Therapist Dishonesty

We recruited 271 (N=271) practicing therapists from 38 states and 12 countries to participate in research that investigated the extent to which therapists are occasionally dishonest in psychotherapy. Among this sample, 19.2% were male, 79.7% female, and 1.1% other; 61.7% had been practicing less than 10 years, 21.4% between 10 and 20 years, and 16.9% more than 20 years. When asked about primary therapeutic modality, 11.3% of respondents indicated Dynamic, 21.4% indicated Cognitive Behavioral Therapy/Dialectical Behavior Therapy (CBT/DBT), 1.5% indicated Humanistic, 57.9% indicated Integrative/Eclectic, and 7.9% indicated Other. 

The Psychotherapists’ Assessment of Truth, Candor, and Honesty (PATCH) Survey explores the frequency of “therapist lying” across 23 topics:

  1.    Being less than alert
  2.    Forgetting something a client said
  3.    Competence or expertise
  4.    Confidence in being able to help
  5.    Clinical progress
  6.    Clinical availability
  7.    Reasons for canceling/rescheduling
  8.    Reasons for being late/absent
  9.    Conversations with others
  10.   Discussing diagnosis
  11.   Explaining fees
  12.   Discussing training or credentials
  13.   Having outside knowledge
  14.   Own physical/mental health
  15.   Own physical or emotional state
  16.   Aspects of one’s own personal life
  17.   Personal beliefs or values
  18.   Knowledge of someone or something
  19.   Liking/disliking clients
  20.   Feelings of frustration/disappointment
  21.   Romantic/sexual feelings for a client
  22.   Reasons for not taking on a client
  23.   Reason for termination

The frequency of lying for each topic is measured on a 7-point Likert scale with 1 = Never, 4 = Sometimes, and 7 = Frequently. Therapists’ responses to the scaled lying items were averaged to determine the most common topics of lies.    

In addition to our lab’s overarching hypothesis that therapists occasionally are less than completely honest more frequently about certain topics, we also hypothesized that more experienced therapists dissemble with greater frequency.  Since therapists theoretically become more comfortable navigating conversations in psychotherapy as they gain more experience, we predicted that a longer period of time practicing therapy would correlate to an increased ability to use tools of redirection and tactful concealment. To study this hypothesis, we performed a Latent Class Analysis (LCA) to identify class membership by lying topics. The distinct classes were then compared to the demographic variables “practice years,” “studentvs. non-student,” and “age” to determine if experience effects the lying behavior of therapists.

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