Empowering Patients: Keys to Effective Counseling

“Can't you just tell him what to do?”

That's what a friend once said to me, intrigued to know how I “do” with my patients.

And frankly, it's the kind of phrase you hear more often than you think... 😒

Some patients may imply, sometimes subtly:

“And you, in my shoes, what would you do?”

“Couldn't you just tell me what to do?”

“I don't know what to do anymore, what would you advise me to do?”

And then, admits, there's this little moment of hesitation.

Because deep down, you may have an idea of what would be “good” for your patient.

But you know that your role is not to give advice.

❌ No, being a shrink isn't about throwing out ready-made solutions.

Still, the temptation can be great sometimes, we're not going to lie, especially when we see our patient in pain (or diving headfirst back into their patterns).

But you know what?

Counseling isn't guiding.

It's short-circuiting the therapeutic process.

It's not telling them what you think they should do, not helping them to understand what's right for them.

And the difference is huge!

Because if you give advice:

👉 You're taking responsibility for him.

👉 You make it seem (even unintentionally) that they are not capable of finding their own solutions.

👉 And if it doesn't work? You're the one who's “responsible”.

But guiding is something else entirely. It's about :

✅ Helping your patient explore his or her own resources.

✅ Asking the right questions that open up perspectives.

✅ Being genuinely supportive, without dictating what to do.

I was talking about this recently with a colleague in supervision.

She said: “He kept asking me what I thought he should do. At one point, I felt like telling him... And then I thought: no, if he's expecting that from me, maybe it's because he's having trouble allowing himself his own choices.”

And that's exactly it.

Keys to Effective Counseling :

✅ Active listening

✅ Empathy

✅ Communication

✅ Not being judgmental

✅ Building trust

✅ Pay attention to the Nonverbal communication

✅ Reflective questioning

✅ Affirmation and validation

✅ Create a safe place

Our role is to empower the patient. Not to give them a crutch they'll rely on for the rest of their lives.

Keep in mind: patients don't need you to show them the way.

They do, however, need to feel that they can walk it themselves, thanks to your guidance.

And that's what real guidance is all about.

Understanding the Role of the Counselor or Therapist

In the realm of therapy and counseling, the relationship between a therapist and their patient is nuanced and critical. It’s easy to fall into the trap of providing straightforward answers to complex problems, especially when we see our patients struggling. The suggestion from a friend to simply "tell them what to do" reflects a common misunderstanding of the therapeutic process. The therapist's role is not to be a directive authority but rather to foster the patient's own ability to navigate their challenges.

The Power of Choice in Therapy

When patients ask questions like, “What would you advise me to do?” they are often expressing a deep-seated frustration or confusion. It might seem tempting to offer clear-cut solutions. However, giving advice can undermine the therapeutic process for several reasons:

1. Taking Away Autonomy: By providing ready-made solutions, therapists inadvertently rob patients of their agency. Empowering patients means enabling them to make their own choices, reflecting on their values and desires.

2. Creating Dependence: If patients rely on their therapist for solutions, they may struggle to develop the problem-solving skills that are essential for long-term emotional health. They might end up seeing the therapist as a crutch rather than a guide.

3. Transferring Responsibility: When a therapist or counselor provide advice, they take on the burden of responsibility for the patient’s outcomes. If the advice doesn’t work out, the patient might feel less accountable for their own decisions and look to the therapist or counselor for blame.

The Process of Guiding vs. Advising

Therapeutic guidance is fundamentally about exploration and understanding. Rather than dictating actions, therapists facilitate an environment where patients can explore their feelings, thoughts, and options freely. Here are some essential components of effective guidance:

- Asking Open-Ended Questions: Rather than providing answers, therapists can ask thought-provoking questions that encourage patients to look inward and evaluate their situation. This method promotes self-reflection and critical thinking (use Socratic questioning!).

- Exploring Resources: Encouraging patients to identify their own inner strengths and past successes reinforces their self-efficacy. This exploration can help patients recognize that they have faced challenges before and can do so again.

- Fostering a Supportive Environment: A therapist’s role is to create a safe space where patients feel comfortable acknowledging their fears and uncertainties. A supportive atmosphere can empower patients to confront their issues without fear of judgment.

The Importance of Self-Discovery in Therapy

The journey of therapy is one of self-discovery rather than instruction. Patients come to therapy not just to find solutions, but to gain insights into themselves and their patterns of behavior. For instance, if a patient repeatedly asks “What should I do?” it may indicate a struggle with decision-making or a fear of making the wrong choice. Here, the therapist can guide the patient to explore these underlying issues rather than simply providing an answer.

As one colleague noted during supervision, the act of asking patients what they think they should do can lead to significant breakthroughs. It invites them to consider their own beliefs and desires, and ultimately, to take ownership of their own decision-making processes.

Conclusion: The Role of Empowerment in Therapy

The ultimate goal of therapy is empowerment. By shifting the focus from giving advice to guiding patients in finding their own paths, therapists can foster resilience and autonomy in their clients. The therapeutic relationship is a partnership, where the patient is the expert on their own life and the therapist serves as a facilitator of insights and growth.

In this light, the role of the therapist isn’t merely about solving problems but about supporting patients in navigating their challenges, discovering their strengths, and becoming the architects of their own healing journeys.

Empowerment in therapy is not just beneficial; it is essential for lasting change. So, the next time a patient asks for advice, remember: it’s not about what you think they should do; it’s about helping them discover what’s right for them.

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Empowering Patients: Keys to Effective Counseling

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