Dear Therapist:

My sister-in-law sees an unlicensed therapist. This concerns me and I asked my sister-in-law about it who assured me that the therapist has very solid training and good results and she is happy with her. This doesn't sound right or ethical to me, but I am not sure what to do, if anything. I would appreciate the thoughts of the panel members.

 

Response:

Generally speaking, it’s not ethical for someone who is unlicensed to promote herself as a professional. This is true for doctors, therapists, lawyers, accountants, and the like. There are many reasons for this, ranging from lack of training to efficacy to legal liability. I don’t know if the person who is seeing your sister-in-law presented herself as a professional therapist or simply as someone who helps people deal with certain specific issues.

I don’t know what your sister-in-law’s issues are. If she has no clinical diagnosis and this person does not purport to be helping her in that regard, she may simply be an advisor, and part of your sister-in-law’s support system. Part of the problem is that a non-professional does not have the training necessary to identify whether someone does, in fact, has a disorder or simply requires advice and support.

If your sister-in-law previously saw a competent therapist who assured her that she has no disorder, there theoretically may be no harm in her seeing this person. It might be viewed as similar to pastoral counseling, or even discussions with a close friend. The relationship, however, between your sister-in-law and the person whom she’s seeing would need to be very clear and unambiguous, with a distinct understanding of each one’s role. There would need to be a sharp distinction between areas that arise which might require professional help and those that could be discussed within the confines of this relationship.

This, however, is all theoretical. In reality, non-professionals will likely not have the understanding, training, and experience necessary for them to identify these and other factors that would allow them to properly distinguish between “therapy” and friendly advice and support. This is part of the reason that there are clear legal guidelines that preclude unlicensed people from referring to themselves in professional terms.

All that being said, it is your sister-in-law’s decision. If you might be able to help her to see the disadvantages and possible negative consequences of seeing an unlicensed person, I hope that this information is helpful to you. If, however, your sister-in-law won’t be swayed by anything that you might say, the point is probably moot. It can be frustrating to be concerned about someone in your life and feel powerless to help. If there’s nothing that you can do yourself, however, perhaps there’s someone else with whom you could speak whose opinion your sister-in-law would respect.

 

Yehuda Lieberman, LCSW

 psychotherapist in private practice

 Brooklyn, NY   |   Far Rockaway, NY

 author of Self-Esteem: A Primer

 www.ylcsw.com / 718-258-5317