Theses Doctoral

A Qualitative Study of Therapist Dishonesty

Newman, Mandy

This qualitative study aimed to investigate psychotherapists’ experience of dishonesty in the therapy setting. Therapist dishonesty is broadly defined as “behaviors or words, spoken or withheld, that are meant to deceive or mislead” (Jackson & Farber, 2021, p. 1). Though it is anecdotally acknowledged in the clinical literature, the phenomenon of therapist dishonesty has been empirically under-researched and unexplored, in favor of topics such as client dishonesty and client and therapist self-disclosure. Designed as a follow-up to a quantitative study of 401 participants (Jackson & Farber, 2021), the present study aimed to capture a comprehensive phenomenological understanding of the circumstances, motives, feelings, perceived consequences, guidelines, and attitudes therapists carry about dishonesty in therapy.

Further, this study aims to understand the extent to which therapists, in practice, are dishonest, and whether this occurrence is consistent with professional ethics and guidelines regarding dishonesty. Additionally, this study intends to review and synthesize the advice practicing therapists would provide to beginning therapists on handling situations in which they are tempted to refrain from telling the entire truth to patients.

Following the methodology of Consensual Qualitative Research (CQR), 20 psychotherapists participated in semi-structured interviews prompting the factors that contribute to honesty and dishonesty in psychotherapy and its perceived impacts and clinical implications. Nine domains and various salient findings emerged from the analysis. Findings revealed that most commonly, dishonesty occurs around personal disclosures to patients, reasons for dishonesty are typically associated with boundary setting to protect therapists’ needs or patients’ feelings, while nearly all therapists would not have handled their dishonest moment differently, many regret this moment, and typically, therapists contend that their honest disclosure have increased, rather than decreased, over the course of their careers. Therapist dishonesty and its association with clinical tact, therapist disclosure, and therapist matching are discussed. Limitations, clinical implications for novice therapists, and future directions are noted.

Keywords: Therapist dishonesty, therapist honesty, therapist disclosure, clinical tact, therapist effects


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More About This Work

Academic Units
Clinical Psychology
Thesis Advisors
Farber, Barry A.
Ph.D., Columbia University
Published Here
October 4, 2023