’s assume you and I have a great working relationship and that hearing this advice from me feels less insulting. Even if this were the case, your choice to exercise will primarily be out of a desire to please me or “because my therapist said to.” As I’ve discussed in other areas of the blog, doing things as conditions of worth (in this case exercising now becomes a condition of your worth in the therapy space) can actually sabotage your motivation by preventing you from finding your own intrinsic desires for embodied movement.

2. It can undermine your long-term growth

You are much more likely to maintain any gains you make in therapy if you attribute those gains to your own efforts. There is good evidence to suggest that if you are taught (explicitly or implicitly) by your psychologist that they caused your improvement (through their interventions or advice) you are less likely to persist in any gains you make long-term (Liberman, 1978, Wampold & Imel, 2015). This is why when a client reports to me that something miraculous has happened since our last session I am always curious to learn what it is that they did that allowed this. By exploring what they did differently, clients are able to identify their own skills and strengths which can help them maintain their gains long after we stop meeting together.

You are the #1 reason you get better through therapy

3. It misses what is truly effective about therapy

Not only does it undermine your long-term growth, giving you advice is also a bit of a lie. By giving you advice your counselor is assuming that it is their expertise and knowledge that is the active ingredient in therapy. This is not the case. You are the single biggest determinant of any growth you experience. In fact we know that client factors (meaning your unique personality and environment) explain roughly 86% of the variation in clinical outcomes (Duncan, 2013). 86%. Displaying this graphically (see figure) gives you a sense of just how small the effects of treatment look as compared to the work you do outside of session. While this isn’t to say that therapist and treatment factors don’t matter, it is to so say that giving you advice—rather than helping you identify what you already have in your world and experience that can help you manifest the life you want—misses what we know about how treatment works.

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Most psychologists are not diametrically opposed to advice in all circumstances. There are conditions when I think advice can be non-damaging. These are: 1). you are actively soliciting advice from your psychologist, 2). you have worked together long enough to recognize that receiving advice does not play into a larger pattern of underestimating your own abilities or strict family/societal roles, and 3) the psychologist has a kernel of knowledge they genuinely think can be helpful. Under these three conditions I absolutely believe psychologists should not withhold what may be useful. Even then, however, its usually best for your psychologist to ask what you already know about the topic, offer any advice like they might offer you a cup of tea, and always check-in to see how well the advice fits with your experience and the extent to which you believe you could enact it.

Ultimately it will be you, not your psychologist, that determines whether any advice you receive has any sort of value to you and your journey.