Very Bad Therapy

Your therapist is having a bad day. Will this impact the quality of counseling? If you ask the therapist, probably not. But what does the research suggest about clients' perceptions of therapists who are riding the struggle bus? Today's guest Allison describes her increasingly bizarre experience with a clinician who wasn't quite able to bring her 'A' game to the counseling room.

Do you have a story of very bad therapy? Send us a message to share it on the show!

Show Notes:

• Donate to International Rescue Committee
• Blog post: 4 Lessons from 20 Weeks of Very Bad Therapy
• The Contribution of the Quality of Therapists' Personal Lives to the Development of the Working Alliance
• Very Bad Therapy: Website / Facebook

Tricare is government managed health insurance given to United States military personnel and their dependents. It is also very confusing to understand, even for many of the providers themselves. As we learn from our guest Anna, this can lead to a frustrating search for helpful counseling. To make sense of the mystifying details of Anna's story - as well as all the acronyms - Julie Payne joins us to discuss everything you ever wanted to know about military mental health care.

Show Notes:

• Donate to Wounded Warrior Project
• What does losing your keys have in common with the treatment of trauma?
• Adoption by VA Residential Programs of Two Evidence-Based Psychotherapies for PTSD: Effect on Patient Outcomes
• Julie Payne's Website / Peninsula Family Therapy for Children & Adults
• Very Bad Therapy: Website / Facebook

What is at the root of very bad therapy? The common feeling that something is lacking in the education, training, development, and services provided by psychotherapists is backed by a wealth of research supporting the notion that a paradigm shift is sorely needed. Dr. Scott Miller is leading this movement with his work in the areas of routine outcome monitoring and deliberate practice.

VBT in Focus is a series of sporadic episodes in which Carrie and Ben have the privilege of chatting with their favorite thinkers in the field of psychotherapy. Thank you for listening.

Show Notes:

• Dr. Scott Miller's Website
• International Center for Clinical Excellence
• Scott Miller, PhD - The Evolution of Psychotherapy: An Oxymoron (2013)
• The Heart & Soul of Change: Delivering What Works in Therapy
• Beyond Measures and Monitoring: Realizing the Potential of Feedback-Informed Treatment
• Very Bad Therapy: Website / Facebook

What constitutes bad termination? In the words of Justice Potter Stewart, "I shall not today attempt to further define [it]... But I know it when I see it." In today's episode, R shares their story of termination that we can clearly know to be bad. But is it unethical? Ben and Carrie search for answers and discuss a pantheoretical framework for good termination. Thank you for listening. All reviews, ratings, Facebook likes, and feedback to soothe Ben's anxiety are greatly appreciated.

Show Notes:

• Donate to Project Reunify
• Codes of Ethics on Termination in Psychotherapy and Counseling
• Comparing therapist and client perspectives on reasons for psychotherapy termination
• Do all therapists do that when saying goodbye? A study of commonalities in termination behaviors
• The Termination Checklist (International Center for Clinical Excellence)
• Very Bad Therapy: Website / Facebook

Lewis Terman was one of the most influential innovators in educational psychology and IQ testing. He also believed that segregating and sterilizing "feebleminded" individuals - as determined by a biased paradigm of general intelligence - was the necessary path toward a better society. This is the second installment in our monthly series on very bad therapy through the decades.

Show Notes:

• The Uses of Intelligence Tests (Terman, 1916)
• The Vexing Legacy of Lewis Terman
• The Kallikak Family (Wikipedia)
• Reconstruction: America After the Civil War (PBS)
• Very Bad Therapy: Website / Facebook

Young children need play - not interrogation - to help them learn and form relationships. Today's guest PJ recalls his experience as an eight-year-old with a therapist who chose not to use play therapy in favor of a more investigative approach. Next, child therapy expert Megan Costello discusses the nuance of play therapy and what went wrong in PJ's story. And for some reason, we introduce our new sure-to-fail concept: The Richard Spencer Matrix for Therapists.

Show Notes:

• Donate to Kidspace Children's Museum
• Megan Costello's Website
• Therapy Reimagined Conference 2019
• Free Licenses for the Outcome Rating Scale (ORS), Child ORS, and Young Child ORS
• Very Bad Therapy: Website / Facebook

In 2019, there somehow exists at least one psychotherapist who feels that it is helpful to tell a female client that her entire gender is biologically predisposed to prefer domestic life to a professional career. We cringe-laugh our way through an engaging interview with Aviva before diving into the research on societal biases, gender norms, and gender matching in the therapeutic relationship. Climate change is real.

Show Notes:

• Donate to March of Dimes and/or RAICES
• Why Men Don't Listen and Women Can't Read Maps
• Race Bias, Social Class Bias, and Gender Bias in Clinical Judgment
• Physicians' attitudes toward preventative therapy for coronary artery disease: Is there a gender bias?
• Therapists' Approaches to the Normative Challenges of Dual-Earner Couples
• Does Client-Therapist Gender Matching Influence Therapy Course or Outcome in Psychotherapy?
• Effect of Patient-Therapist Gender Match on Psychotherapy Retention Among United States Veterans with Postttraumatic Stress Disorder
• Very Bad Therapy: Website / Facebook

Imagine a spectrum of unethical therapist conduct. Far, far toward the most extreme end, just before sexual coercion, are activities like grooming behavior and inappropriate physical touch. Our guest Jessica shares her dread-inducing story of working with a therapist who abused his power in ways that mental health professionals should only experience when reading ethics textbooks.

Show Notes:

• Donate to Renewed
• APA Ethical Principles and Code of Conduct
• AAMFT Code of Ethics
• Recognizing and Managing Erotic and Eroticized Transferences
• Very Bad Therapy: Website / Facebook

Adolescent girls should be sent to the country to prepare for housewifery and motherhood. So writes G. Stanley Hall, first president of the American Psychological Association, in 1904. This is the first in a series of monthly episodes exploring very bad therapy in the decades preceding the stories of today. Floating uteruses not included.

Show Notes:

• Chapter XVII: Adolescent Girls and Their Education (Hall, 1904)
• Wherein Should the Education of a Woman Differ from That of a Man (Gordon, 1905)
• G. Stanley Hall (Wikipedia)
• Very Bad Therapy: Website / Facebook

Gathering client information: good. Transcribing client responses into a computer while facing a wall: not good. It is estimated that 34% of clients don't return after their first session, a strong indication that the traditional intake model is in need of repair. Dr. Daryl Chow joins us to discuss our guest Bryan's bad intake experience, the importance of focusing intakes on giving rather than taking, and we explore how psychotherapists can achieve better outcomes over the long-term future.

Show Notes:

• Is Dropout After a First Psychotherapy Visit Always a Bad Outcome?
• The First Kiss: Undoing the Intake Model and Igniting First Sessions in Psychotherapy
• Beyond Measures and Monitoring: Realizing the Potential of Feedback-Informed Treatment
• Daryl's Website
• Daryl's Blog: Frontiers of Psychotherapist Development
• Very Bad Therapy: Website / Facebook