Eve B

So this author is saying that psychotherapy is still effective despite flimsy evidence? Since psychology is really a pseudo-science anyway, I guess that kind of wishy-washiness is fitting.

Yes, the cumulative effects of a string of bad therapists can indeed be too overwhelming for any one "good enough" therapist to fully correct. I suppose the best we can hope for is not to get worse after those experiences. What causes therapy harm isn't the therapist's credentials, it's who they are as a person/personality and how they apply their treatments on unsuspecting clients.

But wouldn't the general public assume that a PhD means the therapist should be more knowledgeable and effective simply because of the higher degree and fees of service?

Could it be the PhD education (not the therapy itself) that convince people therapists should be sufficiently knowledgeable to offer solutions? I think the public generally sees therapy as just talking to somebody who will listen to their problems and provide advice.

Extroverted therapists would also be more likely to have arrogant personalities and violate client boundaries!

What does it really mean to take care of one's mental health? There are people with emotional issues who harm others or themselves, so who's helping them with their mental health? What if you don't know how to apply the self-help books, don't feel comfortable with social groups, can't motivate yourself to exercise, or don't have friends/family who you can talk to with your problems? Therapists fill a void, and maybe for some, having even an illusion of hope is better than nothing?

Let me try to play devil's advocate by asking how do we explain the people who say therapy has helped them? Are they just deceiving themselves too? Or, maybe, they've fallen under the influence of subconscious conditioning similar to Stockholm syndrome?

Hello and welcome to the forum, PsychoLogical! All your points are valid, and I personally believe that many therapists aren't as honest as they could be mainly because they can't afford to lose the business. Would people want to try expensive therapy if there was a clear disclaimer of no guarantees or refunds? Their lack of accountability would probably be due to shame, embarrassment, arrogance, and/or denial. The most these "experts" will admit when they screw up is that they're only human and will make human mistakes. There are some clients who have benefited from good therapy, but I wouldn't expect them to understand if they haven't gone through the negative experiences. It takes a lot of time and venting to recover from this kind of ordeal, and healing afterwards may never feel complete.

Episode 37: What does it imply (or confirm) about the psych profession if anyone can call themselves a therapist for just $16?

When therapists don't listen to their clients, then yeah, they're only interested in satisfying their own curiosities. Listening and good communication are two important skills that psych schools don't seem to teach and train adequately enough.

I don't like being an object of their curiosity either, but from the therapist's perspective, it's supposed to be a good thing. Showing interest usually means they're more motivated to be helpful, and I think their profession can't avoid being voyeuristic because of what they expect their clients to tell them-- personal information that nobody else but the therapist will know and keep confidential.

Therapists know that outcome depends on client response, so it's not surprising to me if they resort to manipulative and controlling tactics. Maybe authenticity is more real when therapists and clients are more compatible with each other, therefore, the emphasis on a "good fit"?

"results were published in Cognitive Therapy and Research, found that 43% of CBT patients in their sample experienced side effects, which they define as 'negative reactions to an appropriately delivered treatment.'" "One such side effect — deterioration of symptoms due to therapy — has been found to occur in 3 to 10% of patients. "The study has several limitations. As psychotherapists reported side effects, reports may have been influenced by therapist bias; the authors suggest that future studies use a blend of stories from patients, therapists, and outside interviewers. The study’s sample was composed of patients with various diagnoses, and as such, results would likely be different in a more homogenous sample, or with a different form of therapy. Additionally, as approximately half of the patients whose cases were reported on in the study were taking psychotropic drugs, and it is thus impossible to rule out the effect of medication on the observed side effects." -Therapy harm is real, but there just aren't enough studies because of the difficult nature of collecting accurate data.

I think there will be more internet reviews on therapists just as ratings for medical doctors also seem to be increasing. Therapy shouldn't be a special case, and a lot of it depends on how comfortable clients are with putting themselves in a publicly vulnerable position by giving up confidentiality to tell their side of the story. The truth matters, but being believed is what makes the difference.

Yes, I wish this could be made mandatory and implemented! The concern, however, would be those unethical clients who would abuse it to get "revenge" against their therapist. It's easy for both sides to feel personally wronged in therapy because of miscommunication or poor communication. I suppose these evaluations would need to be carefully worded so that only facts are presented and not emotional reactions?

What good are changing the training programs if how therapists practice behind closed doors can't really be monitored and enforced, though? The privacy of the therapy sessions ends up protecting the therapist more if the client feels too afraid to file a complaint. Even if these types of improved consent forms are made mandatory, it's unfair that the client would still be carrying the greater responsibility to recognize the therapist's violations and do something about it (terminate and/or report the misconduct). There are also many therapists who believe they're doing what's best for their clients no matter how much the client may insist otherwise.

What's the most common reason why a therapist wouldn't do what the client tells them? Can we simply narrow it down to a controlling and arrogant personality? If that's the case, the psych schools should be filtering these types of people out of their programs as much as possible because those are obviously dangerous traits to have as professional caregivers.

Episode 33- Therapist Violating Client Boundaries Another example of therapists believing they know better and not listening to what the client wants.

Episode 31- Confirming how therapists can overanalyze and try to oversell theories to their clients and that "psychotherapists don't improve with time" (00:21:53). Hmm, I wonder why that could be... Maybe something to do with therapists (over-)reacting to honest client feedback instead of really listening to it?

Therapists seemed to pay more attention when I said, "I feel that..." even though I'm pretty sure that in the real world, people would usually say, "I think that...." I've noticed myself using "I feel that..." when talking about my emotions to a therapist but then I'd switched back to "I think that..." if the conversation was with anyone else outside of the session room. Maybe it's just part of the therapy language for clients if they want the therapist to be able to listen and connect with them better? Episode 30 also discussed the money aspect of the profession and the question of whether the process works better when clients pay (more) for it versus being a free service or a lower rate. From my experience with various therapists ranging from intern level to the PhDs, it's not the price of the therapists that influenced me to want to cooperate with them as how they communicated their personality, knowledge, and skills.

It may be too much to expect these well-educated therapists to ask questions that show such common sense and courtesy.

Seems like effective therapy goes back to the "good (or good enough) fit" theory then. Why should clients be expected to pick the right fit therapist when there could be greater emphasis on training therapists to have better bedside manners and flexible approaches to their clients' issues?

Asking questions is helpful to clarify the problem and find solutions. Maybe it's not that therapists need to ask questions but that they're not asking sensible or useful questions appropriate for each client's issues?

Listening respectfully doesn't mean therapists will understand their clients either. I've had a few therapists who seemed polite and respectful, but I could tell they still didn't know what to do to effectively help me. Showing empathy should also include showing respect, but I think better empathy means a therapist will try harder to work with their clients' needs.

How therapists "help" is often as vague as the process itself, so maybe it's inevitable that they won't ever see eye to eye with their clients? It just keeps reaffirming the necessity and importance of listening empathetically to honest client feedback and responding appropriately instead of reacting like they're (the therapists) the ones being harmed.