Therapist DOs and DON'Ts

Post Reply New Topic

i'm okay with the early intervention psychosis team and therapists and psychologists i work with. they're liberating. i've not got much to complain about them. we have debates and lengthy discussions about the world and issues, sometimes one sided on my side, oops. the above list is more for if you haven't considered the above ideas and if you are uneducated on the different complexities of patients. i've found my own way to accommodate and self help the different aspects of me but some therapists may not be able to see past their own biases and knowledge and may not be able to see the patients mental and emotional landscape and end up damaging their well being by forcing them into a unnatural mind set, etc, so i guess it's all about accommodating the patients different aspects, that's the outline of my point, which is obvious, i think. no therapist has done that to me, only i have done it to myself before...

by doing this, you are also allowing the patient to discover their potential and put that potential into motion, on their own terms.

Do not interrupt

Do not double book

Do not comment on my appearance, intelligence or demeanor

Do not take your dog to work

Do not be late

Do not end early

Do not keep asking "why?"

Do not act like you know everything

Do not act like you are superior to me

Do not cancel sessions with short notice

Do not say "does that make sense ?" When it is just your opinion

Do not overreact

Do not say "huh" or "what"

Do not think you know more about me than I do. Do not assume anything about me or about my Autism just because you might have a stereotypical understanding of Autism.

Do take what I say at face value.
Do believe that I know myself well as an adult.
Do not say that I am argumentative or defiant if I do not agree with you
Do not tell me that I am hurting your feelings if I do not agree with you (I have had therapists tell me that)

Do try to speak logically and factually rather than socially or emotionally.
Do understand that I speak logically and factually rather than emotionally and socially and that my convictions are based on researched facts and not on social and emotional whims.

DO: Remember my name.
DON'T: Call me by another client's name.

DO: Let me finish what I am saying.
DON'T: Finish my sentences for me.

DO: Ask me how I'm feeling.
DON'T: Ask me how I'm feeling more than once (maybe twice) per session.

DO: Have a box of tissues nearby.
DON'T: Keep reminding me that "It's alright to cry".

DO: Accept what I say as true.
DON'T: Accuse me of lying, exaggerating, or otherwise fabricating events that really happened.

DO: Listen when I talk about my interests (i.e., AD&D, Astronomy, et cetera).
DON'T: Interrupt me when I talk about my interests to focus on some minor detail I mentioned three weeks ago.

DO: Accept how I identify myself as valid (e.g., Gynotropic Cis-Male).
DON'T: Try to convince me that I should either identify myself in some other way or actively explore other identities.

DO: Ask me if I would feel comfortable with a student in the room before he or she comes in.
DON'T: Suddenly tell me that the stranger in the corner is a student who will be observing the session.

DO: Ask me if I would feel comfortable being referred to another counselor.
DON'T: Refer me to another counselor without advance warning.

DO: Pay attention to me.
DON'T: Eat, groom, apply makeup, check your email or text during session.

DO: Let me know when you are feeling fatigued, sleepy or tired.
DON'T: Fall asleep during the session.

DO: Keep our sessions in strictest confidence.
DON'T: Let me hear my boss repeat something word-for-word that I've said to you in private.

DO: Suggest reading from a wide variety of cultures and beliefs.
DON'T: Use the session to promote your own philosophic, political, or religious beliefs.

DO: Encourage me to open up about childhood traumas.
DON'T: Keep pressing me for more details about childhood traumas.

DO: Acknowledge what I've said as valid to me, even if it seems a little odd or "out there" to you.
DON'T: Judge me. Don't even sigh when I express a more "creative" idea than any you may be used to.

from experience from people i've worked with in the past:

do not feed my ego, to a point that all logical insight is replaced with your misinterpretation of me. it has took me a while for me to move past the old therapists compliments, judgements and their own view of me and redeem thinking for myself again. i am not an ego, i am my own perspective and i am an absorber of everything, including your 'out of nowhere' misinterpretations of me.

do not start challenging me on every single word i say out of confusion, pushing my logic into context (all logic and perspectives are unique, after all) and do not bring up in a conversation things i have said in the past weeks and months... a week, month or year later on after i've said it. why remember everything i say to challenge me later on? for sure, challenge me at the time about the subject but do not quote things i said, to me weeks or months ago. a therapist, my mum and my brother have done this a few time and it has completely deluded me. removal of insight. warped sense of time.

do not feel threatened by me. a therapist has expressed in the past that they where threatened by me. do not. i have no intentions, unless you start believing that i have intentions, then i may develop some evil intentions to get revenge.

do not ask why i am not making eye contact when i'm speaking or tell me "my eyes are here". therapists and hospital nurses have done this. i find people scary but at the time, there is no explanation but that i am internally afraid of them and overwhelmed.

apart from that, i enjoy the team of people i'm working with at the moment.

Do not keep asking Mandated Reporter screening questions

Do not act like every slightest thing is an emotional rollercoaster

Do not have a morally superior attitude ("is helping people important to you?".). (f**k you Jeanne Courtney stupid b***h. "Helping people". Mussolini was helping the Gestapo. Jeanne acted like she dragged my worthless corpse out of a burning building)

Do not compress spectrum questions into yes/no (for example. Human behavior is not as predictable as it appears. Does not mean unpredictable )


Do not act like you expect me to believe everything you tell me. When it is just your opinion. And then tell me "you think", "you say", "for you"

To Summarize So Far:

Suggestions to Psychotherapists

DO: Accept "I don't know" as a valid answer to any given question.
DON'T: Assume that "I don't know" means ask to me over and over again until I give you an answer you want to hear.

DO: Accept how I identify myself as valid (e.g., I am a Gynotropic Cis-Male).
DON'T: Try to convince me that I should either identify myself in some other way or actively explore other identities.

DO: Accept my talents and acknowledge my difficulties.
DON'T: Treat me like I am either mentally challenged or delusional.

DO: Accept what I have said as valid to me, even if it seems a little odd or "out there" to you.
DON'T: Judge me. Don't even sigh when I express a more "creative" idea than any you may be used to.

DO: Accept actual events from my past as true.
DON'T: Accuse me of lying, exaggerating, or otherwise fabricating events that actually happened.

DO: Acknowledge and compliment me on my progress.
DON'T: Feed my ego to the point that my self-image is propped up with empty superlatives and unrealistic expectations.

DO: Ask me how I feel about what someone else did or said.
DON'T: Ask me why someone else did or said something or what they were thinking when they said or did it.

DO: Ask me how I'm feeling.
DON'T: Try to tell me how you think I should be feeling.

DO: Ask me if I would feel comfortable being referred to another counselor.
DON'T: Refer me to another counselor without advance warning.

DO: Ask me if I would feel comfortable with a student in the room before he or she comes in.
DON'T: Suddenly tell me that the stranger in the corner is a student who will be observing the session.

DO: Ask me what I think may be wrong with me.
DON'T: Presume that I know nothing about myself.

DO: Ask open-ended questions.
DON'T: Ask questions that can only be answered with "No" or "Yes".

DO: Ask questions to clarify what I have said.
DON'T: Challenge me on what I may have said out of confusion or fatigue.

DO: Ask questions to help me clarify my thoughts.
DON'T: Make assumptions regarding what I am thinking or what I am going through.

DO: Be aware of transference.
DON'T: Counsel if you don't know how to handle it professionally.

DO: Be friendly.
DON'T: Try to be my friend.

DO: Encourage group therapy, if you think it is appropriate for the client.
DON'T: Force a client into group therapy just for your own convenience.

DO: Encourage me to open up about childhood traumas.
DON'T: Keep pressing me for more details about childhood traumas.

DO: Encourage the establishment of reasonable goals.
DON'T: Leave the counseling process open-ended.

DO: Express your opinions as opinions.
DON'T: Express your opinions as facts.

DO: Give lots of encouragement
DON'T: Always focus on the negatives.

DO: Have a box of tissues nearby.
DON'T: Keep reminding me that "It's alright to cry".

DO: Have a way of making your care available to low-income people.
DON'T: Treat low-income people like they are not worth your time.

DO: Have an open mind regarding my actions as long as they are not harmful or illegal.
DON'T: Put on a morally superior attitude regarding my actions as long as they are not harmful or illegal.

DO: Have an open mind regarding my opinions as to what could be wrong with me.
DON'T: Deny the validity of my opinions -- they are very valid to me.

DO: Help me work through current situations in my life.
DON'T: Force me to re-live every instant of every personal trauma.

DO: Keep our sessions in strictest confidence.
DON'T: Let me hear anyone else repeat something word-for-word that I've said to you in private.

DO: Let me finish what I am saying.
DON'T: Interrupt to finish my sentences for me.

DO: Let me know when you are feeling fatigued, ill, or sleepy.
DON'T: Fall asleep during the session.

DO: Listen when I talk about my interests (i.e., AD&D, Astronomy, et cetera).
DON'T: Interrupt me when I talk about my interests to focus on some minor unrelated detail I mentioned previously.

DO: Make allowances for clients who feel anxious when making eye contact.
DON'T: Insist on making eye contact with clients.

DO: Make suggestions and leave their implementation up to me.
DON'T: Tell me what to do or that I will face vague and dire consequences if I don't.

DO: Paraphrase what I have said to clarify your understanding.
DON'T: Insist that only your interpretation of what I have said is correct.

DO: Pay attention to me (it's what you're being paid to do).
DON'T: Eat, groom, apply makeup, check your email or text during session.

DO: Remember my name (it's right there in my file).
DON'T: Call me by another client's name.

DO: Show concern for my health, safety, and general welfare.
DON'T: Interrogate me with "Mandated Reporter" screening questions.

DO: Show your humorous side.
DON'T: Make jokes at my expense.

DO: Speak with me on my level.
DON'T: Talk down to me as if I am a child or use terminology I don't understand.

DO: Suggest reading material from a wide variety of cultures and beliefs.
DON'T: Use the session to promote your own philosophic, political, or religious beliefs.

DO: Understand that I am not behaving the same in your office as I do outside.
DON'T: Underestimate the effort it takes to behave as I do in your office.

DO: Understand that I may not want to undergo therapy at all.
DON'T: Assume that undergoing therapy was even my idea in the first place.

DO: Use techniques that are structured according to my individuality.
DON'T: Counsel "By the Book" or try to fit me into the ad-hoc diagnosis you made when I first walked through your door.

DO be willing to admit your knowledge of autism is limited and be willing to learn about autism from your autistic clients.

YES!! ! YES!! !! YES!! !! Let me say it again, YES!! !

DO expect your ASD client to act more and more "autistic" as they become more comfortable with you - and don't treat that like a bad thing/developing problem. Your client is just not trying as hard to act "normal" for your benefit.

DON'T keep asking if your client is listening/if you are being boring when they don't make eye contact. Many listen BETTER when they stop making eye contact.

Do not dial my phone number unless to cancel a session or something similar

Do not cancel with little notice for small reason



Do not come late or leave early

These are excellent, especially the first point. I totally agree 100% with these. I agree with all the others as well but this one is really important because a lot of people don't understand the concept and can bully us when we appear more Autistic than they are used to.

Here's something that no one mentioned net. If your job title says "family", then you'll have a conflict of interest on your hands: your patient and your customer aren't the same person. The person sitting in front of you is the child, but you're there to serve the parents' wishes, usually to help them "manage" their child. So here are the do's and don'ts; not all of them may be specific to family therapy.


DO provide full disclosure. Tell your patient what answers you want for when you ask a question, rather than let them guess. Is it basic emotions, like "happy" or "sad"? Is it complex emotions, like "discombobulated" or "apprehensive"? Is it cut-and-dried facts? Tell them. This includes psych tests. Without having at least an idea of what answers they're supposed to give, they'll go into panic mode, which will mess up the test results.

DO be willing provide antidepressants (indirectly). Chance are, your aspie patient already researched it, and knows how they will benefit from the drugs. If you dismiss or deflect their suggestions, they'll stop trusting you, and find their own "antidepressants". At best, they'll start drinking too; at worst, they'll buy opiods on the street. For me, it was whiskey and cooking wine.

DO give practical advice and/or guidance. It's the reason aspies come to therapy. If you fail at it, they'll lose trust and respect for you, and may be turned off therapy for life. If you can't bring yourself to give advice because it goes against your therapy philosophy, at least refer them to someone else.

DO give the patient a heads-up when the session is nearing the end, so they can finish and close out whatever they're talking about. A 10-minute warning, followed by a 2-minute warning work best.

DO keep things and ideas dry and factual. Avoid anything metaphysical or spiritual like the plague. Those belong in a house of worship, not a therapy office.

DON'T withhold information. Aspie patients are far more shrewd that NTs give them credit for. They'll know you're doing it. They may not know what you're hiding, but they'll know you're hiding something. So don't even try.

DON'T pretend to be your patient's friend. An aspie will see right through your act, and will instantly lose all trust in you, especially if you take their parents' side for any reason.

DON'T EVER UNDER ANY CIRCUMSTANCES say the word "aww". It's not empathy, it's not compassion, it's dismissal and mockery. It's something you say when you see a 2-week-old puppy struggling to walk, not when a patient tells you how his parents threw away his drawings. OK, you can say "aww" when your patient shows you a funny kitten video on their cell phone, but that's about it.

DON'T repeat or "reflect" what you patient told you, unless you're seriously asking for clarification. And if so, specify "Let me repeat it back to you to make sure I understood you." Very, very few therapists know how to "reflect" without coming off as taunting or mocking.

DON'T try to "get a patient in touch with their feelings". A "newbie" will fail miserably. A "hardened veteran" will memorize "right" answers and recite them to appease you. And if you succeed in making a patient cry, you will be no different than the bullies who push them into a locker.

DON'T force a patient to talk about painful or difficult situations, like being bullied. That will not help; it's ridiculous that people think it will. All you will do is retraumatize him/her.

DON'T EVER UNDER ANY CIRCUMSTANCES turn questions back onto the patient. If they ask you something, answer it, admit that you don't know, or say you're not supposed to do it. The minute you say "you tell me" or "what do you think?", you'll be thought of an blithering idiot who's unqualified for therapy work.

DON'T force your patients to draw anything. Most aspies are horrible drawers. Chances are, whatever they'll draw will look like crap, and won't accurately reflect what's on their mind, anyway. You'll only waste the patient's time and unnecessarily frustrate them.

DON'T give unnecessary compliments. At best, you'll come off as trying too hard. At worst, you'll be thought of as an untrustworthy liar. Keep any compliments you give matter-of-fact and nonchalant.

DON'T EVER UNDER ANY CIRCUMSTANCES pretend not to know what a patient is talking about, even when their statement presents a conflict of interest. For example, a child patient says his parents don't love him, when they're the ones paying you. You, as a person with a psychology degree, should know what patients talk about. When you don't, there's a problem, so don't pretend not to. The best thing you can say is "You may be right, but I hope I can change your mind." Or with a patient high school-age or older, you can even tell about the conflict of interest.

Don't come up with theories and present them as facts

Don't be so dramatic ("I wish it didn't happen.". "it was an unfortunate thing that happened." )

Don't make things black and white

Don't be biased in favor of the customer ("what do your parents not like about you?". How about, they don't like when I continue living. . Just because they don't like something doesn't mean that I don't have a "right" to do it. Nobody has a "right" to live. They just happen to be alive)

Do not violated confidentiality

Do not act surprised so easily

Do not say "sorry" for sympathy because when you do do something wrong "sorry" means nothing

Do not act like I can't handle anything bad

This boils down to money. Who pays for therapy, i.e. is the real customer? The parents. So the therapist will cater to their interests, not the child's. They pretend to be the child's friend, but aspies can easily see through the fake facade, oftentimes much better than NTs can.

There's nothing wrong with saying "sorry" to express sympathy per se. But an age-old NT maxim comes to mind: "it's not what you say, it's how you say it". Most therapists don't know how to moderate their tone of voice: they react to a child getting mistreated by his parents the same way they react to a two-week-old puppy struggling to walk. (The latter is easily the cutest sight ever.) In other words, they say "aww, I'm sorry!" in a cooing tone, rather than "oh no, I'm sorry!" in a serious tone. In the end, they come off as a clown at best, and as a bully at worst. Which explains why I never told my therapist that my grandfather was in a hospital in critical condition.