Most of us have borne witness to someone struggling emotionally to the extent that they’re having a hard time functioning, and as a loved one it’s gut-wrenching to watch. It hurts to feel powerless watching someone suffer, just wanting to make it better and take away their pain. Trust me, I get it- and as a counselor, I see it all the time.
I also frequently get calls and emails from spouses, parents, and family members detailing their loved one’s struggles and pain, where they are trying to set up an intake with myself or one of my teammates on behalf of their loved one. I totally understand where the mentality is coming from- this person is having a hard time functioning, and they need help with the simplest of tasks and this seems like one of those things. I’m here to get real and lay some truth out there because if you’re a loved one and you are doing this, you might not see the repercussions it’s actually having.
So, here are the reasons why contacting a therapist on behalf of your adult loved one is a bad thing:
1.) The counselor and client need to ensure goodness of fit for each other.If you’re culling a list of providers in the area and filtering through possible options, that’s actually narrowing the field for the potential client. They need to choose who is right for them, themselves. Also, your providing information to the therapist gives them a filtered view of the client, and it undermines the client’s opportunity to make the connection themselves without any filters over their struggles and problems. The client might not have the insight you feel you do into their lives and problems- but part of the therapeutic journey embarked on by the client and the clinician is to increase their insight into their own issues. If you’re butting in with your (unsolicited) thoughts and opinions, you’re making it harder for everyone involved to build rapport and work through barriers to treatment.
Also, I feel like it’s important to say that I’ve worked hard and honed a specific niche that involves clients NEEDING to be voluntarily involved in treatment, because of the nature and depth of work we do. I’ve accepted referrals from family members and spouses in the past, and nine times out of ten the client found out about the appointment and cancelled at the last minute because they didn’t want to do it and they weren’t ready. This impacted my income and the client’s chances of working with me in the future. Let them make the first contact for themselves. If they’re serious about getting help, they’ll do it even though it’s scary.
2.) You probably don’t have an accurate view of how they’re actually doing because of your emotional attachment to the person.It’s easy to say that someone is struggling if they’re in bed for days or actively using drugs and alcohol- however they’re not totally incapacitated if they’re able to get themselves drugs and alcohol. They may have some secondary gains to having you believe they’re not doing well- and I’m not saying that they are doing well. I am saying that they may feel inappropriately taken care of by getting you to do the simplest things for themselves that they can totally do on their own (if they truly want to), and they could be forcing you into a situation where you are enabling them to actually not get better. A good clinician won’t have the same emotional attachment to the situation you do, and can position themselves in such a way as to challenge the client when needed in a way you may not feel empowered to do. If you’re imposing your own emotions into the therapeutic relationship, this creates more challenges and barriers and can be confusing to the client.
The truth is- if they were struggling that badly, would they be able to go to work, get themselves the alcohol or drugs, or engage with that hurtful, problematic friend/boyfriend/girlfriend? Probably not. And if they’re not functioning in life at all, an hour of outpatient therapy per week is probably not going to help them very much. Instead, they might need a higher level of care and it’s time to call the local mobile crisis team. If it’s not enough of an emergency to call 911, it’s not enough of an emergency to call mobile crisis and therefore is not a crisis. If your loved one wants you to believe something is a crisis when it’s truly not, ask them what the hardest part is for them and if you can help them make a plan of action (which doesn’t involve you taking steps on their behalf). Let them know you’re happy to provide emotional support while they take the steps for themselves, but that you value their autonomy too much to take steps for them when they’re capable of doing so themselves.
3.) Every time you do things for the client, it undermines their ability to do things for themselves-and therefore undermines their opportunity to feel capable and confident. If calling or sending an email to a potential therapist is that simple, they should have no problem doing it for themselves and should offer relief that it’s done. Then all that’s left to do is meet with the therapist and begin building rapport and talking about goals. If it’s truly too hard for them to pick up the phone or send a quick email to a local therapist, they may need a higher level of care than an hour of outpatient therapy per week and they may need to be stabilized in a hospital setting first.
4.) It sends more of a message to the clinician than you realize. Whenever you reach out on behalf of another adult, a therapist is definitely thinking that this client might not be ideal to work with them because they might not want to do the deep work needed to drive results, or they might not even be aware that this appointment is for a therapy intake and the family member is going to set them up with some unwitting (and unwelcome) intervention. Or the therapist might assume that you are the one who actually needs the help because boundaries aren’t where they need to be, and now they’ve finally gotten uncomfortable enough for you that you are the one who is reaching out.
5.) They have to voluntarily attend treatment. Therapy should never, ever be seen as a last resort before someone in their life disengages with the client entirely- but too often it is. If someone is emotionally holding a gun to a client’s head it’s even more difficult to get them to want to be involved in their own treatment. Instead, highlight some of the benefits of therapy as you, personally, experience them. If you’re not involved in therapy yourself, how can you preach it to your loved one?
What you can do instead:
1.) Hold space for the person- encourage them to share their feelings and feel through them rather than suppressing or running away from them. Validate their feelings and tell them some concrete strengths and facts about themselves that help you know that they can do it. Encourage them to share their emotions, but also to take action and do something about them. Remind them that you’re not here to do the work for them, or to make it so that they don’t have to do their own work, but that you’re happy to support them while they do it themselves.
2.) Tell them what you’re willing to do- and not do- in order to be helpful, but also outline what they are capable of doing for themselves.Be specific about the kind of support they can expect from you- and reiterate that it’s their job to do the work, but that you’re proud of them for taking the first steps and doing so. Reaching out and getting started with a therapist can be extremely difficult, so make sure to congratulate them on taking the first step and ask them how you can be supportive. If they say “just be there when I need to talk,” great. If they say “I need you to come to all of my therapy sessions and talk about what is going on because you do it better than I can,” NOPE!
3.) Have strong boundaries. Stick to them. Don’t make exceptions- the point of therapy is not for it to be easy- the point is for growth to happen. Growth doesn’t typically occur because people are comfortable and happy, and the point of boundaries is to protect YOUR energy, not to make life as easy as possible for the person who may be unwittingly draining you of your life force. Things may get worse before they get better with your loved one because they’re dredging up some difficult things in therapy- that’s when it’s most important for you to stick to your boundaries and still be supportive, but on YOUR terms. And if you don’t know how to do that- now is the time to seek out a therapist of your own to start to learn.
4.) Let them know that, once they match up with the right therapist or counselor for them, you’re happy to participate in the occasional therapy session to help work on any problem dynamics or try to communicate differently. But then you MUST follow through! This doesn’t mean you’ll be present at every therapy session, but if it’s part of your loved one’s goals and treatment plan to work through any problematic dynamics or heal relationship pain between the two of you, then it’s important for you to participate to that degree. You’ll be asked when you’re needed. In some cases it may also be appropriate to refer to an additional therapist for couple’s or family therapy- it’s important for you to engage in that as well, otherwise every argument you just used to convince your loved one to seek out their own therapist is completely invalid, they will probably have a really hard time trusting you ever again, and you probably won’t feel awesome about it.
5.) Set boundaries if needed. If this person’s entire dynamic with you is constantly taking, you need to hold yourself accountable for allowing that to happen, forgive yourself for not doing anything differently up to this point, and decide what you’re willing to give and what you are willing to do for this person and where you draw the line. This puts you back in the driver’s seat- and having your own therapist can be extremely helpful (more on that in a moment). It’s empowering to state “this is what I am willing to do, and here is how I will help,” because it does allow you to see that you’re not helpless, and that this person can start taking back some of the emotional baggage they’ve been giving to you. It also doesn’t leave a ton of room for them to drain your energy if that’s something they’ve been doing.
6.) Contact a higher level of care. As mentioned, if they’re truly incapable of functioning in any capacity, including working/attending school, making contact with a therapist by phone or email, taking medications, eating, showering, or are addicted to drugs or alcohol, the needs are probably beyond what an outpatient therapist can provide for an hour a week. They may need a detox or inpatient psychiatric admission, a day treatment program or intensive outpatient program of some sort, or other intermediary level of care not appropriate for outpatient psychotherapy.
7.) Get a therapist for yourself. If you truly want your loved one to buy into the efficacy of therapy, they’re not going to want to hear it from someone who hasn’t bothered to go through that process themselves. You won’t have firsthand information as to how therapy is helpful, so you won’t be able to provide personal accounts of how it can be difficult to connect with a therapist and do deep emotional healing work. They won’t take you seriously. If you truly believe therapy is going to be helpful, why not get a therapist for yourself to heal your own stuff? If your loved one is providing you with emotional challenges and there are poor boundaries already in place, it’s likely you’ll benefit from your own therapist for emotional support and navigating better boundaries anyway.
a. This part is also going to be hard to hear-If you’re someone who struggles with boundary-setting, this may be an issue that contributes to the issues your loved one might be struggling with. Getting your own therapist will help you to increase your own insight, redistribute the emotional baggage, and heal your own emotional wounds that can then give the client in question permission to do the same.
8.) Disengage if needed. It doesn’t have to be a full disengagement, unless that is what feels healthiest for you. But making statements such as “I’m not willing to discuss ____ (specific issue) with you until I know you’ve taken action to handle the issue themselves,” sends a clear message and lets them know that this is their situation to handle. Use your discretion as to when this tactic should be used, and use it sparingly. But this still falls under the umbrella of setting boundaries and communicating clearly, which lays the groundwork for good therapeutic outcomes inside and outside the therapy room.
Obviously, this doesn’t go for minor children- young children probably wouldn’t know how to choose their own therapist or how to get into contact with them, so parents/guardians making that decision for them is absolutely OK. For adolescents and teens, it can be helpful and important to give them a small selection of therapists and let them know that the expectation is for them to attend therapy weekly, but they can select with whom they meet. Perhaps you can even craft an email together to best introduce the teen and what they’d like to work on in therapy!