Psychotherapy in the Trump Era

Since President Trump was elected, clinicians across the nation have expressed feeling overwhelmed by the ways in which our current political climate has impacted their work, for both therapists and clients alike.

Now, a new study conducted by psychologists Nili Solomonov and Jacques P. Barber has elucidated how therapists are experiencing the force of politics on their work with clients. In particular, they were interested in whether therapists disclosed their political orientations and values, and how politics relates to the therapeutic alliance (the relationship between therapist and client).

Solomon and Barber point out that since politics has a fundamental effect on our everyday lives, it’s curious that its influence on psychotherapy has received little to no attention in training programs in psychology. In the past, and for the most part, politics was rarely an issue in psychotherapy. Yet studies show that when therapists and patients share the same political orientation, the therapeutic outcomes are better for clients. This is perhaps especially true in our divided country.

So here’s what Solomon and Barber did. They recruited therapists from all U.S. states. In terms of political party, 62% were Democrats; 7% were Republican; 23% were independent; and 8% were other. Therapists then completed a survey in which they were asked about the effects of the current political climate on patients’ and therapists’ experiences in therapy and the therapeutic relationship.

Overall Results

A whopping 87% of therapists reported that they have spoken with their patients about politics. In terms of political party, 63% of therapists believed most of their patients were Democrat, 11% believed most were Republican, 6% Independent, 8% another affiliation, and 12% believed that most of their patients had no political preference.

The investigators also found that therapists who believed that most of their patients shared their political views were more likely to talk about politics in therapy.

Political Views and the Therapeutic Alliance

Therapists who reported having a higher percentage of patients who shared their political views tended to describe stronger therapeutic alliances with their patients. Therapists who believe they shared political views with most of their patients were also more likely to disclose their political views in session.

Moreover, 63% of therapists reported either implicitly or explicitly disclosing their political orientations, and 73% of therapists reported that most of their patients also disclosed their political views.

Therapists who felt that in-session political discussions were more positive were more likely to have stronger alliances with their patients.

Changes in In-Session Discussions of Socio-Political Topics

After the 2016 election, therapists who voted for Clinton observed significant increases in political discussions in the following areas:

• Insufficient/excessive checks and balances
• Distrust of the government
• Distrust of journalists and the media
• Education policies
• Environmental policies
• Distrust of specific ethnic groups
• Foreign policies
• Government regulations
• Immigration policies
• Social security, Medicaid, Medicare and other health benefits
• Military and defense policies Controversies regarding police behaviors Tax policies
• Policies that affect women

By contrast, therapists who voted for Trump reported that their patients did not discuss these topics significantly more.

Changes in In-Session Expression of Negative and Positive Emotions

Therapists were asked: “In your discussions with your patients about the Trump administration, how often did your patients express feeling the following [emotions]?”

Therapists who voted for Clinton reported an increase in patients’ negative emotions in the period before the election as well as decreases in positive emotions after the election. By contrast, therapists who voted for Trump saw the opposite: Their patients were reportedly more positive after the election.

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According to Solomon and Barber, and unsurprisingly, these findings suggest that patients and therapists who oppose the current administration may be more deeply affected by its actions.

The old saying goes that the personal is political — and the results of this study suggest that this sentiment indeed remains the case.