Most psychotherapists have had the experience of being in an informal setting, like at a party or at the gym, where people ask for clinical advice about a problem they're dealing with at the time.
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| It's Unethical and Irresponsible to Give Clinical Advice in Informal Settings |
In these situations, the person usually provides a snippet of information to the therapist and hopes to get an answer to their problem.
Most of the time, the people who are seeking clinical advice in this way see it as being innocuous. But there are important ethical and clinical implications involved if a psychotherapist gives advice under these circumstances.
So, for instance, if someone at the gym finds out that another gym member is a psychotherapist or a psychiatrist, he might say something like, "Say, I hear you're a mental health professional. Can you tell me what I should do about my teenage son who is doing poorly in school?"
Aside from the fact that the gym member seeking help is giving very little information and the therapist hasn't met the teen who is having the problem, if the therapist gives clinical advice, like, "Your son might be anxious" and the gym member relies on this information, things could go terribly wrong if the teen is actually depressed or misusing alcohol or drugs, and the therapist can be held responsible.
In order for a therapist to diagnose a problem, there needs to be a thorough biopsychosocial assessment and it usually takes at least several sessions to get a complete picture in a clinical setting.
So when someone briefly mentions a problem to a therapist outside of a clinical setting, it's obvious there isn't going to be a thorough assessment and there can be many possibilities as to what the problem might be.
Here's another example: A gym member approaches another member, who happens to be a psychotherapist, and says they're having headaches. They ask the therapist if the problem might be related to stress. The appropriate response from the therapist would be to seek help from their medical doctor first to rule out any medical problems.
An inappropriate response would be, "It sounds like stress to me. Have you tried meditation?"
Imagine if the gym member who has headaches follows this therapist's advice, but later on finds out that the headaches were actually the result of a brain tumor. It's clear in this case that the therapist was ethically and clinically irresponsible to have made assumptions about the problem and to have given what turned out to be inappropriate advice.
Not only could there be disastrous results for the person with the headaches, but the psychotherapist could be placing their license in jeopardy.
Most lay people understand this, especially if the therapist explains why they can't speculate on the problem or give advice. But, at times, there are some people who don't understand. They misunderstand and think the therapist is being evasive or withholding information.
So, if you ever ask a psychotherapist for informal advice and the therapist's response is for you to seek help from a licensed mental health professional in a clinical setting, the therapist is not trying to get rid of you. They're being responsible and giving you the best advice under the circumstances, which is to have your problem thoroughly evaluated by a mental health professional who is licensed and who has the skills and expertise relevant to your problem.
Getting Help in Therapy
Often, the most challenging part of seeking help in therapy is taking the first step by contacting a licensed psychotherapist.
In New York City there are many ways to seek help from a licensed mental health professional.
If you have health insurance, you can contact your insurance carrier for a list of names of licensed professionals in your area.
If you don't have health insurance, you can seek help from one of the many postgraduate mental health training institutes in New York City that offer the possibility of low-fee therapy depending upon your income.
There are also psychotherapy directories, like PsychologyToday.com, which have therapists listed by name, licensure, location and expertise.
About Me
I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT and Somatic Experiencing therapist.
I work with individual adults and couples.
To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.
To set up a consultation, call me at (917) 742-2624 during business hours or email me.
Also, see my article: Why Your Psychotherapist Can't Be Your Friend.