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  • This blog provides a forum for discussion of therapeutic technique, including cognitive behavioural and psychodynamic technique. The focus of the blog is on psychotherapeutic technique and issues in the room rather than case or theoretical discussions. At the bottom of each post is a comments section. Feel free to make any comments you like. Please remember this blog is a public forum.

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  • Chris Allan is a clinical psychologist and Director of the Psychology Clinic at the University of Wollongong. He has a strong interest in both cognitive and psychodynamic therapies and an ongoing fascination in the interaction of technology and psychology. His interests are varied and include martial arts, playing guitar, cooking, chess, clothes, poetry and computer gaming. He is married with two children two dogs and a budgie.

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Comments

Yvette Vardy


Why are we, as therapists, afraid of being "misunderstood", by accepting a gift when we are unsure what the client means by giving the gift? Should we not be equally afraid of how the client might interpret the refusal to accept a gift?

Rejecting a gift out of fear seems quite a defensive reaction. Gift giving can be an appropriate and effective way of showing appreciation, so why put up a wall around that method of expression rather than any other method of expression? Why is the verbal expression of gratitude so much "safer" than a gift?

a client

So interesting!

I'm new to this therapy thing, and it seems to be a very unique relationship. I take a pottery class in between sessions, that has helped reduce my anxiety quite a bit.

I was thinking that a mug made in class would make the perfect christmas gift -- since it's not expensive and it represents the work I'm doing, which I'm grateful for.

I never even considered that this would create some kind of moral dilemma for my therapist. But this makes me stop and think.

I guess I'll ask first!!

Marcia Naomi Berger, LCSW

As a psychotherapist, I have occasionally been in the position of being offered a gift by a patient My training stressed the importance of not accepting gifts during the course of treatment because of the likelihood that doing so will, in the long run, interfere with the effectiveness of the therapy.

While it is tempting to provide immediate gratification to the giver by accepting the gift, it does push the boundaries and distort the frame of what therapy is and should be about. Accepting a gift during a course of treatment subtlely implies a different kind of relationship. Therapy is not a friendship where gifts are often accompanied by expectaions of some sort of reciprocation. Such expectations may be counterproductive to the patient. The patient may feel off the hook about bringing up difficult subjects or feelings in session, thinking unconsciously that the therapist owes him or her that "out" as a quid pro quid. And the therapist may either unwittingly succumb to that expectation or exert too much energy to counteract a natural desire to reciprocate in a way that is not in the best interest of the patient in the long run.

When a gift is offered during the course of psychotherapy, I acknowledge appreciatively the feelings of gratitude to me that it expresses, but explain that it is not my policy to accept gifts because I believe that the patient will get more out of therapy when I do not accep them. The discussion that follows between my patient and myself, particularly when the patient feels rejected, can have profound implications for the patient's healing and growth that will translate into more fulfilling relationships with others outside of the therapy office.

Ofer Zur, Ph.D.

Giving gifts is an ancient and common and human way to express gratitude, appreciation, and care. Gifts in psychotherapy and counseling are very common and often take place around the holidays, with children-clients, in termination, at an important junction of therapy. Therapists not only receive gifts they also may give gifts. Usually therapists' gifts have clinical significance and involve appropriate symbolic gifts, greeting cards, transitional objects, or psycho-educational material, such as books, audiotapes or CDs. Appropriate gifts by therapists to clients and by clients to therapists are ethical and can benefit the therapeutic process.

As my paper at http://www.zurinstitute.com/giftsintherapy.html discusses, rigidly rejecting clients' gifts can be insulting and harmful to therapy, especially to children and certain cultures.

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I recently came across your blog and have been reading along. I thought I would leave my first comment. I don't know what to say except that I have enjoyed reading. Nice blog. Anyway, I'm been looking for topics as interesting as this. Looking forward to your next post.

-pia-

a member of the public

Overall you make some interesting points, but I have the feeling this shouldn't have been posted on a 'public' forum... It seems a little insensitive (for example the comment you made about 'a client' who gave you the 'cross words' gift - If I were that person and read it here I would feel like my trust and right to privacy have been completely betrayed!)
I understand that this blog is more for professionals than 'clients', but it is a 'public' space after all...

Angelina

I thought of giving a handmade card to my therapist and doctor? Both of them have been really kind and i wanted to give them something like a handmade card to show my appreciation. Now that i know i'll be leaving for good and not see my therapist again makes me sad. He's a grandpa figure to me :(

do you think if i ask to take a picture of them will be offensive / unprofessional / conflicting etc. ? I wanted to make a scrap book of people who had helped me through tough times. I thought it will be good for me. It will be a reminder for me that life is worth living.

Send Flowers to France

Lovely flowers! Wish I can also arrange beautiful flowers like that. I want to learn how to arrange flowers cause it so interesting. Anyway, I enjoyed reading this post. Thanks for sharing!

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As empty vessels make the loudest sound, so they that have least wit are the greatest babblers. (Plato, Ancient Greek Philosopher)

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Also- It's important to keep your focus on the person(s) you are giving head to. It can be easy to just let your attention float off while you go through your practiced routine motions. Great head incorporates FOCUS~ENERGY~INTENTION.

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You have good insight on the topic, i have bookmarked your site. I have to show my mate this.

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The patient may feel off the hook about bringing up difficult subjects or feelings in session, thinking unconsciously that the therapist owes him or her that "out" as a quid pro quid. And the therapist may either unwittingly succumb to that expectation or exert too much energy to counteract a natural desire to reciprocate in a way that is not in the best interest of the patient in the long run

Femmes russes

A good blog! I was thinking that a mug made in class would make the perfect christmas gift -- since it's not expensive and it represents the work I'm doing, which I'm grateful for.

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well done!thank you for your comments!

newport

Fabulous article!

http://www.newportpsychotherapy.com/index/list_index.html
Kaynaz Nasseri’s psycho-therapy practice is built on a broad range of training and knowledge that allows her to address a wide variety of issues, some of which include relationships, mood, school concerns, life transitions, and other psychology issues. Her approach to psychotherapy and psychological assessment is warmly interactive, providing support, insight and useful feedback to help one resolve difficulties and achieve one's goals.

Coach Factory

well done! we hope you can give us more useful opinion!

newport

Nice post....

My psycho-therapy practice is built on a broad range of training and knowledge that allows me to address a wide variety of issues, some of which include relationships, mood, school concerns, life transitions, and other psychology issues. My approach to psychotherapy and psychological assessment is warmly interactive, providing support, insight and useful feedback to help one resolve difficulties and achieve one's goals. http://www.newportpsychotherapy.com/index/list_index.html

Camarad

I think, this theme is quite actual now. The patient may feel off the hook about bringing up difficult subjects or feelings in session, thinking unconsciously that the therapist owes him or her that "out" as a quid pro quid. And the therapist may either unwittingly succumb to that expectation or exert too much energy to counteract a natural desire to reciprocate in a way that is not in the best interest of the patient in the long run.

Sara

I'm in my last few months of school for social work and this topic has come up a few times.
It is so important to reflect on cultural differences before rejecting a gift.
Also, it can be really shaming to deny a gift. Clearly, there are some gifts that are inappropriate, ie-sexual gifts, but often times clients just want to show appreciation with a small gift during holiday season or at termination. I wouldn't jump to the conclusion that the client had issues with termination because they gave a gift. I would definitely want to explore it with my client but at the end of the day, I would probably accept it because I would never want to shame a patient.

Jason Segel

Thanks for this post! Thanks to my supervision group for exploring this issue so openly and frankly in discussing their responses and thoughts on gifts as part of our supervision session. This has led me to summarise some of these thoughts and add a few of my own that I thought might be useful for other students and supervisors to think about.

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One of the reasons why I like visiting your blog so much is because it has become a daily reference I can use in order to learn new nice stuff. It's like a curiosities box that surprises you over and over again.

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I find life an exciting business,The point is succinctness of expression.

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Yo no soy mucho de un lector en línea para ser honesto, pero los sitios realmente bonito, sigue así! Voy a seguir adelante, y su sitio favorito para volver más tarde. Todas las cosas valiosas best.pretty, en general creo que esto es digno de un marcador, gracias..

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Tout d'abord je tiens à dire blogue génial! J'ai eu une petite question que je voudrais vous demander si vous ne me dérange pas. J'ai été intéressé pour savoir comment vous vous centrez et effacer vos pensées avant l'écriture. J'ai eu un moment difficile de compensation mon esprit à me faire des idées sur. J'ai vraiment plaisir à écrire ne mais il semble tout comme les 10 à 15 premières minutes sont généralement gaspillées juste à essayer de comprendre comment commencer. Toutes les idées ou des conseils? Je vous remercie!

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