Friendship Cannot Replace Therapy

More people are taking part in psychotherapy than ever before. I find this encouraging, not only as a therapist but also as a human. When growth, exploration, and healing are prioritized, we all benefit. Psychotherapy gives a place for that.

With therapy now accessible both in person and remotely, with most insurance plans providing at least some mental health coverage, and the general de-stigmatization of counseling, the role of psychotherapy seems to be changing. For decades, therapists have been taught the differentiation between friendship and psychotherapy: It is a friendly relationship. We do care about the individuals we work with. If we crossed a line into friendship, it would likely damage the therapeutic relationship. It's also become more taboo to make your friend your de facto therapist. While friends often genuinely desire to help, they may not have the tools to do so, and it could complicate the relationship.

Still, can a therapist relate to a client in a way that is friend-ly? Of course. And can a friend provide emotional support? Yes. The distinction between a friend and a therapist is a bit less clear for a psychotherapist than for, say, a physical therapist. Yet, there are some important differences.

Your Therapist: Should Have an Assessment and Treatment Plan for You

While a therapist can be casual, the process of psychotherapy is typically quite intentional. It is traditional for a psychotherapist to begin the assessment process in the first session working with you to explore what has brought you to therapy and to create a case conceptualization. From there, a treatment plan is drawn up. This is a roadmap of goals, objectives, and interventions to help you reach those goals. Not all therapists will provide a formal written plan to you; however, your therapist should have one in mind.

Your Friend: If Your Friend Has a Treatment Plan for You, You Might Want to Look Into That

Friendship is bi-directional. It is not a service. While friends can certainly help each other, there should be balance. Even if your friend is a psychotherapist, they should not be meeting with you weekly to provide psychotherapy. It muddies up the friendship. Your friend knows you; you are part of their social circle and they are part of yours.

Your Therapist: Is Probably Billing You or Your Insurance

Psychotherapy is a transaction. It is a service. Psychotherapy is one of the only relationships focused entirely on you. Your therapist will also only meet with you at designated appointments or coaching calls. They aren't involved in your other relationships and are bound by confidentiality. This is a place where you can talk about many things without fear of it affecting your other relationships.

Your Friend: Shouldn't Be Sending You a Bill

Friendship should not be a single transaction. If all you do with a friend is give them a ride, you aren't their friend, you are their taxi driver. Friendship is multidimensional, involving any combination of several interactions. It also is a two-way street.

Your Therapist: Went to School to Learn Their Craft

While there is some variation, most therapists will hold at least a master's degree. That means six to seven years of schooling. After getting that schooling, most states require therapists to practice for two years "under supervision" where they meet with another therapist to guide them as they prepare for independent practice. Even after licensure, therapists complete continuing education each year. Psychotherapy is a skilled profession.

Your Friend: Might Go to School With You

Typically, a therapeutic relationship takes place within the confines of a designated setting for a purpose; your emotional and relational well-being. A friendship is much more versatile. You may share memories with your friend ranging from that time you pulled them out of the mud when they got their car stuck in Farmer Smith's field to that time you both stayed up all night on the phone, and everything in between. This is irreplaceable.

Your Therapist: Might Talk to You About Your Goals or an Identified Problem

People typically come to therapy with an identified goal or difficulty such as working through grief or treatment of a mental health condition. Psychotherapy conversations usually center around these treatment goals. It's unlikely that your therapist will come to you with their problems, as this would damage the focus of the relationship.

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Your Friend: Might Talk to You About Their Achievements and Problems, and Ask About Yours

Friends provide mutual support. There may be times when you are there for your friend, and times your friend is there for you. Conversations between friends can reach into a world of topics. You get to share life. There's something meaningful about that.

In Closing

Therapy is not friendship, and friendship is not therapy. The reality is that many of us need both. One cannot replace the other.

To find a therapist, please visit the Psychology Today Therapy Directory.