How Psychotherapists Support Client Decisions Without Taking Over

When a client asks me to tell them what to do, I treat it as useful information. Often they are tired, overwhelmed or afraid of choosing wrong, and the question is really a request for support. I try to acknowledge that first. Then I'm happy to offer what I can: options, possible outcomes, and my honest clinical view when it matters, especially around safety or medical questions. After that, I hand the decision back to them, because they are the one who will live with it.

One phrase I use: "I can share what I'm seeing, and you know your life best. What matters most to you here?"

It keeps the conversation moving, because I'm not leaving them stuck. It also keeps the choice with the client by bringing the focus back to their values, not my preferences.

Early in my career, a teenager with severe anxiety asked me for help with panic attacks. I offered a breathing technique, but he told me to stop trying to fix him. I realized that even well-intended advice can feel like taking over a person's choices. Now I try to make room for the client's own preferences. I might ask, "Would it help to look at a few options together, and you can decide what feels right?" It invites the client to consider next steps without telling them what to choose. Their answer gives us a natural place to continue the conversation.

Clients often ask for advice on what they should do in session, as a clinician I want to normalize this request. I do this by validating their desire to want to have an answer and the belief that a professional could provide them with a more correct answer than the one they may find for themselves. I will often give client's the example that if I were to answer the question now, what will happen the next time they struggle with making a decision, an urgent, one where I am not available? Ultimately, most client's want to be able to rely on themselves and trust themselves to right by them. Cultivating this self trust is hard and risky for most people and having someone to blame (aka the therapist in this case) for the possible wrong decision is one way of self-soothing/self-protecting.

Patients in addiction treatment ask this constantly: "Just tell me what to do. Should I tell my boss? Should I leave him? Should I never drink again or just cut down?" It is tempting to answer, especially when you can see a clear risk. But a decision I make for them is a decision they can drop the moment it gets hard.

The phrase I use most is: "I can tell you what I've seen help other people in a similar situation, and then you tell me which of it fits your life. Would that be useful?" It keeps me genuinely helpful, because I do share knowledge and experience, while the choice stays theirs. Asking permission first matters: people listen very differently to information they have agreed to hear.

Then I hand the question back: "Of these options, which one feels most possible for you this week?" Not the best option in theory, but the most possible one. That small shift keeps the conversation moving and turns advice into a plan the patient actually owns.

Where safety is involved, I am direct. If someone plans to stop heavy drinking abruptly at home, I say clearly that it can be dangerous. Supporting autonomy does not mean staying silent about risk.

When a client asks "what should I do?" I will help them talk all about the situation. As they talk this through and we have considered options and feelings and conditions, they most often have opinions about what's possible, what's optimal. If they still ask "what should I do," I will first ask "what is your thinking?" or "what is your best guess" and have them tell me. This helps them develop initiative in general. And if they ask yet again and if I think it's helpful, I might contribute something of my experience with their issue.

It's common for clients to finish telling a story of struggle and ask point blank, "So what do you think I should do?" They usually ask it with the recognition that the question itself is leading them astray from a more effective answer, which is something they come to within themselves. Yet it's hard to resist the hope that there is some concrete "right answer" that's going to make the uncomfortable feelings of uncertainty go away.

I think the question, "What should I do?" reflects an effort to seek certainty and control in a moment where following the unknown is probably the best and only path. What I have seen is that most clients recognize that the purpose of therapy isn't for getting "all the answers" about how to live their life from their therapist. But when confronted by uncertainty, many people feel anxiety, fear, panic and overwhelm, and it's common to try and grasp onto concrete answers to regain a sense of stability and control.

When a client asks me to tell them what they should do, it's a signal for me to usher their attention back to their emotions about the situation. Our emotional reactions are rich landscapes of information about our perspectives, beliefs (conscious and unconscious), biases, judgments, hopes, fears, etc. Likely there is confusion coming from a lack of clarity within oneself, and seeking someone else's answer doesn't help get that clarity. In fact, it might cause further confusion.

Here are a few phrases I might say when someone is struggling with a decision and asks me what I think they should do:

"I think you are hoping there is a concrete right and wrong to this situation, and I can tell you honestly that there isn't. But what I want for you is to come to a conclusion that feels most right to you, and I think the information we need is within your reaction to what happened."

"I don't think I or anyone else can make this decision for you. But I do trust that the answer will emerge the more we explore this issue."

"I wish I could provide some certainty in this situation, but I don't think certainty exists here. What I can tell you is that there is something in your perspective causing you to feel conflicted, and I'm more interested in what those parts of you have to say."

The intention behind these phrases is to gently steer their attention back to themselves and back to the discomfort of their own confusion, while also acknowledging the humanness within their yearning for a simple solution.

Wow that's a tough decision. I'm not sure what I would do. I would then guide my client to sit in the reality of accepting each side of the decision. When you fully embrace this side, what are you noticing in your body and your breath? Oh, some tension in your shoulders. And if that tension in your shoulders could speak- what might it say? Now, really embody the other side. What do you notice now in your body? I would ask- what's the difference between sitting in both sides? Additionally, I might explore the pros and cons of each side.

Working with couples, I am frequently approached by one of them to help reach a decision. But it is crucial that they understand I am not there to make decisions. If I choose option A for one of them, and option B for the other, then I am taking a side in the decision, thereby benefitting one of them at the cost of the relationship between the two. Instead, I encourage them to talk through their choices aloud with one another, so I can hear what is important to them most, just as they can hear what the other cares about. The key question I ask is: 'What choices will work best for both of you, and which would you like to talk about first?' This way they can preserve the decision-making for themselves, along with the decision-making process from then onwards.

I'm Dr. Wildaliz Caro, PhD, and I'm a Medical Contributor at Aura Recovery Center. We're located in Scottsville, Kentucky. https://aurarecoverycenter.com/contributors/wildaliz-caro/ https://aurarecoverycenter.com

A client's question could be a sign of uncertainty, fear of regret, conflicting values, or a search for reassurance. Follow-up questions can help clients make overwhelming decisions more feasible. One question I might ask is, "What matters most to you in making this decision?"

Educate the client about the proposed alternative, so that they understand why it is being proposed. And, when therapists think that what a client requests will not prove helpful, they can raise that concern with them. At times, the meanings people give to a situation may not be fully formulated but rather will have to be drawn out by the therapist. You can have things that you'd like the client to work on, but ultimately it has to be up to them. Otherwise, you're basically trying to force an outcome. Instead, it's far better to communicate in a way that gives the other person the freedom to make their own decision. Taking ownership of a situation gets away from the blame game and focuses more on what you have to do to fix it. Of course, some people may need urgent emergency help if they are at risk of hurting themselves or others. Emergency response measures are recommended in times of immediate danger.

When a client asks me to tell them what to do, I first validate how overwhelming the decision feels and how natural it is to look outside themselves for an answer. I then gently remind them that I believe they have the wisdom to clarify their own needs and make a choice that fits their life. From there, I invite them to explore what they are thinking and feeling about each option, so the decision comes from their own values rather than from me. For example, I might say "It makes sense that you'd want someone to give you the answer. This is a lot to carry. I trust that you know more about what you need than you might feel right now. Let's slow down and look at what each option brings up for you."

When a client asks me for direct advice, I am quick to remind them that our purpose in therapy is to explore any and all relevant ideas and concepts. I tell my clients that they are the Pilot of their journey. My role as therapist makes me their Co-pilot and Navigator, which allows me to guide their consideration of thoughts and emotions while holding up a metaphorical mirror so they can see themselves with more clarity. I often insert the words “for now” or “at this time” when my clients are overwhelmed, as a reminder that changes of circumstance are inevitable, often unexpected—and come with options and choices.