Question

Should it be up to psychotherapist or to patient to decide what are real problems of patient to be treated, and what is only patient not fitting to contemporary social norms, what patients prefers not to be tried to change?

Answer 1

The therapeutic process involves a collaborative relationship between the psychotherapist and the patient. Ideally, decisions regarding what issues to address in therapy should be made jointly, with both parties having input and working together to identify the most relevant and meaningful concerns to focus on.

1. Patient Autonomy: The patient's autonomy and preferences should be respected and taken into consideration when determining the treatment goals. Ultimately, the patient knows their own experiences, thoughts, and feelings best. It's essential to create a safe and non-judgmental space where patients feel comfortable expressing their concerns and discussing their goals for therapy.

2. Therapist's Expertise: On the other hand, psychotherapists bring their expertise in mental health and human behavior to the therapeutic relationship. They can help the patient explore their emotions, behaviors, and thought patterns to gain insights into their struggles and identify areas for growth and positive change.

3. Therapeutic Alliance: A strong therapeutic alliance, characterized by trust, empathy, and collaboration, is crucial for effective therapy. When the patient and therapist work together as a team, they can address the patient's genuine problems while respecting the patient's values and boundaries.

4. Differentiating Pathology from Individuality: It is essential for the therapist to differentiate between issues that may be causing significant distress or dysfunction in the patient's life (pathological) and aspects of the patient's personality or values that are merely different from societal norms but do not harm the patient or others.

5. Cultural Considerations: The therapist should also be sensitive to cultural differences and societal norms, recognizing that what might be considered "abnormal" in one culture could be entirely normal and acceptable in another.

In summary, the decision-making process in therapy should be a joint effort between the psychotherapist and the patient. It is essential to strike a balance between addressing genuine problems that cause distress or impairment in the patient's life and respecting the patient's individuality and preferences. The therapeutic process should be client-centered, where the therapist provides guidance and expertise while honoring the patient's autonomy and cultural context.