Is it ethical to give suggestions as a therapist?

The scientific community has found recently that therapy versus medication, for 16 weeks, initially has approximately the same effectiveness (58% responsive). Here’s where it gets interesting: Long term (1 year later), 76% of patients who withdrew from the anti-depressant relapsed into depression. Only 31% of patients treated with CBT relapsed after 1 year of being withdrawn from therapy.

This amazes me because in my personal experience with having many, many therapists in my day, anecdotally, and my experience with my peers at my previous university, and what I have heard from others who have been in therapy themselves, I just think most therapists are not that effective at treating people.


I know it’s harsh to say, but that has been my experience, for what it’s worth.

I’ve had about 13 therapists of my own, of all different schools of psychology, and they mostly repeated back to me what I just said and listened. At least I think they were listening. I didn’t get much feedback. I wanted advice and in counseling school, they tell you not to give advice; that it’s unethical.

“What if you tell someone what to do with their life? Then they become dependent on you and it’s a liability,” they would say.

Here’s my radical idea.

What if you offered suggestions and not advice? What if you phrased it like, for example, “You said you feel lack of energy, motivation, and low self-esteem. You’ve told me you feel down about yourself most of the time and feel like things will never get better. Do you suppose you might be depressed? Would you like to work on some techniques or “homework” to alleviate some of these symptoms you’re experiencing?”

That to me is not unethical.

That is a whole lot different from, “You are depressed. Start exercising and eating healthier. Dump that loser you’re dating and start making a resume for a new job.”

The therapists I’ve had that do offer suggestions have been my favorite and helped me the most. They didn’t tell me what to do with my life, they just showed non-judgmental compassion and practical guidance.

This is the kind of therapist I want to be. I want to feel good about people getting their money’s worth from me. Especially with how expensive healthcare is. I couldn’t sleep at night if I was taking people’s money and sitting there in a chair like a blob in silence.


Cognitive Behavioral Therapy versus Medications for Depression: How Do They Compare? | Psych Central Professional. (2016). Retrieved from

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