All therapists have an ethical mandate to advocate for their clients. Various mental health associations describe this mandate in their codes of ethics. However, many feel a lack of confidence regarding how they should implement this expectation.
For many therapists, advocacy takes the form of strategically writing to health insurance companies or passionately protesting outside of their offices expressing the need for improved client care coverage and accessibility. For others, advocacy is expressed through active association participation, including lobbying on Capitol Hill expressing the need for changed policies, or defending the legitimacy of mental health professional licensure.
Unfortunately, the number of professionals who engage in these direct advocacy efforts are minimal in comparison to the number of licensed professionals in the state. Many of the therapists who do not participate in these activities agree with the need for these perspectives to be actively expressed; however, whether influenced by limited professional time or personal discomfort with overt expressions associated with these activities, many therapists conclude, advocacy simply does not suit them. I do not believe this needs to be the case.
Advocacy can be described as effort made to increase the likelihood of client’s needs being acknowledged and met outside of the therapy environment; however, these advocacy efforts need not be limited to behaviors initiated outside of the therapy room. What should not be overlooked are opportunities to advocate for our clients within the therapeutic environment as well.
In this time in our country’s history, many issues related to social justice are being addressed out of necessity, often in reaction to significant events, generating emotions, and inspiring action in one form or another. Many therapists feel compelled to do something, but do not know where to begin. I recommend they consider advocacy within the therapy room as a good place to start.
Advocacy within the therapy room can take several forms – including but not limited to:
Assertiveness & Conflict Resolution Skills Training: Helping clients learn to express their feelings in a healthy manner rather than bottle them up increases the likelihood that when clients engage in discussions about sensitive social justice issues in their home, work, or community environments, they will be able to do so constructively while expressing themselves effectively.
Teaching clients how to express very strong opinions in a non-aggressive manner is a great gift – to your client, as well as the person on the receiving end of that opinion. This can be considered advocacy because you are helping your client increase the likelihood of their voice being heard and creating significant change.
Empathy Skills Training: Helping clients identify and understand the validity of others’ opinions, especially those contrary to their own, is a great gift to clients as well as their opponents, increasing the likelihood of healthy solution seeking and reducing the likelihood of opponents being treated as enemies in a highly polarized context.
Empathizing with a contrary view is not the same as agreeing with the opposing view; rather it is understanding how someone else, based on their experiences and perspectives, could have the opposing view being expressed. The challenge is learning how to disagree respectfully.
Self-Awareness Skills Training: Understanding others is often viewed as an act of empathy. However, in order to effectively understand the similarities and differences between another person’s perspective and one’s own, one must make intentional efforts to understand one’s own perspective. Ignorance of one’s own ignorance can be a dangerous thing – and often contributes to poor decision making and emotional reactivity, which are often precursors for headline making social justice incidents and debates. Fortunately, therapists are uniquely positioned to help clients explore and identify the experiences that contribute to their strong opinions and perspectives, which also helps prepare them to more effectively empathize with their opponents.
I challenge you to consider not only the clients who are victims and in need of advocacy, but also the clients who are labeled as perpetrators of injustices. Whether or not your client is the abuser, the abused, or the falsely accused, therapists have a unique opportunity to help in recovery efforts after significant events, as well as help all sides prepare for a healthy discussion of relationship reconciliation in hopes of healthier interactions in the future.
Consider the therapist who helps a future judge empathize with contrasting perspectives when making decisions with significant implications. Consider the therapist who helps a law enforcement officer identify and reduce their biases and assumptions without fear of ignorance and potentially save the life of an innocent person. Consider the therapist who helps a politician with very strong opinions learn how to hear the validity in the very strong opinions of their opponents, resulting in less dehumanizing and vilifying of their opponent, healthier collaboration and decision making, and the potential meeting of a greater variety of needs in underserved communities.
For therapists cautious of the fear of exploiting clients by pushing certain agendas, let me validate that fear, while also reassuring that the goal of this form of advocacy is the exact opposite – not to unethically exploit the therapeutic relationship to promote a particular agenda; rather, to promote the healthy expression, discussion and understanding of various strong opinions and perspectives.
There is and will continue to be a need for advocacy outside of the therapy room. However, there will also be a need for therapists to utilize opportunities within the therapy room to help guide clients to healthier balanced perspectives and interactions. Working together, these indirect advocacy efforts help pave the way for the direct advocacy efforts.
This article was published in the MAMFT News, Volume 36, No 4 (Fall 2018)
Lambers Fisher, MS, LMFT, MDiv, is an AAMFT Clinical Fellow, and a Licensed Marriage & Family Therapist, with over 15 years of experience counseling individuals, couples and families from a variety of cultural backgrounds. Lambers’ training experience includes facilitating national seminars and guest lecturing on topics related to multicultural awareness and diversity, as well as being an Adjunct Instructor and Supervisor for aspiring mental health and other helping professionals.