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In Allannah Furlong's review (2003) of my book Negotiating Consent in Psychotherapy (1998), she continually confounds what my interview subjects thought with what I think.
Furlong notes, as though it were a criticism of my work, that some of the therapists described in the book told new patients of therapist characteristics (e.g., gender, school of therapy) that they thought would be most suitable for them. Furlong says, “The paternalistic nature of these interventions does not seem to have been recognized by O'Neill or his participants” (p. 575).
I agree that this “paternalism” was not recognized by the participants; however, I wonder what makes Furlong think it was not recognized by me? She seems to have wanted me to make judgments on everything my participants said and did—a very paternalistic prescription in itself. I said at the outset of the book that it was not intended to be “an exposé of bad practice” (p. 6).
I have long experience with therapeutic paternalism, going back to my own clinical training, one component of which was six-session crisis psychotherapy (one of those passing fads to which Furlong refers with appropriate skepticism).
We were to tell clients that six sessions was the maximum allowed; then they would have to get on with their lives without us. The theory was that since meaningful therapy starts when the end is in sight, the therapist should put the end in sight immediately. Our supervisor for this component, who specialized in the six-session format, told us that crises normally resolve themselves—with or without intervention—in about six weeks. We asked why, in that case, we were intervening. He said the purpose was to use the client's crisis to effect basic personality change so that (among other things) the client would be less vulnerable to such problems in the future.
As interns, we were advised not to tell clients about our deeper goals, but to seem to work on the crisis for which the client sought help. The su