Therapist dishonesty across theoretical orientations

ABSTRACT

To examine whether and how therapy orientation is associated with psychotherapists’ perceived reasons for, feelings about, and regrets around their own dishonesty in therapy. A sample of 255 psychodynamic (n= 81), cognitive-behavior (n= 92), integrative (n= 64), and humanistic (n= 18) therapists who reported having been “less than completely honest” to a client provided open-text responses regarding this occurrence. A bricoleur approach was used to identify themes among responses, and Fisher’s exact test analyses were used to compare responses across theoretical orientations. The most frequent reason offered for instances of less than complete honesty was “treatment strategy” (i.e. it was deemed necessary for treatment). The most common feeling reported was discomfort, including anxiety. Most respondents reported that, in retrospect, they would not have handled the situation differently. Therapist orientation was not significantly associated to any pattern of responses to these questions. While therapist dishonesty is perceived as occurring primarily in the service of the client and tends to evoke similar reactions among therapists across theoretical orientations, most therapists report experiencing negative feelings after acting somewhat dishonestly. Training programs should encourage greater discussion about the potential benefits and consequences of therapeutic dishonesty, including instances of therapeutic tact.

KEYWORDS:

• Dishonesty
• therapist disclosure
• tact
• therapist effects
• psychotherapy integration

Acknowledgement

We would like to acknowledge the contributions of several research assistants on this project, including Elyse Blake, Catherine Crumb, Daniel Sauermilch, Jeffrey Wainstein, and Xinyao Zhang.

Disclosure statement

No potential conflict of interest was reported by the authors.