Psychotherapy is often described as a form of conversation, but not every conversation qualifies as psychotherapy. A recent legal case, Chiles v. Salazar, brings this philosophical question into a real-world context. The case examines a Colorado law banning conversion therapy for minors. The therapist in question argues that psychotherapy is a form of protected speech, asserting that restricting it infringes on her First Amendment rights. The state, however, maintains that psychotherapy is a regulated medical procedure and that the law is a legitimate measure to prevent harm, particularly the kind of harm caused by conversion therapy.

The central idea is that psychotherapy is indeed a conversation—but it is not an ordinary conversation. It is a conversation with a constitutive aim, a guiding purpose that defines what psychotherapy is. This aim is to support the mental health of the client in line with the client’s own values and desires. Unlike everyday dialogue, the topics discussed in therapy serve the overarching goal of enabling the individual to cultivate the kind of mind they wish to have.

Conversion therapy, by contrast, actively opposes the client’s values or desires regarding their mind and therefore fails to fulfill the constitutive aim of psychotherapy. Such practices, although they may occur in licensed offices with formal structures, cannot be considered genuine psychotherapy because they lack the guiding purpose central to therapeutic work.

This framework allows psychotherapists a degree of freedom in conversation, yet it is bounded by the client’s goals. Even interventions that seem helpful, such as promoting healthy habits, mindfulness, career choices, or new relationships, must align with the client’s own mental health aspirations. The constitutive aim of psychotherapy provides both flexibility and clear constraints.

Ultimately, recognizing psychotherapy as speech with a constitutive aim clarifies why the state is justified in prohibiting harmful practices like conversion therapy while also guiding ethical considerations for permissible therapeutic influence.