In the moment, a clinician’s first impulse may be to correct mental health misinformation or educate a patient about a term they’re misusing—but that’s not always a good idea, Caldwell-Harvey said.
“I think about the power we hold as psychologists, and correcting somebody can be really off-putting and almost feel like shaming,” she said. “That’s definitely not what we want to do.”
Instead, here are a few things for clinicians to consider if they encounter inaccurate beliefs about mental health in therapy.
Balance the competing goals of therapy
When a patient mentions a term like “narcissism” during a session, Caldwell-Harvey weighs goals that may sometimes be in conflict, including delivering psychoeducation and building a strong therapeutic relationship, as she decides how to respond. Often, she’ll ask a probing question (“What makes you say your mother is a narcissist?”) and make a mental note for later. She might decide the point is worth circling back to, for instance if the misunderstanding is causing harm for the patient or making it hard for them to align their thoughts and behaviors.
“There’s really a delicate dance that has to be done in therapy with deciding when it’s appropriate to counter and re-educate clients on the language that they’re using,” she said.
Help patients expand their lexicon
Palmer says providing accurate information doesn’t necessarily require telling a patient they’re wrong. “Trauma” might mean one thing in a therapeutic context, and something different in popular culture.
“You can help them see the difference between the technical usage and the popular usage, and then leave space for the popular usage,” he said.
Palmer also reminds patients about alternative, nonclinical ways to call out bad behavior. (Your boss might be a jerk, but that does not necessarily mean they have a personality disorder.) The same goes for self-diagnoses: A tough experience may not be “trauma,” but it can still have meaning with a different label.
Approach conversations with empathy
Keep in mind that patients who seek out mental health information—accurate or not—are generally doing so because they want to improve their lives and relationships.
“I don’t see this as malicious in any way,” Piacentini said. “I see this as people really trying to understand themselves and others in a world that may be difficult for them to navigate.”
A tool known as the Empathetic Refutational Interview (ERI), developed by psychologists to address vaccine misinformation in doctor-patient interactions, might also be useful in therapeutic contexts, said co-creator Philipp Schmid, PhD, an assistant professor of health communication at Radboud University in Nijmegen, The Netherlands.
In the ERI approach, a provider asks open-ended questions to learn about a patient’s concerns and misperceptions (for example: reports that CBT is dangerous), then affirms them. That might sound something like: “We all have fears when we encounter new treatments and that’s completely normal. When it comes to CBT, I have 30 years of experience. Can I share some of what I know about this treatment with you?” The provider then debunks the misinformation and shares accurate information in its place (Health Psychology, Vol. 43, No. 6, 2024).
“In a one-on-one situation, we don’t typically recommend rebutting misinformation directly, because that usually increases reactance to anything that comes after it,” Schmid said.
Get familiar with the content your patients consume
Caldwell-Harvey said it helps to know what ideas patients are exposed to through popular psychology books, celebrity memoirs, podcasts, and wellness accounts on social media. While the intention is rarely to cause harm, influential people can get psychological concepts wrong, “and there are no checks and balances,” she said. “It could just go viral, and that’s that.”
Create content or provide advice to those who do
One antidote is for psychologists to position themselves more deliberately as co-editors and advisers for authors and creators sharing research-backed messages around mental health.
“What I would love to see is people consulting with a psychologist if they are infusing psychological concepts into books about their lives or wellness content,” Caldwell-Harvey said.
Clinicians can also create their own content or earmark credible sources of information about mental health, then refer the patient there if inaccuracies come up during a session.
“The fact that influencers are so vocal means that the rest of us have an obligation to get good information out there,” Lorenzo-Luaces said. “As psychologists, it’s important to think about whether we have an obligation to disseminate real information in areas where we have expertise.”
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