Andy Reynolds, MSW, LCSW – Featured art by Becky Jane Krotts
Upon learning that I am a clinical social worker, my friend from college asked this question with apparent frustration and confusion, “Why does my therapist repeat everything I say back to me?” We were standing to the side at a mutual friend’s engagement party, and I couldn’t help but laugh. My friend always had an ability to be honest and real, and I loved that about her. Whenever she would tell her therapist something, she’d just repeat it back to her. “I know what I’m saying… do you?” she interjected.
“I even tell her: yeah, that’s what I said! And almost every time she just repeats what I say. It’s so annoying! It’s like… are you even listening to me?”
My friend’s therapist was doing a counseling technique called reflection. Reflecting back what someone says as a statement – rather than a question – reduces the risk of the therapist adding or subtracting too much from what the other is saying by helping to preserve the phraseology of the client, and it is commonly used in Miller and Rollnick’s Motivational Interviewing. For a visual to better understand, reflection pushes the ‘conversation ball back into the client’s court’ so that they can challenge their own statement, confirm it for themselves, or even expand upon what they intended to communicate.
Client: I just don’t know how to connect to my son. He feels so distant, like he doesn’t want a relationship with me at all!
Therapist: You don’t know how to connect to your son.
Reflection is not a bad conversation tool in therapy, on the contrary it is super helpful in particular moments. But there appeared to be three main problems from my friend’s situation.
Reflecting too often can be too obvious and repetitive. Relying too heavily on one conversation tool is just bizarre, and anyone with some social intelligence can pick up on that awkwardness. When conversations become cumbersome, like this, honest communication is stifled.
When therapists do not explain why they reflect it can lead to confusion. People pick up on unique tactics that don’t occur in natural conversations often. Not addressing them can lead to bewilderment. If a client is mostly confused by the therapist’s behavior, then they are not getting what they deserve and what they are paying for: proper focused therapeutic care of their needs.
In creating confusion and frustration the therapist compromises the therapeutic alliance with her client. Any action that brings about the response: Are you even listening to me? is one that you want to reconsider.
This story highlights the importance of shedding light on clinical practice techniques. Reflecting is a great way to keep conversations going, but when reflection is overused or unexplained it can cause more harm than benefit.
Therapists are not magicians who need to conceal tricks to help others. Share these tricks freely. In my classroom, I encourage my students to take every opportunity to educate their future clients. Explaining why you do what you do, how you do it, and how they can become better problem solvers for their lives is ethical clinical practice. What harm could have occurred if my friend knew of reflection, and was aware when her therapist was reflecting? For my friend’s case it could have increased understanding, increased insight, and saved the therapeutic alliance by avoiding unwanted frustration and confusion. These are all good things to shoot for.