Of course, the question of whether to give advice will always be influenced by the kind of therapy you offer, and how directive your underlying theoretical approach tells you to be. But if you can see an obvious course of action and the client doesn’t seem to be able to see it, or if the client asks you directly what you would do in their situation, it’s sometimes hard to hold back. So, should you?
When therapists might give advice
- When it’s a professional knowledge-based issue, for example, whether or not the client is contraindicated for hypnotherapy or what approaches might suit them best.
- When it’s an ethical issue, for example, the General Hypnotherapy Register Code of Ethics (para 8) says that if a client wants help with physical symptoms they should be ‘advised to contact a registered medical practitioner.’ [1, my emphasis]
- When it’s a therapy issue, for example, when you are choosing coping strategies to teach the client, you are indirectly advising them that this is a good approach for them.
- When you are giving the client add-on* or support tasks to do at home, for example, ‘It would be useful for you to keep a negative thoughts diary this week’. (*Never call it homework – too many negative associations from school!)
Why therapists might not give advice
- Your advice (inevitably) comes through the filter of your own life, experiences and attitudes which are not the same as the client’s. You might be the expert on your therapy, but the client is the expert on themselves.
- The point of therapy is to give the client a safe space to come up with their own solutions.
- Issuing instructions can spoil your rapport, either because the client doesn’t like being told what to do generally, or because they think you’re wrong.
- If there is an answer to the client’s situation that seems really obvious to you (e.g. leaving an abusive or cheating partner) and the client simply doesn’t seem to see it, there’s a reason (usually an unconscious one). Explore possible reasons rather than breaking the wall yourself.
- Giving advice can introduce or exaggerate issues such as the client’s expectation that the therapist will solve their problems for them; the client’s desire for an instant solution; the client’s lack of confidence (in making decisions for themselves); transference; the client needing to be ‘parented’ by the therapist.
- Giving advice could leave you legally liable if it all goes horribly wrong.
What’s coming from this, I think, is the idea that there is more than one kind of advice and some kinds work better in therapy than others. Sharon K Anderson (2012) [2] refers to ‘substantive’ and ‘process’ advice and it’s a useful distinction.
Substantive advice boils down to telling people what to do and is likely to include phrases like ‘you should’ or ‘you ought to …’ and ‘why don’t you…’. The problem with this is that it tends to come from what you would do rather than what is best for the client but nevertheless blocks off other options. Since you're at the authoritative end of the therapeutic relationship, the client will more than likely take your advice and I’m sure you can imagine what can go wrong when this happens.
Process advice is encouraging the client to think for themselves, by suggesting ways in which they could approach their decision-making. It’s the difference between guidance and orders: ‘Are there any practical ways to increase the amount of exercise you do?’ (process) versus ‘You should exercise three times a week’ (substantive).
How to avoid giving advice
- Accept that what you would do in the client’s situation isn’t necessarily what’s right for the client.
- Question your underlying motivations for offering advice – it is ego? Transference? A feeling that you ‘know best’? Are you identifying too strongly with the client’s situation?
- Point out the client’s positive attributes (ideally with examples), especially those that will help in decision making, and let them know you have confidence they can take control of their own lives (confidence building/ego strengthening).
- Validate and normalize their feelings (even if those are about being stuck or not knowing what to do) and then help them move to a more resourceful point of view. Metaphors (used in and out of trance) can be useful for this.
- The response often recommended if a client asks directly for advice is to reflect the question back. C: ‘What do you think I should do?’ T: ‘What do you think you should do?’ or similar. If not used carefully, this can come over as evasive, so look at other ways to phrase it to get them to think about their own answers. For example, ask ‘What do you think the options are?’ or 'What have you already tried?' and take the discussion from there.
- Encourage clients to identify new options, perhaps by brainstorming or asking them to dissociate from the situation, for example ‘If your best friend was in this situation what would you think they should do?’
- Once they have identified some options, help clients to assess them, perhaps with a pros and cons list, or by using future pacing with each option in turn.
- Teach coping strategies and behaviour modification techniques to help empower clients in situations that were difficult in the past.
It’s not always easy to avoid jumping in with both feet and giving clients advice. But remember that you are a therapist, not a consultant or trainer. A trainer will tell you what to do and how to do it. A consultant is brought in by a firm specifically to tell them how to do something. However, your client has come to you to be empowered and to have their lives made better – and that won’t happen if you undermine their confidence and ability to make their own decisions by telling them what to do.
References
[1] General Hypnotherapy Register. (2020). The General Hypnotherapy Register’s Code of Ethics. [online] Available at: https://www.general-hypnotherapy-register.com/code-of-ethics/. [accessed 18.12.20]
[2] Anderson, Sharon K. (10 May 2012). To Give or Not to Give Advice. [online] Available at: https://www.psychologytoday.com/gb/blog/the-ethical-therapist/201205/give-or-not-give-advice [Accessed 18 Dec. 2020].
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Author: Debbie Waller is an experienced hypnotherapist and hypnotherapy trainer. She is the author of The Hypnotherapist's Companion and Their Worlds, Your Words and a co-writer of the Hypnotherapy Handbook, all of which are available from Amazon.
Find out more about Debbie's services on
Yorkshire Hypnotherapy Training - multi accredited hypnotherapy practitioner training, taster days and foundation levels.
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