Clients’ perceptions of therapist dishonesty

Although honesty is valued highly within psychotherapeutic work, therapists, like individuals in any interpersonal situation, are occasionally dishonest. The primary objective of this study was to explore clients' perceptions of therapist dishonesty, including their views on whether and under what circumstances therapist dishonesty is acceptable. Participants (N = 566) were clients currently engaged in psychotherapy who completed an online Qualtrics survey (Clients' Assessment of Tact, Concealment, and Honesty; CATCH) and the Working Alliance Inventory. Most clients perceived their therapists to have been somewhat dishonest at least once during their treatment and believed it acceptable for their therapists to be dishonest about several topics, including their frustration or disappointment in clients. Clients who had a stronger working alliance perceived less therapist dishonesty and were more likely to view dishonesty as acceptable; these findings did not vary significantly by age, gender, race, or education level. Clinical education on the varied nature and ethics of therapist dishonesty is indicated and ought to include discussion of instances in which less-than-complete honesty may be advisable, as well as its potential detrimental effects. Clinical training might well focus on beginning therapists' awareness of how their occasional dishonesty, including therapeutic tact, affects clients.