50/50


This week we will look at the movie 50/50. Briefly, this is a movie that follows the protagonist Adam (played by Joseph Gordon-Levitt) through his diagnosis and fight with cancer. He finds out in the beginning of the film that he has a rare form of cancer in his spine. In the film the audience meets his social support system comprised of his best friend Kyle (played by Seth Rogan), his parents, and his therapist Katherine (played by Anna Kendrick). Throughout his medical treatment he sees Katherine who is a student working towards her Ph.D in clinical psychology.

This movie has an interesting take on therapy as a whole for two main reasons. The first, is that Katherine is a student therapist. She is seeing Adam most likely for an internship or working towards her clinical hours. Student therapists, or the process to become a psychologist is not depicted in many films. The second reason is that Adam has no diagnosed pathology. He is not seeing her for depression or schizophrenia, he is seeing her because he is going through a major life event and is having difficulty coping and adjusting. Often times there is stigma associated with going to a psychologist that something is "wrong" or someone "has something". It was a bit refreshing to see that Adam could see Katherine under different circumstances.

During Adam and Katherine's therapeutic relationship the audience learns a lot about the two characters. The first time Adam meets Katherine it is a bit awkward. Katherine looks extremely stiff and uncomfortable. It comes out during the session that Adam is Katherine's third client. Ever. He tries to shrug this information off, but it becomes apparent through some of his statements that he is a little worried. From a clinical perspective self-disclosure can be a positive and a negative. One needs to know their client and know what information they are disclosing. In this case it worked, but it was a major risk that could have backfired. For the patient's comfort it might have been wise to disclose that she was a student, not a licensed psychologist, and leave the number out of it.

Katherine being a student also lead to her seeking feedback from Adam about certain techniques. Katherine came off quite well read and well versed in empirically supported treatments, which all psychologists should be. However, she was not so great at making clients feel comfortable. There are several scenes in the film where she attempts to place her hand on Adams arm because she read that patients often found it comforting. She is too stiff and it makes Adam feel awkward. The patients are there for therapy, not to validate her skills. It is understandable that a young therapist could be nervous, but she should have been asking about how therapy was going, or checking in regarding treatment, not her personal skills.

Lastly, the therapeutic relationship got into dangerous territory. Katherine did several things that are considered unethical and within bad practice for psychologists. It should have been the first thing she learned about in school. There were several infractions she committed. First, she gives Adam a ride home. There is controversy about this topic among psychologists and some do it, some do not. However, she took the ride home too far by self disclosing about her ex-boyfriend and letting Adam help her clean the garbage out of her car. One should never be too personal with their clients. Katherine also gave Adam her personal cell phone number. Many psychologists have a separate phone for clients to call them on so they do no accidentally get their phone stolen, or mix clients and friends. Adam calls her late at night when he has a bit of a breakdown before his surgery and the discussion is extremely personal on both ends. This also crosses an ethical line when it comes to personal relationships with clients. At the end of the film Katherine and Adam end up dating. The APA code of ethics states that a therapist can be personally or sexually involved with a client after two years if no harm comes to the client. Many psychologists make it a point to never be personally involved with a client. Katherine definitely did not wait two years. This is a major ethical violation and could have cost her her clinical licence.

Overall, The topics of student's conducting therapy, and Adam not having a diagnosable mental illness are interesting. However, the film could have done much more to show them in a more positive light. Katherine breaks way too many rules and makes students look incompetent and unprofessional. Ideally, in real life she would have a supervisor who was watching her more closely and would warn her against these behaviors.