"If the patient describes a nearly unbearable work situation, the therapist will tend to focus on the nature of the patient’s response to the situation, implicitly treating the situation itself as unchangeable, a fact of life. But an untenable or unjust environment is not always just a fact of life, and therapists need to consider how to talk about that explicitly.
"This is, in ways, an old quandary in psychotherapy. Should therapy strive to help a patient adjust, or to help prepare him to change the world around him? Is the patient’s internal world skewed? Or is it the so-called real world that has gone awry? Usually, it’s some combination of the two, and a good psychotherapist, I think, will help the patient navigate between those two extremes.
"When therapists make the dialogue only about their patient’s life narrative, without including a frank discussion of social and economic hardships, they risk reducing psychotherapy to a tool of social control. That might sound overly polemical, but consider a government proposal in Britain last year to put psychotherapists in jobs centers to offer counseling for the unemployed, with the unemployed possibly facing a reduction in benefits if they declined treatment. In such a situation, therapy could easily become an arm of the state, seeking to “cure” listlessness or a reluctance to work, potentially limiting social and political awareness among those it is intended to serve. "
And of course, the government has indeed put therapists into job centres and many
therapists have applied for and taken those jobs.
