Therapeutic Failures In Psychotherapy

This book examines therapeutic failures in psychotherapy. Despite the consistent positive outcome findings and psychotherapists’ best intentions in their efforts to help their clients, psychotherapy simply does not work in all cases. In fact, 5-10% of adult clients deteriorate during psychotherapy. Although not exclusively due to treatment failures per se, almost a fifth of clients terminate their therapy prematurely and findings suggest that that between 20 and 30% of clients do not return after the first session with half terminating after just two sessions. Therapeutic failures could include a range of negative therapy outcomes, such as harm, deterioration, client non-response, premature termination, or dropout, as well as process factors, such as negative therapy experiences, impasses, or alliance ruptures. Investigating therapeutic failures holds the key to improving the effectiveness of psychotherapy as well as understanding some of the fundamental conditions that need to be in place for the change mechanisms of psychotherapy to take effect. Although psychotherapy has made many strides over the last few decades to improve research rigour and to promote evidence-based practices, it is a profession that is still growing. By embracing the opportunity to learn from therapeutic failures the profession will continue to refine its practices to better serve clients and to strive toward developing ethical and effective practices. Both comprehensive and accessible, this book will be of great interest to psychotherapists in practice, therapists-in-training, as well as students and professionals in psychology and mental health in general. The chapters in this book were originally published in Counselling Psychology Quarterly.

Bad Therapy offers a rare glimpse into the hearts and mind's of the profession's most famous authors, thinkers, and leaders when things aren't going so well. Jeffrey Kottler and Jon Carlson, who include their own therapy mishaps, interview twenty of the world's most famous practitioners who discuss their mistakes, misjudgements, and miscalculations on working with clients. Told through narratives, the failures are related with candor to expose the human side of leading therapists. Each therapist shares with regrets, what they learned from the experience, what others can learn from their mistakes, and the benefits of speaking openly about bad therapy.

In this book the editors have solicited the unique and unmediated voices of fifteen leading psychotherapists, who share intimate and revealing stories from their clinic of professional incidents that shook the therapeutic bond and left a scar in both parties. The contributors courageously agreed to revisit the cases that still burn inside of them, attempting to conceptualise these and give them words, and to demonstrate the mutual vulnerability inherent within the psychoanalytic and psychotherapeutic endeavour. While failure is recognised as developmentally necessary and a cornerstone in the formation and maintenance of attachment relationships, stories of therapeutic failures are seldom told in our profession. Can we fully recognise our failures without shaming ourselves and others? Can we bear it while attending to our narcissistic wounds and rescue fantasy? This book addresses all of these concerns, while examining what relational theory and practice has to contribute to the understanding of, and working with, therapeutic failure.

Psychotherapy and psychoanalysis don't always work. Inevitably, a therapy or analysis may fail to alleviate the suffering of the patient. The reasons why this occurs are as manifold as the patients and analysts themselves, and oftentimes are a source of frustration and vexation to clinicians, who aren't always eager to discuss them. Taking the challenge head-on, Arnold Goldberg proposes to demystify failure in an effort to determine its essential meaning before determining its causes. Utilizing multiple vignettes of failed cases, he offers a deconstruction and a subsequent taxonomy of failure, delineating cases that go bad after six months from cases that never get off the ground, mismatches from impasses, failures of empathy from failures of inattention. Commonalities in the experience of failure – conceived as less a misapplication of technique than consequences of a co-constructed yet fraught therapeutic relationship – begin to emerge for scrutiny.

Failure is a theme of great importance in most clinical conditions, and in everyday life, from birth until death. Its impact can be destabilizing, even disastrous. In spite of these facts, there has been no comprehensive psychoanalytic exploration of this topic. Understanding and Coping with Failure: Psychoanalytic Perspectives fills this gap by examining failure from many perspectives. It goes a long way toward increasing understanding of the numerous issues involved, and provides many valuable insights into ways of coping with these challenging experiences and several chapters discuss positive aspects of failure - what can be learned from what would otherwise simply be regrettable experiences. Brent Willock, Rebecca Coleman Curtis and Lori C. Bohm bring together a rich diversity of topics explored in thoughtful ways by an international group of authors from the United Kingdom, Canada, and the United States of America. Failed therapies (which have been examined in the literature) are but one element freshly explored in this comprehensive exploration of the topic. The book is divided into sections covering the following topics: Failing and Forgiving; Society-Wide Failure; Failure in the Family; Therapeutic Failure; Professional Failure in the Consulting Room and on the Career Path; Integrity versus Despair: Facing Failure in the Final Phase of the Life Cycle; Metaphoric Bridges and Creativity; The Long Shadow of Childhood Relational Trauma. Understanding and Coping with Failure will be eagerly welcomed by all those trying to increase their awareness, understanding, and capacity to work with the many ramifications of this important issue. Because of the uniqueness of this broad, detailed exploration of the complexities of the failure experience, it will be essential reading for psychoanalysts, psychotherapists, psychologists, psychiatrists, social workers, counselors, and students in these disciplines. It will also appeal to a wider audience interested in the psychoanalytic perspective.

Psychotherapy and psychoanalysis don't always work. Inevitably, a therapy or analysis may fail to alleviate the suffering of the patient. The reasons why this occurs are as manifold as the patients and analysts themselves, and oftentimes are a source of frustration and vexation to clinicians, who aren't always eager to discuss them. Taking the challenge head-on, Arnold Goldberg proposes to demystify failure in an effort to determine its essential meaning before determining its causes. Utilizing multiple vignettes of failed cases, he offers a deconstruction and a subsequent taxonomy of failure, delineating cases that go bad after six months from cases that never get off the ground, mismatches from impasses, failures of empathy from failures of inattention. Commonalities in the experience of failure – conceived as less a misapplication of technique than consequences of a co-constructed yet fraught therapeutic relationship – begin to emerge for scrutiny.

If you’re a long-time veteran of feminist therapy or someone just starting out, you’ll find a helpful, reliable list of “dos” and “don’ts” in Learning from Our Mistakes: Difficulties and Failures in Feminist Therapy. Frank and honest in tone, makeup, and style, this one-of-a-kind publication looks at the failures and roadblocks that have hampered feminist therapists in the past so you can learn from their misfortunes and avoid them in your own professional endeavors. In Learning from Our Mistakes, you’ll come face-to-face with classic difficult cases, and you’ll see from a feminist perspective how therapists used various treatments to deal with these seemingly insurmountable challenges. You’ll find that these and other topics will help you in navigating the difficult situations that arise in your personal practice: the pros and cons of terminating with a client who has an eroticized transference differences between therapists and clients in terms of race, ethnicity, and age problems encountered by rural therapists in small communities using a translator in therapy when the therapist and client don’t speak the same language feelings of anger in therapy many other “log jams” in the therapeutic process It’s no mistake that Learning from Our Mistakes is full of what works and what doesn’t. In it, three veteran discussants give you the tools necessary to overcome the uncertainties and inadequacies that plague therapists. You’ll come away understanding the many ways failure is embedded in both the theory and practice of psychotherapy. Ultimately, you’ll find that mistakes are really only failure narratives waiting to be used, shaped, and turned toward the positive experiences of both client and therapist.