Trump in the Therapy Room

Within days of the 2016 presidential election, Nili Solomonov, then a Ph.D. candidate in psychology at Adelphi, began to notice an unusual phenomenon. Some of the patients she was seeing in her clinical practice were disturbed by the election’s outcome, and they wanted to talk about it.

“There was a lot of talk about it in clinical circles, too,” Solomonov recalled. “My colleagues were observing the same thing. I thought, ‘There’s something important happening here and we have to address it.’”

Dr. Solomonov discussed the matter with Jacques P. Barber, Ph.D., dean of the Gordon F. Derner School of Psychology, and the two launched a research project that resulted in a paper: “Patients’ perspectives on political self-disclosure, the therapeutic alliance, and the infiltration of politics into the therapy room in the Trump era,” published in the May 2018 issue of the Journal of Clinical Psychology.

Dr. Barber and Dr. Solomonov believe their study is the first “quantitative psychotherapy research study that investigates the effects of the 2016 presidential election, Trump administration actions and the current political events on patients’ experiences in therapy.” They also think it explores
issues that are rarely encountered in the therapeutic process.

“Historically,” they wrote, “studies focusing on the effects of historical-political events on the therapy process have predominantly emerged following a national traumatic event, such as the September 11 terrorist attack on the World Trade Center in New York…or the aftermath of Hurricane Sandy.” What many news outlets called “post-election stress disorder” impacted the therapy process in a different way, creating a significant dilemma for many therapists (and, by extension, for their patients).

“Traditionally, psychotherapists have been reluctant to say much about themselves during counseling,” said Dr. Barber. “The idea was to keep the dialogue focused on the patient.” However, many of Dr. Solomonov’s patients, as well as many of her colleagues’ patients, wanted to know if their counselor’s political views diverged from their own. In turn, the counselors wondered, as Dr. Solomonov did, “What do I do if my patient has different views from my own?”

The primary aim of the research project became investigating two interrelated issues: patients’ perspectives on politics in the therapeutic space, and “what happens when the therapist and the patient have divergent and often polarized perspectives on a major political-historical event affecting their everyday lives.”

In collaboration with faculty in Adelphi’s Derner School, Dr. Solomonov and Dr. Barber developed a survey tool. Then, for nine months following the presidential inauguration, they recruited patients anonymously through online websites, listservs, social media and local community clinics nationwide. Although Dr. Barber and Dr. Solomonov applied highly conservative exclusion criteria to the 1,300 patient responses that were collected, they were still left with an impressive sample of 604.

The highly diverse sample included participants from every state, both major political parties and a range of ethnic and racial backgrounds. About two-thirds reported having political discussions with their therapists and nearly half said they would like to talk about politics more often in their sessions. Similarly, about two-thirds of participants said their therapists
had divulged their political leanings.

While Dr. Solomonov and Dr. Barber acknowledge the study’s limitations, they also stress that it has important clinical implications. “The evidence suggests that patients want to discuss politics in their sessions and may benefit from appropriate self-disclosure of their therapists’ political stances and open and genuine discussions about current sociopolitical topics,” they wrote. “Our results also indicate that in the face of an unstable and disruptive political climate, therapists are highly likely to disclose their political orientation, explicitly or implicitly.”

Dr. Barber and Dr. Solomonov presented their findings in late May 2018 at the Society for the Exploration of Psychotherapy Integration conference in New York. They are also working on a companion paper exploring the issue from the therapists’ perspective, which they expect to complete later this year.

» Learn more about Adelphi’s Clinical Psychology Ph.D. Program

Jacques Barber, Ph.D., is recognized internationally for his research into the process and outcomes of psychotherapy. Author of more than 180 refereed journal articles, he has written about depression, panic attacks, substance addiction and personality disorders. This year, he received the Distinguished Psychologist Award for Contributions to Psychology and Psychotherapy, a lifetime honor from Division 29: Society for the Advancement of Psychotherapy.

Nili Solomonov, Ph.D. ’18, received her degree from the Derner School of Psychology in May. In addition to her research on psychotherapy in the Trump era, she is working on the development of ratings for quality of continuing medical education, in conjunction with eight pharmaceutical companies.