Premature Therapy Termination

[Eve B]

http://www.apa.org/monitor/2015/04/clients.aspx

If the speakers in the above article are saying that therapists should be taking more initiative to empower clients so they don't drop out too soon from therapy, then I agree with a lot of their points. It's interesting that they note how premature termination by the client is one of the big stressors for therapists in practice. I think maybe they need to also do a study on those therapists who prematurely dump their clients and the harm that causes.

[Mary S]

I have some comments on this part of the article:

"Another strategy you suggest to keep clients engaged is to have them play a role in choosing the type of treatment they will get. Why is this important and what are the challenges to putting it into practice?

Swift: This is part of building collaboration with clients. Part of the clinician's job is to give the client the information so he or she can offer an informed opinion. It's not about giving clients what they want. It's about helping them feel they have a voice in that decision-making process. It can be strange for clients to offer their preferences if they are used to just doing what a health professional says. But the more that we can get them to play that bigger role, the more invested they will be in the treatment."

This sounds patronizing and arrogant to me. I'd say that clients have a right to play a major role in choosing their treatment -- specifically, I believe clients have a right to be given information about possible treatments, plus the advantages and drawbacks of each possibility, in order that they (the client, not the therapist) can make an informed decision about what treatment to choose. This is what in the health professions is called "shared decision making", and I think it is becoming more common in medicine. So clients may in fact not be "used to just doing what a health professional says." Calling having clients "play a role in choosing  the treatment they will get" a "strategy .. to keep clients engaged" misses the point that clients have a right to informed consent. It's not about "helping them feel they have a voice in that decision-making process"; that also misses the point that this ethically is their right.

 

[Eve B]

Why do you think it is that these therapy professors and professionals seem to look at informed consent and shared decision-making as things to be encouraged but not as a client right? Does this kind of mindset go back to their being the 'experts', so they're still the ones who know better and clients aren't smart enough or, maybe, they're assuming that this particular client right is a given and emphasizing that point wouldn't be necessary because they're more focused on trying to get their peers to better treat clients like equally intelligent human-beings?

[Mary S]

I think that this is an example of therapists focusing on "guild ethics" rather than "professional ethics". (See http://therapytheclientside.invisionzone.com/search/?q=guild)