Feeling offended by clients: The experiences of doctoral student therapists.

Abstract

Ten doctoral student therapists (8 White, 5 female) in 1 counseling psychology doctoral program located in the Mid-Atlantic United States were interviewed for approximately 1 hour each about their experiences of feeling offended by a client during an individual psychotherapy session. Interview data were analyzed with consensual qualitative research (CQR). Trainee therapists typically felt offended related to their sociocultural identities (e.g., being a woman, LGBTQϩ, racial-ethnic minority), felt frozen after the events and uncertain about how to respond, wished they had handled the events differently, and struggled when clients expressed opinions or beliefs that ran counter to their own values. Trainees had difficulty maintaining an empathic, nonjudgmental therapeutic stance where they could both value the client and maintain their own sense of integrity and beliefs about social justice and multiculturalism. Implications for training, practice, and research are provided. Public Significance StatementDoctoral student therapists reported on instances in which they felt offended by clients related to cultural or value differences. Therapists typically felt frozen and unsure of how to handle such situations, especially given their own countertransferential reactions, but wished they had handled the situations differently. These findings highlight the importance of training to provide therapists with tools to become more self-aware of inadmissible feelings and of alternative ways of handling difficult situations.

Asian international psychotherapist’s experiences of client’s microaggression in therapy.

“…Two instruments were used to collect data in this study, including (a) a demographic questionnaire was used to screen participants for inclusion and to record participants demographic information, and (b) a semistructured interview protocol was developed based on a literature review on discrimination from the perspectives of Asian Americans/Asian internationals (Peng et al, 2022) and microaggressions in a therapeutic context (Ahn et al, 2021; E. Yeo & Torres-Harding, 2021) as well as researchers’ experiences of providing psychotherapy and considerations of clinically cultural exchanges.…”

“…To the best of our knowledge, we only found one study that examined therapists' experiences of being offended by clients (Ahn et al, 2021). This study and Ahn et al (2021) acknowledged how therapists can experience harm in therapy. Although this study highlighted how these events can impact treatment, future research is needed to identify the impact from the client's perspective.…”

“…Researchers have documented high rates of microaggressions perpetuated by therapists and their detrimental effect on treatment processes such as therapeutic alliance and client outcomes (Hook et al, 2016; Owen et al, 2014). Although this research is informative, examining therapists’ microaggressions toward clients neither fully captures the dyadic relationship nor acknowledges that therapists may similarly experience microaggressions (Ahn et al, 2021). The literature on xenophobia suggests that Asian international psychotherapists (AIPs) who come from Asia and now provide psychotherapy in the United States may also face microaggressions and negative cultural events in therapy.…”

“…It is important to acknowledge that the structure within psychology focuses mental health service provision largely on the experiences of clients (Ahn et al, 2021). Moreover, much of the psychotherapy literature focuses on how White or U.S.-born therapists can work with clients of color; however, this position further perpetuates the longstanding notion that therapy is a White space (Ali et al, 2005).…”

Interviewing and Counseling Skills—Beginnings: The Initial Interview

“…Th e American Psychological Association Code of Ethics (2017) more explicitly encourages psychologists to "try to eliminate the eff ect on their work of biases based on [social identity] factors, and they do not knowingly participate in or condone activities of others based on such prejudices" (p. 4). Trainees have reported that they have experienced off ensive statements in direct reference to their own identities and have found it diffi cult to maintain an empathic stance ( Ahn et al, 2020 ).…”