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To Give or Not to Give Advice: Is that in Question?

May 30, 2019 By scottdm 8 Comments

My family and I had a frightening experience this past Memorial Day.  While driving through Indiana on the way home to Chicago, Screenshot_20190528-122146_Messagesour mobile phones began to alert.  You know the sound — part cicada, part microphone feedback, but louder.  

“Tornado warning in this area.”

Not a watch, mind you, a warning.  The difference is critical.  A watch means conditions are favorable for a tornado.  A warning means, IT’S HERE!

Looking ahead, we could see the dark, fast moving clouds.  No rotation, but menacing nonetheless.  That’s when our phones screeched the warning again.

“Take shelter now.  Check local media.”

Turning on the radio, we listened to the weather broadcast, distorted by the now abundant flashes of lightening.  We quickly learned we were heading directly into the affected area.

“What do we do?” I muttered to myself.   Cars and trucks were already pulling to the side, taking up positions under overpasses.  A few had become stuck while attempting to turn around in the already flooded ditch separating the two directions.

“Check Google maps to see where we can get off,” I barked.  I knew from prior experience that sheltering under overpasses was a bad idea.   We had to get off or risk having the Tornado hit us head on.  Problem was we were on the tollway where exits are few and far between.

“Two miles to the next exit,” my son soon replied.

20190528_122122That’s when we first saw it.  The clouds rotating overhead, a conical shape beginning to push downward.

Once more, our phones alerted: Take shelter now.  With my adrenaline pumping, and no other way to go but forward, I pushed on the accelerator.

Thankfully, we made it to the exit, racing northward up a country road at 85 miles-an-hour to escape the storm.  Ten or twelve minutes later, we spied a small gas station and pulled into the lot.  It was pouring rain, alternating with hail.  The sense of relief was palpable nonetheless.

Once the danger had passed, we resumed our journey.  The cabin of the car now quiet, I began running the experience over and over in my mind.  Something about it really bugged me, in particular the warnings and advice we’d received via our mobile phones and from the media.  It was clear, to be sure.  At the same time, it was absolutely unhelpful.  Yes, we were grateful for the warning.  And, of course, it was a good idea to seek shelter.  But where and how?  Absent more concrete direction, the result was people either panicked (like us) or made poor, even dangerous choices (e.g., sheltering under overpasses instead of laying in a ditch).

We have a similar problem in the field of mental health.  Google “advice and psychotherapy” and you get roughly 6 million hits many, if not most, of which are negative.  “The best advice a therapist could get,” one prominent site counsels, is “Stop giving advice.”  Another warns, telling people how to solve their problems, is “counterproductive” and potentially unethical.  A variety of reasons are given — largely having to do with the assumed nature of therapy (i.e., helping people help themselves) or client resistance to such help.

But do clients agree with such sentiments?  Until recently, no one had bothered to ask.  mirrorNow, a newly published study provides some provocative answers.  Researchers Cooper, Norcross, Raymond-Barker, and Hogan surveyed therapists and clients about their preferences, finding large and robust differences between the two groups.  Therapists, on average, preferred more emotional intensity and less directiveness.  Their clients?  The reverse!   The researcher’s advise to practitioners?  One page one of the peer reviewed article: Stop projecting your own desires onto the people you treat.

“Easier said than done” says lead author, Professor Mick Cooper.  I had the chance to speak with him about the study.  The interview provides direction for putting these importance findings into practice.

Until next time,

Scott

Scott D. Miller, Ph.D.
Director, International Center for Clinical Excellence

Filed Under: Feedback Informed Treatment - FIT

Comments

  1. Jewels says

    May 31, 2019 at 8:31 pm

    Thank you Scott!

    Reply
  2. Jason Seidel says

    May 31, 2019 at 10:14 pm

    Hi Scott-
    Interview aside, glad you all are okay after that tornado warning! Coincidentally, this theme (caring about and responding to our patients’ preferences to keep them engaged long enough to benefit from treatment) shows up in a film called (what else?) “TAKE SHELTER.” If you haven’t seen it, I recommend it. The protagonist is coming unraveled as he senses a massive storm coming and starts to take action, and is bounced between psychiatrists and therapists who diagnose and treat him without listening, without humility, empathy, or curiosity. And the character keeps saying ‘no’ to all that and listening to what is inside of him. And as a result, he’s able to have a “good outcome.” https://www.rottentomatoes.com/m/take_shelter
    Cheers!
    Jason

    Reply
  3. Michele Weiner-Davis says

    June 1, 2019 at 4:25 am

    Scott, I ask EVERY client at the start of therapy about their previous therapy experiences, what’s been helpful, what hasn’t and why. Hands down, the biggest complaint I’ve heard is that their previous therapists were too laid back, didn’t offer advice, suggestions, homework assignments and were lacking direction.

    Most people want our input, feedback and concrete guidance!

    Interesting discussion!

    Reply
    • Mary Farrell says

      August 5, 2019 at 11:11 pm

      I absolutely never wanted advice from the therapist I hired. I had no belief their advice would be useful or relevant. I had a much harder time getting the therapist to shut up, to listen to me, to pay attention to what I was saying rather than to their own ideas. Advice from a therapist was absolutely not what I wanted.

      Reply
  4. Scott Laurence says

    June 1, 2019 at 12:50 pm

    Like all ideological straight jackets, “not giving advice” is absurd…clearly, at minimum, therapists generally do (or should) recommend having therapy itself. And, we advise people to make positive changes, and many other things we believe to be true or useful. Often, advice turns sour if it reflects a particular way or method to achieve a mutual goal, without considering its practicality or if the client is willing or capable of doing it this way or that. As from anyone, advice given poorly or without knowledge can backfire, and therefore the cheap and safest way out is to give none, lest we be blamed for failure.

    Reply
  5. Terry Hickey says

    June 1, 2019 at 10:39 pm

    Hi Scott,

    I have found that at some point I may say, Would it be Ok if I offered a suggestion. The response is usually a congruent yes. I think of this as part of what is helpful in achieving the outcome we have both decided on. I suspect that not offering occasional suggestions to certain clients may be counterproductive.

    Reply
  6. Marianna says

    June 5, 2019 at 5:37 pm

    Strongly agree with the idea “stop giving advice!”

    Reply

Trackbacks

  1. Therapeutic competency no 1: awareness - by Stanislaw Malicki says:
    June 3, 2019 at 7:18 pm

    […] forgotten my interaction with the trainee. However, in the last week the memory has been revived by the newest blog by Scott Miller. His post drew my attention to another therapeutic principle (which I do not always follow, either) […]

    Reply

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