Thoughts on the Relationship Between Cleavage and Professional Counseling and Psychotherapy

The following is a short discussion about cleavage in counseling and psychotherapy.  We’re not especially trying to be provocative (which is one reason why no photo accompanies this blog post) and so we’re interested in your thoughts on this short excerpt BEFORE we include it in the 5th edition of our Clinical Interviewing text.

[Excerpt starts here] For the first time ever in a textbook (and we’ve been writing them since 1993), we’ve decided to include a discussion on cleavage. Of course, this makes us feel exceptionally old, but we hope it also might reflect wisdom and perspective that comes with aging. 

In recent years we’ve noticed a greater tendency for female counseling and psychology students (especially younger females) to dress in ways that can be viewed as somewhat sexual. This includes, but is not limited to low necklines that show a considerable amount of cleavage. This issue was discussed on a series of postings on the Counselor Education and Supervision listserv which includes primarily participants who teach in master’s and doctoral programs in counseling. Most of the postings included some portion of the following themes.

  • Female (and male) students have the right to express themselves via how they dress
  • Commenting on how women dress and making specific recommendations may be viewed as sexist or inappropriately limiting
  • It is true that women should be able to dress any way they want
  • It is also true that specific agencies and institutions have the right to establish dress codes or otherwise dictate how their paid employees and volunteers dress
  • Despite egalitarian and feminist efforts to free women from the shackles of a patriarchal society, how women dress is still interpreted as having certain socially constructed messages that often, but not always, pertain to sex and sexuality
  • Although efforts to change socially constructed ideas about women dressing “sexy” can include activities like campus “slut-walks,” the clinical interview is probably not the appropriate venue for initiating a discourse on social and feminist change
  • For better or worse, it’s a fact that both middle-school males and middle-aged men (and many “populations” in between) are likely to be distracted—and their ability to profit from a counseling experience may be compromised—if they’re offered an opportunity for a close up view of their therapist’s breasts
  • At the very least, excessive cleavage (please don’t ask us to define this phrase) is less likely to contribute to positive therapy outcomes and more likely to stimulate sexual fantasies—which we believe is probably contrary to the goals of most therapists
  • It may be useful to have young women watch themselves on video from the viewpoint of a client (of either sex) that might feel attracted to them and then discuss how to manage sexual attraction that might occur during therapy

It’s obvious that when it comes to clinical interviewers showing cleavage, we don’t have all the perfect answers. Guidelines depend, in part, on interview setting and specific client populations. At the very least, we recommend that you take time to think about this issue and hope you might also consider discussing cleavage issuesJ with your class or your supervisor.

Info on Clinical Interviewing – the text and videos – is at:


3 thoughts on “Thoughts on the Relationship Between Cleavage and Professional Counseling and Psychotherapy”

  1. John, as you often are willing to do, you bring to light a topic that bears heavy potential for backlash. YET, as so many “avoided” topics, you address a critically important topic in this post: our responsibility as clinicians (and as clinical students) to be thoughtful, insightful and self-examining about the messages we express — both verbal & non-verbal. This is a crucial discussion of transference & counter-transference, and of social-emotional boundaries, that we may avoid (as supervisors) to keep from appearing judgmental or (OH NO!) harassing. BRAVO to you, John!
    I’ll add a few thoughts from my own experience. First, my graduate school internship at the VA Medical Center (I was 27) brought me into a storm of awareness of how clients may respond to a young female social worker, and the potential for them to consciously or unconsciously sexualize the relationship. One’s sexuality can be a powerful element in relationship, and it is the social worker’s (counselor’s, psychologist’s, etc.) responsibility to be cognizant of both the client’s inherent vulnerability in the relationship, and the environ & decorum that sets the professional’s tone. An initial session includes expressed role induction. If I were to wear cleavage revealing clothing, then I am choosing to send a message about how this relationship “works,” including my own need to be found appealing. It would send a mixed message to the client.
    In a similar vein, you blogged about requesting female students to write about the social expectations of women. You posted a long & thoughtful narrative written by a student about the conflicted messages we (as women) receive from our social environs. We are trained to consider & be thoughtful of the messages we send as clinicians — that is, after all, OUR JOB!
    When I served as the Clinical Director of three therapeutic group homes, a young woman applied for a position as a behavioral health tech (immediate child-care staff). Her present work situation was as a “dancer” in a two-drink minimum establishment. She arrived in a short SHORT skirt, heels, makeup, etc. While I did not hire her at that interview, I praised her effort to shift her vocational aspirations to something that she believed had intrinsic meaning, while I also encouraged her to reflect on how her outfit sent a sexualized message to the little girls in our care. People were surprised that I was frank with her, but what is the alternative? To only focus on her lack of experience with treatment, when her presentation made such a negative impact on her interview? It would be a disservice to her, in her personal/professional aspirations, and to our own profession as a whole, to pretend that wasn’t an issue front & center.
    So YES JOHN! Keep talking about the things that make us uncomfortable BECAUSE WE NEED TO OPEN THESE DISCUSSIONS!

    1. Hey Margaret.

      It’s great to hear from you and thanks for adding your thoughts. I can imagine you grappling with this issue at age 27 and then continuing to address the issue by being frank and direct with dancers who have other professional aspirations. GO MARGARET! I’m so glad to have met you back in 1982:)!

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