As therapists we sometimes catch ourselves applying value judgments during our sessions — at least in our inner dialogue. We might internally deem something a client shares as good or bad, right or wrong, moral or immoral.
We, like our clients, reflect our upbringing. As objective as we might want to believe we are, we’ll certainly at times try to steer clients with our own moral compasses. But can we maintain our effectiveness and professionalism when we find ourselves judging the client and his or her family culture?
A Case Study
This case study was presented at a seminar for therapists: A 10-year-old boy was in mandated treatment. Both his parents were incarcerated, and he lived with his maternal grandmother, who was described as loving and attentive. She also cared for many of his cousins, their parents being imprisoned as well.
Many generations of the family had arrests for non-violent crimes, and the grandmother reinforced these behaviors. The 10-year-old was incredibly intelligent; he’d read auto manuals to learn how to remove car alarms.
In a therapy session, a counselor told the boy his family was bad. His reaction was to set a fire at his school and steal a school bus, and then abandon it, leaving it to roll down the street in neutral.
Evaluating World Views
The seminar facilitator asked the class to consider what any reasonable person with the boy’s background would come to believe about himself, relationships and the world. Then the seminar leader asked about his possible fears.
The group offered input, suggesting the boy might believe about himself that he could do whatever he wanted without consequence, that he might believe about relationships that family is good and the legal system is bad, and that he might believe about the world that everyone outside his family was an enemy, or a “mark” to be exploited or tricked. His fears, they said, might be getting caught, being separated from his family by child protective services, or disgracing his family by succeeding in ways that broke with their tradition.
The facilitator, who’d become the boy’s therapist, revealed that because the family believed the attorneys who’d defended his parents had failed them, the boy felt the family needed its own attorney — him. He spent years preparing to fill that role.
He avoided trouble with the police, studied for and passed the bar, and became a defense attorney. Someone in the class characterized him as “a productive member of society.” But as the facilitator pointed out, his world view might not have changed, and he still had potential to pass the values he grew up with on to the next generation.
A class participant asked if, in the course of treatment, there was ever a mention of empathy for the crime victims. The answer was no, because it would have been a foreign concept for the client. In his world view, his family’s needs came first, to the exclusion of the needs and rights of others. The participant asked further whether the therapist brought up accountability and consequences. Again, the answer was no.
Because the client’s outcome was deemed positive, the other issues were considered less therapeutic. They also would’ve reflected the therapist’s judgments of right and wrong, going against the tenet that treatment should meet clients where they are, respecting their views as valid for them.
No Clear Answers for Therapists
The case study raises important questions for therapists to consider — questions that unfortunately don’t have definitive answers:
- What responsibility do we have to introduce pro-social values and actions to clients?
- Should we encourage changes that will help clients break unhealthy patterns?
- Is it possible to teach empathy in clients whose world views tell them it’s unnecessary?
- Is it our right to try to help clients break the cycle of family behaviors if they see nothing wrong with them? For example, part of the family culture might involve drinking together, then driving home. Should we remind clients those decisions could have deadly consequences?
- And perhaps most importantly, how can we support our clients, knowing that they’ll make choices based on value systems that might not be in harmony with ours?