Very Bad Therapy

Today's episode is a deep dive into the nuances of harm reduction therapy. How does stigmatization, politicization, and cultural bias regarding substance use influence the way mental health professionals view and work with their clients? What happens when abstinence is not a client's preferred option? Also, Ben and Carrie say hello to Sweden!

Show Notes:

• Donate to Harm Reduction Coalition
• What Does Recovery Mean in Practice? A Qualitative Analysis of International Recovery-Oriented Practice Guidance
• The Antidote To The Opioid Crisis: Harm Reduction As A Pathway To Autonomy, Connection, And Hope
• Harm Reduction Therapy: A Practice-Friendly Review of Research
• Lauren's Website
• Very Bad Website / Facebook / Instagram

The quality of the therapeutic alliance is one of the largest predictors of successful therapy. What doesn't help with building rapport? 25 minutes of paperwork to begin every session. Today's guest Meredith shares her challenges in working with a therapist who failed to convey appropriate messages of empathy but felt very strongly about the positive impact of collecting sticks from the ground.

Show Notes:

• American Foundation for Suicide Prevention: Give a Gift
• The Harmful Effects of Psychotherapy: When the Therapeutic Alliance Fails
• Therapist shortage, or saturation? Depends on who (and how) you ask
• Synchronous Telehealth Technologies in Psychotherapy for Depression: A Meta-analysis
• Best Practices in the Online Practice of Couple and Family Therapy
• Very Bad Website / Facebook / Instagram

Societal messages around health, beauty, and body image can contribute to problems that lead individuals to seek out therapy. But what happens when the therapist herself is unaware of how these cultural influences impact how treatment is provided? Our guest Holly shares her story about working with a therapist who reinforced unhealthy disordered eating behaviors under the guise of helpful therapy.

Show Notes:

• Performing a Project Premortem
• Health at Every Size
• Intuitive Eating: The Diet That Tells You to Quit Dieting
• Psychotherapy for eating disorders: A metaanalysis of direct comparisons
• Rachel Coleman's website
• Very Bad Website / Facebook / Instagram

Today's episode features a story about a therapist who pleaded with her client to help with research for her Master's thesis. We discuss why this is objectively problematic and look at the difference between boundary crossing and boundary violation in the context of inherent power dynamics within the therapeutic relationship. Plus, Carrie and Ben share their own absurd experiences of very bad therapy.

Show Links:

• Drawing on the Right Side of the Brain
• Calm the F*ck Down: An Irreverent Adult Coloring Book
• Patient-Therapist Boundary Issues
• To Cross Or Not To Cross: Do Boundaries In Therapy Protect Or Harm?
• Very Bad Website / Facebook / Instagram

In Zimbabwe, hastily trained "Grannies" were found to be significantly better at treating depression than the standard of care that best resembles Western psychotherapy. Ben and Carrie put on their researcher hats to explore how lessons from Friendship Benches in Africa reflect the need for a mental health paradigm shift around the world. Ben says thank you for taking care of his feelings.

Show Notes:

• Busting the myth that depression doesn't affect people in poor countries
• Effect of a Primary Care-Based Psychological Intervention on Symptoms of Common Mental Disorders in Zimbabwe
• Practicing Psychotherapy in Constructed Reality: Ritual, Charisma, and Enhanced Client Outcomes
• The Heart and Soul of Change: Delivering What Works in Therapy
• The Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work
• Beyond Measures and Monitoring: Realizing the Potential of Feedback-Informed Treatment
• The Question of Expertise in Psychotherapy
• Very Bad Website / Facebook / Instagram

Therapists are not supposed to tackle their clients*. But what are the ethical limitations in trying to prevent a potential suicide attempt? Today's guest Katherine recounts her experience with a caring clinician who went to extreme lengths to protect her safety, and Dr. Ben Caldwell shares his expertise to help us understand how therapists should manage delicate yet ambiguous situations with clients.

*Unless perhaps the client is attempting to physically harm someone else in the room. Perhaps.

Show Notes:

• Dissociative Identity Disorder (Multiple Personality Disorder)
• Bellah v. Greenson
• Dr. Ben Caldwell's Website
• Saving Psychotherapy: How Therapists Can Bring the Talking Cure Back from the Brink
• SimplePractice Learning
• Suicide Prevention, Assessment, and Intervention (6 hours CE)
• Very Bad Website / Facebook / Instagram

Dr. Dana Stone joins us to unpack our guest Carol's experience with a therapist who chose a stance of defensiveness following a rather shocking microaggression. How can we become not just better clinicians, but better human beings as well? Any why might some therapeutic ruptures ultimately serve to benefit the client?

Show Notes:

• Cultural Humility: Measuring Openness to Culturally Diverse Clients
• The Session Rating Scale: Preliminary Psychometric Properties of a "Working" Alliance Measure
• The working alliance in treatment of military adolescents.
• What is the essential quality of effective feedback? New research points the way
• The Secret of Supershrinks: Pathways to Clinical Excellence
• Finding Your Voice as a Beginning Marriage and Family Therapist
• Black people aren't making things up: The science behind 'racial battle fatigue'
• Privilege: A Reader
• White Fragility: Why It's So Hard for White People to Talk About Racism
• Racial microaggressions in every day life: implications for clinical practice.
• Broaching the Subjects of Race, Ethnicity, and Culture During the Counseling Process
• White Privilege: Unpacking the Invisible Knapsack
• So You Want to Talk About Race
• Very Bad Website / Facebook / Instagram

If a person claims to be gay, should you ever doubt them? Ben shares his story about winning $50 betting on his own sexual orientation, our guest Shaw tells us what it's like to debate your therapist about same-sex attraction not being a symptom of sexual assault, and we look at research that links sexual trauma to sexual identity.

Show Links:

• Does Maltreatment in Childhood Affect Sexual Orientation in Adulthood?
• Impact of Sexual Trauma on Gender Identity and Sexual Object Choice
• Does Incest Cause Homosexuality?
• https://www.verybadtherapy.com
• https://www.facebook.com/vbtpodcast
• https://www.instagram.com/vbtpodcast
• https://twitter.com/vbtpodcast

EMDR is a groundbreaking, controversial, and maybe not-that-special psychotherapy treatment. We explore the research on its mechanisms and effectiveness before hearing from our guest Justin about his EMDR experience with an overeager therapist. Then, Curt Widhalm, LMFT, EMDR certified, and cohost of The Modern Therapist's Survival Guide sits down with us to answer our questions about EMDR and highlight what went wrong in Justin's therapy.

Show Links:

• How Does Eye Movement Desensitization and Reprocessing Therapy Work? A Systematic Review on Suggested Mechanisms of Action
• EMDR: Taking a Closer Look
• Curt's Website
• https://www.verybadtherapy.com
• https://www.facebook.com/vbtpodcast
• https://www.instagram.com/vbtpodcast
• https://twitter.com/vbtpodcast

EMDR is a groundbreaking, controversial, and maybe not-that-special psychotherapy treatment. We explore the research on its mechanisms and effectiveness before hearing from our guest Justin about his EMDR experience with an overeager therapist. Then, Curt Widhalm, LMFT, EMDR certified, and cohost of The Modern Therapist's Survival Guide sits down with us to answer our questions about EMDR and highlight what went wrong in Justin's therapy.