Do You Take a Client’s Side, Even If They’re “Wrong”?
One of the most common dilemmas in psychotherapy is what to do, as a therapist, when a client reports behaving in a harmful or inappropriate way? Do we emphasise the negative consequences of their actions on others? Or, do ‘we take their side’, even when we believe they have done ‘wrong’? The answer here is not straightforward because all of these situations are complex and individual, and the therapeutic alliance is always on the line.
All Actions have Causes
Consider a client with a history of a psychotic episode who recently flew into a rage and shouted aggressively at his teenage daughter. She had seen her dad have an episode once before and witnessed the consequences for everyone and the long road back to a life that felt normal. But, she was so frightened that this might become another episode, she called the police. Her younger siblings were in the house at the time.
As a therapist you might feel compelled, for everyone’s sake, to tell the client he shouldn’t have lost his cool so easily, you might pressure him in subtle ways to never do it again, and a common intervention used in situations like this is to encourage the client to write an apology letter. On the surface, this reprimand and advice make sense, they side with the daughter as the vulnerable minor and they establish a clear moral and behavioural line, which hopefully you can teach the client not to cross again.
Who is the Intervention Really For?
But this is not a solution for the client, who after all is our priority. Paradoxically, this approach forces him into defensiveness and shame, which may be part the basis of the outrage itself. This does not help him to understand what actually happened to him in terms of the overpowering emotions that spilled out in his outburst and the sense of self that is driving that. Naturally, we don’t want this to happen again to a teenage girl or to disrupt their relationship further. But most of all, we don’t want this happening again for the sake of this client. Exploring the client’s internal events that are the source of the problem is a better way to ensure it doesn’t happen again than exploring the external features of what actually happened. In short, it’s already too late for the client by the time internal events have expressed themselves as explosive external behaviour.
The Therapist’s Role
The therapist’s job is not to solve the family conflict, nor to take the moral high ground. Clients do not come to therapy for judgement or even moral guidance - they come for understanding, acknowledgement, help, transformation. They have long histories of judgement by themselves and others, so more judgement from the clinician will be more of the same. Same context will always produce same behaviour.
So, what can we do to facilitate lasting change in the destructive behaviours of our clients, either toward themselves or others, and yet maintain a warm, deep alliance? This is a delicate balancing act because clients are acutely attuned to judgement and self-loathing, which have a detrimental effect on both their identity and behaviour, and actually make challenging behaviour more, rather than less, likely.
Let’s be absolutely clear in our example, what the client did here was morally wrong from a parental stand-point and was harmful to the client himself because that part of his life was not under his control. But, do these aspects of the behaviour need to be our clinical focus? The answer in PBBT is no. Clinical work should never be about teaching a client a lesson.
Solving the Right “Problem”
The main clinical problem surrounding the client’s troubling actions here is not what he did, but why he did it, and there are many variables that will have catapulted the client into that unwanted space. All clients know what they have done, they know it is wrong, and they feel utterly ashamed by its impact on others and by what it says about themselves as human beings. They already know this, telling them again won’t add anything. Often what distresses clients just as much is being unable to understand what is happening to them at the time and why they cannot seem to manage their own behaviour.
Understanding complex behaviour such as this is never easy and explaining it to clients effectively is also a challenge. What we need to impart to clients here is more than situational insight, we need to build a healthy relationship between the client as an identity and their own emotions and actions. When this relationship between identity and action is not placed at the very heart of therapy and the clinical focus is on the client’s actions as separate from their identity, then the relationship between identity and action will actually worsen rather than improve. Worse still, when a client’s actions are the focus of therapy, it will be inevitable that they will feel judged, humiliated, and pressurised to change.
There are no Actions Outside of Identity
In PBBT, clients’ actions don’t directly cause harm to themselves or others, it’s the sense of self that dictates those actions that is controlling the client’s every emotion and movement. That sense of self should be our clinical focus, rather than simply its manifestation in action. Complex behaviour is always dictated by identity. Changing complex action and transforming it into chosen, considered action can only be done by changing identity.
Want to learn more?
Join us for an informational webinar on the Professional Diploma in Process-Based Behaviour Therapy (PBBT).
Date: 25th August 2025
Time: 16:00 (Irish Time)
Time: 16:00 (Irish Time)