Patient’s Manifesto

After hearing a story recently from a friend about how her encounter with a prospective new therapist went (hint: badly), I thought it might be interesting to look at that kind of situation and see what could be made of it. From there, I decided to make a list of things that perhaps therapists should consider when taking on new patients; it is by no means comprehensive, and is not meant to be insulting or an affront to the ethical portion of a therapist’s job – these are just things I would think might be useful for a therapist to consider, coming from someone who has both been a patient for quite some time and who knows many others.

1. Your patient is not just a patient – they are also a husband, wife, father, mother, brother, sister, son, daughter, or friend. They have a life outside of your practice, and while they may have issues that drive them to come to you, that is not all that they are. Don’t treat us as broken just because we have damage.

2. Don’t start the therapist/client relationship with an agenda. It’s cool to form one along with the client, but having one before you go in means that you are already working towards goals that the client might not know about. Work with your client, not through them.

3. We understand that a lot of therapists might do research, and some of their clients might become part of that. But don’t treat us just as research subjects; that’s not why most of us came to you. We want to find help for ourselves, not just help you research something.

4. Listen to what we are saying. You can look at our records and find some things out there, but the best way to help us is to listen to what we say and work from there. Some of us may lie or evade, and if that’s the case then either end the relationship or be more persistent, but listening is important – it’s the best way to find out what’s going on (well, unless you’re like me and write all your issues out in a blog, but still, the advice stands).

5. Try not to judge us. Once you start judging a client, then the relationship changes, and you start to treat them differently. We may have done bad things – stolen, cheated, hurt others, hurt ourselves. But we are coming to you for help because we want to change, and it’s much harder for us to do that if we feel like you are weighing our sins to find us wanting.

6. Our illness can make us feel isolated; don’t add to that by treating us like people who need to be hid away from society. It’s hard for us to ask for help, and we hope that the people we go to for help – especially the professionals like you – will see that asking for help as the courageous effort it is.

7. Some of us with mental illness might not want help. I’ve known people who had mental illnesses, but clearly weren’t ready to accept that fact and try to work to make themselves better. You can’t help everyone; do your best to help them, but be ready for the fact that they might not want to be helped.

8. We may pay for your time, but please try not to treat us as just another paycheck. We came to you because you were a professional who could help us, and if you aren’t doing anything but collecting a paycheck after each session, then it’s a waste of our money and your time. 

9. We might have difficulty establishing boundaries, because our illnesses can make it hard for us to know where that starts. So set your own and stick to them, because otherwise some people will try to monopolize your time with a multitude of issues.

10. Often, treatment for mental illness involves a combination of things – lifestyle factors, medication, therapy, and a support network. We understand that you can’t be all of these, or provide them all, but work with us to help make sure that we can eventually manage things on our own.

I’m sure there are more things that could be listed, but I think ten is a pretty good number. I might also have to write a similar post for people who are suffering from mental illness, because I know that we can often – even without meaning to be – be very hard, mentally, emotionally, and sometimes even physically – on those who are trying to help us.


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