The other day, I scrolled across a social media clip where a creator jokingly referred to their therapist as their “paid friend.” While I thought this was pretty funny in the context of their joking, it got me thinking: How often do we truly understand the distinction between a therapeutic relationship and a friendship? 

It’s easy to see why this confusion happens. Both therapy and friendship involve open communication, active listening, and emotional support. However, critical differences exist, and blurring these lines can have detrimental effects. 

Fortunately, ethical guidelines and professional standards are paramount in therapy. Therapists undergo rigorous training, and licensing bodies enforce strict rules regarding dual relationships and boundary management. This ensures client safety and promotes a healthy therapeutic environment. 

This blog explores how friendship and therapy are similar and dissimilar and how you can use this knowledge to get the most out of your therapy time and protect yourself from an ethical breach.

How the Confusion Between Therapy and Friendship Arises

It’s easy to understand why you might find yourself confused. At the heart of it, we all have a fundamental human need for connection. Therapy provides a space where you can have deep, meaningful conversations, and it’s understandable for this to sometimes feel like a close personal bond.

Also, it's common to think of therapy as simply "talking about your problems," like you would with a friend, but it's important to remember that therapy is rooted in evidence-based practices, and your therapist has undergone specialized training to guide you through a structured approach. 

Additionally, unconscious needs and projections can come into play, where you may be seeking to fulfill unmet emotional needs through the therapeutic relationship. Talking about this with a skilled therapist can help you make sense of these feelings and honor the underlying needs associated with them. 

Understanding the Core Differences Between Therapy and Friendship

Simply put, therapy is a professional service aimed at improving your mental health through proven methods, clinical expertise, and evidence-based techniques. It’s distinct from personal friendship; instead, the relationship we aim to build is the therapeutic alliance—a meaningful relationship built on trust and rapport—that is essential for effective treatment.

Friendship, on the other hand, is a mutually reciprocal relationship built on shared experiences and emotional exchange. Friendships often involve emotional intimacy, trust, and common connection.

What Therapy Should and Should Not Feel Like: 

While we can see how therapy and friendship have many similar qualities, boundaries and professionalism remain at the forefront of a therapeutic alliance. Here are some guidelines for appropriate clinical care.

A good therapeutic relationship should feel supportive and safe.

You Should Feel:

• Empowered: You should feel empowered to participate actively in your therapy and contribute to your goals and treatment planning. 
• Understood: You should feel that your therapist genuinely understands your perspective and experiences. 
• Validated: You should feel that your emotions and experiences are validated and acknowledged. 
• Hopeful: You should feel a sense of hope that therapy can help you achieve your goals, and you should feel a sense that you are making progress toward your goals (even though it may be slow progress at times). 
• Autonomous: You should feel that your therapist respects your autonomy and right to make your own decisions. Therapy is not about your therapist “giving you advice”, it’s about helping your make your own decisions. 
• Free from Coercion: There should be no pressure, guilting, or coercion from the therapist to behave a certain way or make certain decisions. 
• Respected: You should feel that your boundaries are being respected at all times and that there is always a sense of understanding on the part of your therapist. 

You Should NOT Feel:

• Unsafe: You should never feel physically or emotionally unsafe in the therapy environment. 
• Confused about Boundaries: You should never be confused about the therapist's role in your life or the boundaries of the relationship. 
• Disrespected: You should never feel that your opinion, experiences, or boundaries are being disrespected. 
• Judged: You should never feel judged or criticized for sharing your thoughts or feelings. 
• Dismissed: You should never feel that your concerns or experiences are being dismissed or minimized.
• Pressured or Coerced: You should never feel that your therapist is pressuring you into making decisions or taking actions that you are not comfortable with.
• Exploited: You should never feel exploited financially, emotionally, or in any other way.
• The Therapist is Oversharing: You should never feel like the therapist is inappropriately sharing personal information. 
• That You Are Being Given Unsolicited Advice: The therapist should be helping you find your solutions, not telling you what to do. 
• That Your Time is Not Valued: Your time with your therapist should feel helpful and productive.
• That The Therapist Is Gossiping or Engaging In Inappropriate Conversation: Your therapy time should be focused on you and your therapeutic goals. 
• That the Therapist is Not Maintaining Boundaries or Repairing Boundary Breaches: If there is a problem, the therapist should be able to address it with you professionally and appropriately.

According to the National Library of Medicine NIH, “Effective treatment boundaries do not create walls that separate the therapist from the patient. Instead, they define a fluctuating, reasonably neutral, safe space that enables the dynamic, psychological interaction between therapist and patient to unfold.”

Overall, therapy should never feel like a personal exchange of gossip or unsolicited advice. Therapists provide psychoeducation and clinical expertise, empowering clients to make informed and empowered decisions for themselves. Strong professional boundaries are essential, and therapists must be equipped to repair any breaches effectively.

Read more about finding the right therapist in this blog, How to Choose Your Provider: Finding the Right Support for Your Mental Health Journey, or learn What to Do if a Therapist Isn’t a Good Fit here. 

Key Differences to Remember:

• Professional Expertise: Therapists possess specialized training in mental health and therapeutic techniques and provide these skills and services to you through the therapeutic alliance.
• Ethical Standards: Unlike in friendships, therapists adhere to strict ethical guidelines, including confidentiality and boundary management.
• Lack of Reciprocity: Therapy is focused solely on the client's wellbeing, not mutual emotional exchange. The client should never feel obligated to provide emotional support to the therapist. 
• Objectivity: Therapists provide an unbiased perspective, unlike friends who may offer personal opinions.
• Boundary Maintenance: Therapists maintain clear professional boundaries to ensure the therapeutic relationship remains focused on the client's needs.

Final Thoughts and Resources:

As therapists, we often feel a strong connection with our clients, and you need to know that your presence and vulnerability are valued. However, understanding the distinction between therapy and friendship is crucial for a successful therapeutic journey. While therapists may genuinely resonate with their clients, it's paramount to remember that the relationship remains professional because your mental health and therapeutic goals are always the priority. 

Therapists are responsible for managing their own emotions and ensuring clear boundaries, prioritizing your wellbeing above all else. This allows you to fully engage in the therapeutic process, knowing your safety and progress are at the forefront.

Important Note: If you feel that you have been treated unethically by a therapist, you may contact your state’s licensing board to make a complaint. Reports made to the state licensing board are taken very seriously and can result in disciplinary actions such as temporary licensure suspension or permanent revocation.

For more tips on How to Get the Most Out of Therapy, click here.