Mandating Therapy for Clinical Students?

SDN Members don't see this ad. (About Ads)

Hi all,
In speaking with a supervisor at a UCC, it came up that my program/s do not require (or even strongly encourage) personal therapy for their graduate students). My supervisor seemed surprised and I was just wondering if anyone had any opinions on the issue of therapy for doc students. Personally, I think it's absolutely necessary. Not sure how you could ethically enforce a mandate though.

My program doesn't think it's appropriate to mandate or even recommend it.

I definitely think it can be very helpful to be on the other side as a client. It gives insight into the process so that you can appreciate the process. It also normalizes therapy. However, I also don't think it's appropriate to mandate it--sometimes I think mandating therapy is just a way to promote business. For example, I know a PsyD program at a FSPS that mandates a certain number of hours of therapy with a licensed psychologist. Well, the surrounding city is saturated with psychologists, many of which I'm sure went to that school--seems like they're just guaranteeing their own stability, since there are a LOT of students at that school! Call me cynical.

Cara, why not appropriate to recommend? I think being on the other end of therapy is almost an ethical imperative for clinical/counseling folks.

Well, seeking therapy is a very personal decision.

I don't think it's an "ethical imperative" for psychology students to have their own therapy. I think if students feel the need to seek their own therapy, that's fine. But I think it's over the line for a program to mandate it. If one conceptualizes therapy as a treatment for problematic symptoms that cause functional impairment, then why would a student without a problem need to seek therapy? It's like saying that a surgeon should be required to have surgery during residency so they know what it's like to be on the other end of it, regardless of whether they actually have a condition that warrants surgical intervention.

Agree with the above. I'd actually find it very ethically sketchy for a program to make it a requirement for reasons similar to those others have shared. Its fine (and good!) to encourage it and be supportive for those who want to pursue it - my program maintains a list of local providers who offer therapy at a discount to our students, but that's the end of their involvement.

That said, this is likely because I don't buy into the notion that therapy is beneficial for everyone at all times. Seeing it from the other side can certainly be helpful, but I don't know that its reasonable to require it. I'd need to see solid evidence that it would help first (not to mention cost justifications), and I haven't seen anything even close. If there is a specific reason to then certainly, but even then it should be short-term.

Surgery analogy is not quite right, IMO. Working with relationship and all sorts of interpersonal processes IS something that anyone can benefit from and I just think it's irresponsible to profess to help others having never undergone one's own therapy. Everyone has transference/countertransference issues that could be addressed. I do, however, agree that mandating it is probably a bad idea.

To conceive of therapy as "as a treatment for problematic symptoms that cause functional impairment" is reductive in my opinion.

Yes it is personal, but I think we downplay it's utility and stigmatize the endeavor if professors feel the issue is out of bounds.

Originally Posted by Zebra F701

Surgery analogy is not quite right, IMO. Working with relationship and all sorts of interpersonal processes IS something that anyone can benefit from and I just think it's irresponsible to profess to help others having never undergone one's own therapy. Everyone has transference/countertransference issues that could be addressed. I do, however, agree that mandating it is probably a bad idea.

To conceive of therapy as "as a treatment for problematic symptoms that cause functional impairment" is reductive in my opinion.

People will have differing opinions on all of this, though, due to theoretical orientations. Not everyone sees it the same and not everyone works from an interpersonal/psychodynamic perspective (as you hinted above), just as not everyone works from a solution-focused perspective (as psycscientist implied). We all have our biases in that way. In psychoanalysis, personal therapy is required for the reasons you state. However, in a setting where the therapist is not addressing their own reactions in tandem with the client, it is not about the therapist and more about teaching skills. I personally think every situation *could* benefit from the therapist being in therapy, at some point in their lives, because I agree that surgery is about something being done TO you while therapy inevitably involves client participation and learning in virtually every case (although I'm open to being proved wrong on that).

Psychadelic, I agree. I was not thinking about the therpists who simply teach skills. But even then, I still gotta believe it would be important to pay attention to the therapeutic relationship and resistances, etc.

I agree its important to attend to and manage the therapeutic relationship regardless of one's orientation - its a common misnomer that CBT (or related therapies) involve ignoring these things though the nature of how that is done is certainly different. That said, I remain unconvinced formal therapy is a necessary, or even appropriate, way to achieve this. I imagine the vast majority of issues could be addressed by quality supervision.

That said, with the EBP movement you aren't likely to get a lot of buy-in without solid evidence to back this. From my perspective, we can't just assume the fact that discussion of relationships and interpersonal processes is something everyone would benefit from. There is certainly evidence for it in certain situations, but it seems quite a leap to generalize, say ITP for depression to everyone at all times ever. Would it be helpful to discuss interpersonal issues with clients? Of course, but that can happen in many contexts other than traditional therapy. Similarly, would actual therapy have benefits beyond that achieved by a (presumably insightful therapist) spending an equal amount of time attending to and thinking about these issues on their own? Maybe, maybe not. We shouldn't sell ourselves short, but I also think its important not to overstate its utility, lest we look like snake oil salesman.

Originally Posted by Zebra F701

Psychadelic, I agree. I was not thinking about the therpists who simply teach skills. But even then, I still gotta believe it would be important to pay attention to the therapeutic relationship and resistances, etc.

Of course it's important to pay attention to the therapeutic relationship - no good therapists simply "teach skills". But there is no data to suggest that personal therapy enhances or makes one better at maintaining the therapeutic relationship. I also agree with Ollie that there is no data to suggest that therapy is beneficial for everyone at all times.

Originally Posted by Ollie123

Agree with the above. I'd actually find it very ethically sketchy for a program to make it a requirement for reasons similar to those others have shared. Its fine (and good!) to encourage it and be supportive for those who want to pursue it - my program maintains a list of local providers who offer therapy at a discount to our students, but that's the end of their involvement.

That said, this is likely because I don't buy into the notion that therapy is beneficial for everyone at all times. Seeing it from the other side can certainly be helpful, but I don't know that its reasonable to require it. I'd need to see solid evidence that it would help first (not to mention cost justifications), and I haven't seen anything even close. If there is a specific reason to then certainly, but even then it should be short-term.

This is the exact case at my program. We are encouraged to seek therapy (if wanted and/or necessary) and are given a plethora of options. Luckily, our community clinicians are willing to see us for free. I have yet to take advantage of this but I'd love to see what it's like to be on the other side of things.

I would think that at least one of the personal therapeutic goals of any passionate psychologist would be to know his/her mind more thoroughly. This can absolutely be done outside of a formal therapy setting... agreed. However, I very much doubt that any survey-based outcome study could possibly validate (or invalidate) this endeavor.

The way that our program treated us we were all experiencing severe psychological distress by our second year so we all had motivation and need for treatment. I say that only partially joking. But seriously, there was no requirement in our program, but almost everyone did it for an extended period of time. I also think this was due to a lot of interest in dynamic and analytic therapies among the students.

I think one of the only ways that it would be harmful would be if you overgeneralize your own experiences to your clients. Just because such and such helped you, it isn't the one answer for e everyone.

But requiring therapy is just silly. My impression is that it is rare nowadays, though. It is like my favorite psychologist joke: How many psychologists does it take to change a light bulb? Only one, but it has to really WANT to change. If a person doesn't want to engage in the process, it is just a waste if time for everyone.

Best,
Dr. E

Well, is the idea that we should learn about ourselves and our reactions to others simply for the sake of pursing knowledge, or because it would make us more effective therapists? I agree the former would be tough to measure, but your original post seemed to focus more on the latter. Every study has nuance to it and obviously no one study can do it all, but it would be strikingly easy to do research validating/invalidating the basic notion that personal therapy helps one work more effectively with clients - that's one of the reasons I'm somewhat suspicious about its value, since it seems so easily done I wouldn't be surprised if it was sitting a in a file drawer somewhere.

I'm not sure what the problem is recommending therapy for students in a clinical program. Let's say we're all culinary students. I would certainly recommend that culinary students take the time to visit some restaurants and sample their menus, so they can at least get a good idea what it's like being a customer in a fine dining establishment. Bad analogy in many ways, I'm sure, but that's kind of what I'm thinking.

From the APA Code of Conduct

7.05 Mandatory Individual or Group Therapy
(a) When individual or group therapy is a program or course requirement, psychologists responsible for that program allow students in undergraduate and graduate programs the option of selecting such therapy from practitioners unaffiliated with the program. (See also Standard 7.02, Descriptions of Education and Training Programs.)(b) Faculty who are or are likely to be responsible for evaluating students' academic performance do not themselves provide that therapy. (See also Standard 3.05, Multiple Relationships.)

So, technically it is ethical as far as the APA is concerned. However, it is an artifact of past training. My understanding is that only a few schools still require it and it has not been in vogue for decades. Meaning, your supervisor is really old school.

My personal opinion:
I understand that receiving therapy can help students have greater empathy for their clients. I highly support treatment for students that need help. But I find it very wasteful for someone that has no dysfunctional impairment and is psychological healthy to go through it. You might literally have nothing to talk about.

Originally Posted by DynamicDidactic

But I find it very wasteful for someone that has no dysfunctional impairment and is psychological healthy to go through it. You might literally have nothing to talk about.

I have trouble believing that everyone doesn't have at least some sort of issue that might be useful, interesting, or enlightening to talk over with a therapist.

Maybe not "dysfunctional impairment," but, you know, perhaps an area for personal growth? And it's not "wasteful" if it's a meaningful exercise for adding value to the whole package that is a graduate of a clinical program, is it (assuming that it adds value in all, or most cases that is). A psychologist-in-training might not have "needed" therapy in the strict "medical necessity" POV and might not have sought it otherwise, but that's beside the point IMHO.

I tend towards at least recommending it for therapists in training, obviously. I know others may differ....

Originally Posted by JeyRo

I have trouble believing that everyone doesn't have at least some sort of issue that might be useful, interesting, or enlightening to talk over with a therapist.

Maybe not "dysfunctional impairment," but, you know, perhaps an area for personal growth? And it's not "wasteful" if it's a meaningful exercise for adding value to the whole package that is a graduate of a clinical program, is it (assuming that it adds value in all, or most cases that is). A psychologist-in-training might not have "needed" therapy in the strict "medical necessity" POV and might not have sought it otherwise, but that's beside the point IMHO.

I tend towards at least recommending it for therapists in training, obviously. I know others may differ....

This. I agree completely.

Originally Posted by JeyRo

I have trouble believing that everyone doesn't have at least some sort of issue that might be useful, interesting, or enlightening to talk over with a therapist.

I agree with you, in my view psychological health includes discussing your inner thoughts/emotions with someone. However, that role is often played by a partner, friend, or close family member. To repeat the same with a psychologist may not add enough (it usually adds something) to make it a requirement. The best thing to do is just find a significant other in the field and use them as your therapist .

But I agree with you, recommendation (just recommendation) of therapy is useful for many students (or having experienced it in the past).

In the situation you described above (i.e. trying it out to see what different styles are like) I would have no problems with it, but that is very different than the other reasons being discussed.

I'm obviously not opposed to personal growth. However, its certainly a good bit removed (and some might argue, more invasive, though I don't buy that as a rationale for requiring/not requiring it) from traditional training/education. I just think if we're going to push students into getting regular therapy (i.e. not just the "taste test" you reference above), we better be able to back up our reasoning with more than a desire for self-promotion or "It sounds good". There are obviously many gradations of this. The OP uses the words "Absolutely necessary", which to me comes across a good bit different than "Yeah, we recommend you try out being a client with a couple different therapists just to see what its like". I imagine the latter statement would not have gotten quite the response it did.

When a solid study comes out documenting that practitioners receiving personal therapy produced better outcomes/had stronger therapeutic alliances/better managed boundaries/etc. than a control group who spent an hour per week carefully considering these issues on their own, then I'll be the first to recommend it

Originally Posted by Doctor Eliza

It is like my favorite psychologist joke: How many psychologists does it take to change a light bulb? Only one, but it has to really WANT to change.

I'm a big fan of: "How many Freudian psychoanalysts does it take to change a light bulb?" "Two... one to screw in the bulb, and one to hold the penis. I mean 'ladder.'"

Originally Posted by LETSGONYR

I'm a big fan of: "How many Freudian psychoanalysts does it take to change a light bulb?" "Two... one to screw in the bulb, and one to hold the penis. I mean 'ladder.'"

Oh wow, hahaha. Reminds me of the joke (you've probably heard) on my Psi Chi chapter's shirts: "Freudian Slip- when you say one thing but mean a mother." You'd be scared by the amount of fellow psych students that have read it and don't get it...

Personally, I find the idea that psychology students should seek therapy "just because" they're psychology students is kind of... weird. While I'm sure a vast majority of people could derive some benefit from having someone to talk to in a supportive therapeutic relationship, I also think it makes much more sense to treat people in psychological distress over people who want therapy solely because their program requires it for "personal growth." It does seem wasteful to me, tbh.

Also, I'm curious about how this would be feasible in many programs. At both my undergrad and grad school, pretty much every counseling clinic, mental health center, etc., etc., in town was affiliated with the university psychology program(s), either directly or by virtue of being heavily staffed by practicum students. Both of these were college towns, so many of the faculty also maintained small private practices. I've worked in enough clinical settings to know that intraclinic confidentiality can be pretty poor (and isn't usually guaranteed in confidentiality agreements), and so I doubt I'd feel comfortable as a client at a place where my classmates/colleagues/faculty provided services, even without all the potential dual role/boundary issues.

I think it is helpful to have that experience of what it is like to be on the other side but it should be optional rather than mandatory.

There are so many things that I learned: What to do and even more important what NOT to do in therapy based on my own experiences as a client, both positive and negative. Although, of course, therapy should be tailored to individual's needs which vary from one person to another. IMHO, It is easier to understand a client's concerns about the nature of the theraputic relationship etc. if you had been there yourself in some capacity.

I also second the notion that therapy is a wonderful way to increase self- awareness and personal growth and does not necessarily indicate impairment or a diagnosis of some sort. I even think that exploring therapy with different modalities / theoretical orientations can be very helpful in balancing one's own approach and becoming an integrative clinician who is able to use different approaches to suit different clients' needs.

Compassionate1

Originally Posted by futureapppsy2

Personally, I find the idea that psychology students should seek therapy "just because" they're psychology students is kind of... weird. While I'm sure a vast majority of people could derive some benefit from having someone to talk to in a supportive therapeutic relationship, I also think it makes much more sense to treat people in psychological distress over people who want therapy solely because their program requires it for "personal growth." It does seem wasteful to me, tbh.

Also, I'm curious about how this would be feasible in many programs. At both my undergrad and grad school, pretty much every counseling clinic, mental health center, etc., etc., in town was affiliated with the university psychology program(s), either directly or by virtue of being heavily staffed by practicum students. Both of these were college towns, so many of the faculty also maintained small private practices. I've worked in enough clinical settings to know that intraclinic confidentiality can be pretty poor (and isn't usually guaranteed in confidentiality agreements), and so I doubt I'd feel comfortable as a client at a place where my classmates/colleagues/faculty provided services, even without all the potential dual role/boundary issues.

Yes, confidentiality in such settings is a real concern. However, the good news is that many private clinicians have sliding scales and reduced fees, especially if you are a student. Even in NY ( where rates are relatively high) it is not uncommon to find competent therapists who would charge around $50 for a session. This is still an expense but can be very worthwhile in the long run, so I had regarded it as an investment in both my personal and professional development when I used to be in therapy.

Compassionate1

But there are a lot of schools in areas where pretty much all of the local psychologists have some connection to your program. Mine is like that.

Originally Posted by Doctor Eliza

The way that our program treated us we were all experiencing severe psychological distress by our second year so we all had motivation and need for treatment. I say that only partially joking. But seriously, there was no requirement in our program, but almost everyone did it for an extended period of time. I also think this was due to a lot of interest in dynamic and analytic therapies among the students.

I think one of the only ways that it would be harmful would be if you overgeneralize your own experiences to your clients. Just because such and such helped you, it isn't the one answer for e everyone.

But requiring therapy is just silly. My impression is that it is rare nowadays, though. It is like my favorite psychologist joke: How many psychologists does it take to change a light bulb? Only one, but it has to really WANT to change. If a person doesn't want to engage in the process, it is just a waste if time for everyone.

Best,
Dr. E

Joke aside, I think it is quite ironic that programs designated for "raising" the next generation of therapists would be so invalidating or even dehumanizing! This is such a wrong message which if ingrained over time may lead to future clinicians who lack in sensitivity or worse! ( Although, you come across as a kind and competent clinician so obviously some people manage to survive such programs without lasting damage).

Compassionate1

Originally Posted by cara susanna

But there are a lot of schools in areas where pretty much all of the local psychologists have some connection to your program. Mine is like that.

Same here, both for undergrad, Masters, and (probably) PhD.

Originally Posted by futureapppsy2

Same here, both for undergrad, Masters, and (probably) PhD.

I feel bad for both of you! How have other students in your programs seem to solve this problem? And even though those clinicians may have some affiliation with your program, they are still independent therpaists bound by confidentiality laws and ethics. ( This is not the same as a clinic environment where things are more on the 'loose' side and cases are discussed fairly openly under the justification of "peer supervision").

Compassionate1

I know that they would be bound by confidentiality, but I would still not feel 100% comfortable or safe in the room with them.

One way to solve the problem of all psychologists in town having a relationship with the program is to see a different type of mental health professional like an LISW. Although psychologists and social workers may do similar work, they often have very different professional circles. I know this strategy has worked for others.

Best,
Dr. E

Originally Posted by Doctor Eliza

One way to solve the problem of all psychologists in town having a relationship with the program is to see a different type of mental health professional like an LISW. Although psychologists and social workers may do similar work, they often have very different professional circles. I know this strategy has worked for others.

Best,
Dr. E

This is a creative solution which would entail that one ( who is training to be a psychologist) is open-minded enough to seek therapy from a social worker or mental health counselor. I find that there are ofren bi-directional biases concerning the various levels of training in the field of mental health. It is refreshing when people are willing to consider the quality of the clinician, beyond one degree or another.

Compassionate1

My program is in a small city and, as mentioned above, any psychologist in my city might at some point be mentors/supervisors/coworkers/colleagues/etc. Further, our program really tramples down the idea of students seeking help. It's been a huge point of discontent for my cohort, almost all of whom could have benefited from psychological services this year...

I have heard from various individuals that it can be detrimental to have therapy in your medical records. I don't know all of the details, but evidently insurance companies often charge you more money (whether they admit it is due to the therapy or not) if you have things like therapy in your medical records. Has anyone else heard about this? I know this could (somewhat?) be avoided by paying with cash, etc., but I still wouldn't want any documentation to be associated with me.

The issue can be if you ever need to buy insurance privately (as many independent contractors and private practitioners do). If you have insurance through an employer it shouldn't be a problem. If you need to buy insurance privately, therapy will be treated differently based on the dx given and how long it has been since you were treated. Unfortunately, if you are engaging in therapy while applying for insurance you will be automatically disqualified for having an active medical condition.

I could go off on this issue, but I will refrain. Please don't let this prevent you from seeking treatment if you need it.

Dr. E

Originally Posted by Doctor Eliza

The issue can be if you ever need to buy insurance privately (as many independent contractors and private practitioners do). If you have insurance through an employer it shouldn't be a problem. If you need to buy insurance privately, therapy will be treated differently based on the dx given and how long it has been since you were treated. Unfortunately, if you are engaging in therapy while applying for insurance you will be automatically disqualified for having an active medical condition.

I could go off on this issue, but I will refrain. Please don't let this prevent you from seeking treatment if you need it.

Dr. E

If you pay out of pocket I have trouble seeing how an insurance company would even know unless you made a point of telling them.

Originally Posted by awishingstar

Further, our program really tramples down the idea of students seeking help. It's been a huge point of discontent for my cohort, almost all of whom could have benefited from psychological services this year...

What do you mean? Do you mean they actively discourage students seeking help???

Originally Posted by JeyRo

If you pay out of pocket I have trouble seeing how an insurance company would even know unless you made a point of telling them.

Because they ask. If you paid cash and were seen at a private practice, it's unlikely that they'd ever be able to find out that you were seen, but you're still going to have to lie to the insurance company.

Ethically, I honestly don't have a problem with this type of deception, as I think that the insurance industry practice of "stacking the deck" by denying coverage to applicants who are more likely to use it is disgusting. But that doesn't mean that the company won't rescind your coverage down the road if they somehow discover that you lied. Although I've read that recision is controversial and may be the target of legislation in the future, insurance companies have revoked coverage for much more trivial reasons.

Our program suggests therapy, but doesn't require it. I think this makes sense.

My program did not suggest that all students should seek therapy, but did seem to support those who chose to do so, at least as best I could tell. This setup worked fine for me.

We are not required to seek therapy, and I don't think many students seek out therapy here. But I don't think anyone would judge anyone else if they sought out treatment for anything.

Interesting to see this conversation.

My program hasn't even mentioned therapy for students, one way or the other. Definitely do not require it. THAT that said, my personal expereince in therapy has been invaluable in informing the work I do with patients.

Originally Posted by Psychadelic2012

What do you mean? Do you mean they actively discourage students seeking help???

If a student outright asked for help, I'm sure it would be provided. They just pre-emptively let us know that it's a small city and we'd be in contact with all of the psychologists at some point or another. Individual psychologists (e.g. on practicum site tours) have let us know they're open to seeing us, but still...

Originally Posted by awishingstar

If a student outright asked for help, I'm sure it would be provided. They just pre-emptively let us know that it's a small city and we'd be in contact with all of the psychologists at some point or another. Individual psychologists (e.g. on practicum site tours) have let us know they're open to seeing us, but still...

Hmm, was it said with an implicit tone of, "so you'd be better of not seeking help to begin with," or was it perhaps, "if you do look for therapy, this is the honest truth of it, so at least know that up front...?"

I'm of the opinion that therapy should not be required, but supported if needed. Frankly, requiring it is quite invasive and presumptuous (i.e., presuming it will help or at least cause no harm is at best wasteful and at worst... dangerous).

I think though there is a lack of clarification here of what type of 'therapy' people are referring to or recommending be received. I'm in a clinical scientist program that focuses on EBTs for diagnosable disorders. We refer people without diagnosable disorders to let's say the counseling center. Aside from it being potentially wasteful of time and resources for individuals who have no diagnosable disorder (can't work off the assumption that everyone has a problem; in fact, if you read the literature most of the population is highly resilient) to receive certain EBTs, it can also be contra-indicated (e.g., CISD after immediate exposure to trauma). Now if people are suggesting gaining 'insight' and 'personal growth' as the main goal for receiving therapy, that to me indicates something more along the lines of counseling.

Regardless, until I see research indicating otherwise (i.e., that personal therapy = better therapist), I find this a personal issue and preference. Interestingly, there is a pretty notable division in our field about how helpful people find "me-psychology"... either they are biased toward it (i.e., if you haven't been there you can't understand!) or biased against it (i.e., it may lead you to be biased in your research etc). And I see this topic falling within that scope. The truth is probably somewhere in between the two poles.

I fall into the camp that believes that I don't have to be a man to treat a male client with depression effectively using CBT... and I extend that notion to age, ethnicity/race,... all the way to having previously received therapy or not. I think we can all gain empathy in different ways and can learn to conduct EBTs effectively with good supervision (attending trainings, watching videos, etc). Now if that's not true for non-EBTs... well it's not something I would be doing anyway .

I am not saying that learning more about ourselves is a bad thing, but show me evidence that it improves therapy outcomes (...and even this might vary on what therapy you're conducting and outcomes you are measuring... we know that some EBTs are manualized so that non-experts can deliver them effectively as well, whereas that may not be the case with other types of therapy). And hopefully, if a program is in the business of training good researchers or clinicians, they would also provide good supervision to point out or help you address (even if that's by recommending therapy) any character traits that may be interfering with your ability to provide effective treatment (be that your understanding of the therapeutic technique or ability to establish a healthy therapeutic relationship).

Originally Posted by PhDToBe

I have heard from various individuals that it can be detrimental to have therapy in your medical records. I don't know all of the details, but evidently insurance companies often charge you more money (whether they admit it is due to the therapy or not) if you have things like therapy in your medical records. Has anyone else heard about this? I know this could (somewhat?) be avoided by paying with cash, etc., but I still wouldn't want any documentation to be associated with me.

But it is okay for your clients?

Operating from a more or less humanist perspective, I think issues of power and difference inhere in even the most rote, manualized therapeutic modalities. As we see in this thread, being in personal therapy creates a sense of powerlessness in us all... which powerlessness I think the therapists and psychologists have a responsibility to undermine and subvert rather than reify. We reify the power imbalance by sitting above the therapeutic encounter and assuming we don't need help.

Originally Posted by Zebra F701

Operating from a more or less humanist perspective, I think issues of power and difference inhere in even the most rote, manualized therapeutic modalities. As we see in this thread, being in personal therapy creates a sense of powerlessness in us all... which powerlessness I think the therapists and psychologists have a responsibility to undermine and subvert rather than reify. We reify the power imbalance by sitting above the therapeutic encounter and assuming we don't need help.

The only assumptions here that I'm seeing are: Assuming that without personal therapy we reify a sense of powerlessness in our patients. Assuming that we *all* feel a sense of powerlessness being in personal therapy. Assuming that we assume that we don't need help. Assuming that feeling like we don't need something means that we do need help.

1) If issues of power and difference in therapeutic roles is interfering in your ability to be an effective therapist - that is something that your supervisor should point out to you and help you address. Not all of us experience a power imbalance in therapy just because we haven't been in therapy ourselves. In fact, some of us can understand feelings of powerlessness and have empathy for our patients from different experiences in our own lives.

2.Again, not everyone has problems that need professional therapeutic help. Please see the literature on resiliency. Interestingly, this includes psychologists in training O_O. And these individuals do not 'sit above the therapeutic encounter' --- it's simply not indicated for them. Perhaps they already have effective skills or social support necessary to address any stressful points in their lives / to gain insight into themselves.

3. Although I am sure that some individuals assume they don't need help when indeed they might - this can be true of anyone, not just psychology students... (who, per anecdotal hilarity, at times after taking abnormal psych. start attempting to dx themselves lol). Indeed it is probably more likely that there are a) individuals who do need help and recognize it, b) individuals who do need help and don't recognize it, c) individual who don't need help and don't recognize it (disclaimer: don't have any great examples lol), and d) individuals who don't need help and realize it. Discounting that group D exists is a slippery slope (i.e., essentially thinking, with no sound evidence, that this group is simply group B --- whereby you discount their intelligence, self-awareness, health, needs, etc --- is far more indicative of a power issue to me by the one making that judgment).

I think most people on this board who are saying that therapy should not be required but rather supported if desired (or recommended for students in need) are not assuming that none of us need help. Nor are they 'sitting above' the therapeutic encounter/experience. Indeed they are saying that a) those who need help should be able to seek it freely and with support, b) those who are interested in it should be allowed to experience it, c) that if on the off-chance some personal characteristic or trait is interfering with one's effectiveness as a therapist, that they should be encouraged to address it, and d) those who do not need it or are not interested in it, should not be forced to (unless encouraged as per point c). That seems far less presumptuous to me than other perspectives.