Your Therapist Helped You Survive a Challenging Time—Is It Okay to Give Them a Gift?

"Due to the high level of connection that often results from psychotherapy sessions, it’s not uncommon for a client to feel the urge to give a gift—small or large—to a therapist," says clinical psychologist Carla Marie Manly, PhD, author of Joy from Fear and Date Smart. In fact, she says, this gift-giving desire is often mutual—therapists may feel the desire to offer a client a token or two as well.

The American Psychological Association (APA) doesn't offer specific guidance on whether or not such gift-giving is acceptable, Dr. Manly notes; however, the APA code of ethics suggests that clinicians consider if accepting—or not accepting—the gift will potentially harm the client. "As the client’s well-being is the top priority, gift-giving practices are often viewed on a case-by-case basis," she says.

For example, Dr. Manly says, a client who shares a homegrown floral arrangement probably won't experience any harm due to the gift and may feel hurt if the gift is not accepted. "On the other hand, an expensive gift from a client could surely create problems in the therapeutic relationship," says Dr. Manly.

As a result, some clinicians take a firm 'no-gift' policy to avoid any confusion, says Dr. Manly. "Others assess the individual circumstances—including a client’s cultural gift-giving practices—when deciding if gift-giving is appropriate," she explains.

If you're wondering what the big deal is regarding purchased gifts, clinical psychologist Aimee Daramus, PsyD explains that expensive gifts can create an ethical bias in practitioners. They might inadvertently start to favor the gift-giver over other clients who don't or can't do the same. "Gifts can also make it seem like that the therapist is benefiting financially more than their contracts with clients or insurance companies allow," she says. "There's a risk of exploiting the client."

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And some gifts can conflict with therapy goals. For example, a practitioner wouldn't want to accept an overly personal present from a client who deals with boundary issues, nor would they want to accept anything purchased by someone who's having a manic episode, Dr. Daramus says. "Such a gift runs counter to the goals of therapy by encouraging and exploiting the very symptoms you’re in treatment for," she says.

In a similar vein, Dr. Daramus notes that buying your therapist a thank you gift might involve personal fears around self-acceptance. "You need and deserve to know that your therapist likes and respects you for yourself, not for the chocolate or Ray-Bans or whatever," says Dr. Daramus. In other words, even if you feel like your weekly ramblings are annoying, you shouldn't feel the need to bribe your therapist into liking you and if you do, that's potentially something you should discuss—with your therapist.

With all of the above in mind, if you still feel the (very understandable) urge to thank your therapist in some way, both mental health experts recommend checking in with them to see what they accept. If your offer is rejected, Dr. Daramus says it's important to know that your therapist is still registering your gratitude—in other words, it's the thought that counts. And if you're hurt by that rejection, Dr. Manly suggests reframing your perspective. "If your therapist happens to decline your offering, chalk it up to heartfelt concern to do what’s best for you and the therapeutic relationship," she says.

To avoid any such messiness or awkward moments while still showing your gratitude, Dr. Daramus recommends writing a card or note, which is always acceptable, or leaving a good review of their practice online. "Therapists love to know that our work is appreciated," she says.

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