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Clients' perceptions of therapist dishonesty
Catherine Crumb1, Barry A Farber1, Hannah Ades1
1Department of Counseling & Clinical Psychology, Teachers College, Columbia University, New York, NY, USA.
Psychotherapy Research : Journal of the Society for Psychotherapy Research
|September 29, 2025
Summary
Most psychotherapy clients have experienced therapist dishonesty and find it acceptable in certain situations. A strong therapeutic alliance is linked to perceptions of less dishonesty, regardless of client demographics.
Area of Science:
- Psychology
- Psychotherapy Research
- Clinical Psychology
Background:
- Honesty is a core value in psychotherapy.
- Therapists, like all individuals, may occasionally be dishonest.
- Understanding client perceptions of therapist dishonesty is crucial for ethical practice.
Purpose of the Study:
- To explore clients' perceptions of therapist dishonesty.
- To determine client views on the acceptability of therapist dishonesty.
- To examine circumstances under which therapist dishonesty is perceived as acceptable.
Main Methods:
- Online survey administered to 566 psychotherapy clients.
- Utilized the Clients' Assessment of Tact, Concealment, and Honesty (CATCH) survey.
- Assessed the Working Alliance Inventory to measure therapeutic alliance strength.
Main Results:
- The majority of clients perceived some therapist dishonesty during treatment.
- Clients found therapist dishonesty acceptable for specific topics, such as expressing frustration.
- A stronger working alliance correlated with perceptions of less therapist dishonesty.
- Client demographics (age, gender, race, education) did not significantly impact these findings.
Conclusions:
- Clinical training should address the nuances and ethics of therapist dishonesty.
- Therapists need awareness of how their dishonesty, including tact, affects clients.
- Discussion of when less-than-complete honesty may be advisable is warranted.
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