• At Christmas it's customary to give gifts to those people in our lives that we appreciate – but what about your therapist?

  • Therapist Rachel Farhi explores the rules and boundaries of the unique therapist-client relationship

As we approach the time of year when it is customary to give seasonal gifts or cards to those who are part of our lives, there is one person whom you might be scratching your head to decide if it would be the right thing to do – your therapist.

As relationships go, you and your therapist are probably in a pretty intense dialogue and within the highs and lows of therapy, there may be moments when you reflect that of all the people you meet with, your therapist is someone whose presence is reliable, consistent and regular. Surely that’s something worth appreciating?

The whole topic of clients and gifts came up in my training to be a person-centred counsellor and I don’t recall a definitive yes or no to the idea. In some therapeutic philosophies, giving and receiving gifts is seen as symbolic and representative of a power-exchange (e.g.: what is my client really trying to say by giving me a box of chocolates?) which can upset the dynamic of therapy, or which could lead to an exploration of the unconscious processes at work. Within the person-centred tribe, though, because we are person-centred and very aware of ourselves and the impact of the other in the relationship, the approach may be more flexible.

Where there is a communal awareness of an upcoming holiday like Christmas, it may be seen as an appropriate gesture of acknowledgement to include your therapist in your gifting. Many people give small gifts, like sweets, to their GPs or hairdresser or other people who provide personal services throughout the year, so why not also to their therapist?

I think it depends very much on your own intentions and on the type of gift. Ethically, as therapists we are not permitted to accept cash gifts or high value items, however much you as a client may wish to show your appreciation for our work. It could cause problems for us professionally if a client offered such a gift and we were to accept it. What is it that you are trying to say to your therapist when you give her a gift? And if you are aware of what that message is, I think your therapist would see it as a great success of your work together if you were able to articulate that feeling directly to her.

I once received a very expensive Christmas hamper from a client. It was delivered by a courier with a very nice note, and I had no way of sending back the gift. It caused me quite a quandary because I could not accept it for my own use and yet it was filled with time-sensitive foodstuffs. I also had to declare to my clinical supervisor what had happened, and he questioned me quite thoroughly on why I had been singled out for this and if I could use this knowledge in my therapeutic work with the client. He also encouraged me to address the issue directly with my client in an appropriate and therapeutic way. It was a difficult conversation to have – even therapists sometimes find some conversations difficult – but an essential one for the awareness and growth of the client and for me. Something positive did come out of the experience and I managed to donate the food items through a food-sharing app, so nothing was wasted.

So, what can you do to show your therapist that you appreciate them? I think a card is always welcome and if you feel so inclined, a small gift like a plant or a candle may be appreciated and useful for the therapy room – a gift not only for your therapist but one which can be enjoyed by all the clients for whom that space is a special and, sometimes, sacred space.

Rachel Farhi is a verified Welldoing therapist in South East London and online

Further reading

8 tips for healthy boundaries at Christmas

This is why the therapeutic relationship is so different

Why are therapists in therapy?

A letter to my therapist at Christmas