Power in Psychotherapy and Counseling: Rethinking the ‘Power Differential’ Myth and Exploring the Moral, Ethical, Clinical, and Practice Issues of Power in Therapy
Fulfills requirement: Professional Ethics for all professions
This course explores the different aspects of power in psychotherapy and counseling – the ethical and clinical issues involved with power in the therapeutic relationship as well as the legal, moral and professional issues.
From the first day in graduate school, all the way to post-graduate ethics courses, psychotherapists and counselors have been instructed to pay great attention to the “inherent power differential in psychotherapy” and to be aware of the “imbalance of power between therapists and clients.” They have been repeatedly told, “never abuse or exploit our vulnerable and dependent clients.” The view of power as an entity, possessed exclusively by powerful psychotherapists and counselors, has been generally unchallenged. Ethics texts and risk management advice columns have presented a similar unified message about therapists’ unilateral power and clients’ inherent vulnerability.
Many psychotherapy clients are indeed distressed, traumatized, anxious, depressed, young, impaired, and vulnerable and can be easily influenced or controlled by their therapists. On the other hand, other clients are competent, strong, authoritative, and even controlling. Many modern-day consumers are highly informed and seek therapy to enhance the quality of their lives, improve their loving relationships, or find meaning in their lives. They are not depressed, traumatized, or vulnerable. Yet, the myth of the power differential persists as if all clients are the same and all therapist-client relationships are duplicates of each other.
This intermediate-level course presents one of the most extensive analyses and critiques of the beliefs inherent in power differential and the claim that the power of therapists always lasts long after termination. It consists of four audios (with text transcripts provided) that critically review the prevalent belief of “once a client, always a client.” The course begins by defining power and examining the current stances on power in psychotherapy, from denial to exaggerated views. It also takes a critical look at theoretical orientations and power in therapy and provides extensive documentation of the different myths about power. Second, the course reflects on and critiques the potential sources of such faulty generalizations and argues that clients come in all shapes and forms of power. Third, the course reviews nine types of power in psychotherapy, how therapists and clients exert them, and how power may shift during therapy. Finally, the course discusses overarching power issues that are seldom discussed, when a power differential is relevant and valid, and ethical standards related to power. It also proposes new ways to view power relationships in psychotherapy that are realistic to the field of therapy and counseling, respectful and honoring to clients, and, most importantly, helpful in increasing therapeutic effectiveness.
Educational Objectives
- Discuss current stances on power in psychotherapy and counseling.
- Critique the sources of the “inherent power differential” myth.
- Describe the nine types of power and explain how therapists and clients can exert them.
- Explain the settings and populations for which the power differential is relevant and valid.
Syllabus
- What is power
- Power in psychotherapy and counseling
- Current stances of modern therapists in regard to power
- Theoretical orientation on power in therapy
- Myth of power differential: quotes from scholars, ethicists, attorneys, and organizations
- Clients’ power as portrayed in the movies
- Clients come in shapes and forms of power
- Psychoanalytic focus on transference and power
- Feminist therapy’s focus on power
- Prevention of sexual exploitation of women in therapy
- Slippery slope argument
- Types of power that therapists and clients exert
- Legitimate power
- Knowledge power
- Professionalism power
- Positional/role power
- Imbalance of knowledge power
- Coercive power
- Reward power
- Referent power
- Manipulative power
- How power may shift during therapy
- Modern clients as consumers
- Overarching power issues seldom discussed
- Therapist as powerful guide
- Informed consent
- Multiple relationships
- How psychotherapy can isolate clients
- Misuse of the term “resistance”
- “For your own good”
- View of clients as helpless victims in need of rescue
- When the power differential is relevant and valid
- Settings
- Populations
- Ethical standards (APA)
- Beneficence and non-malfeasance
- Fidelity and responsibility
- Integrity
- Justice
- Respect for people’s rights and dignity
- A new view of power in psychotherapy
- Final words on what therapists should pay attention to regarding power
