When Clients Are Untruthful: Implications for the Therapeutic Alliance, Case Conceptualization, and Intervention

Abstract

Therapists endeavor to be genuine and trustworthy with clients, thus facilitating the establishment and maintenance of a positive therapeutic relationship. Unfortunately, clients sometimes knowingly give false or misleading information, maintain counter therapeutic hidden agendas, and deliberately obscure clinically relevant facts. Such factors likely will obstruct the process of case conceptualization, strain the therapeutic relationship, and result in disagreements about proper interventions. We discuss some of the telltale signs of clients’ untruthfulness, and suggest ways in such cases for therapists to draw upon clients’ behaviors in session to construct useful case formulations. Additionally, we describe a number of interventions that increase the chances of pursuing healthy, appropriate, therapeutic goals, irrespective of clients’ degree of sincerity.