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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.
From the Foreword, by Arnold Lazarus, PhD, ABPP: "I shudder when I think... when I, as a newly minted PhD in clinical psychology, was certified as competent and qualified... it is not farfetched to say I knew next to nothing..." "Newly minted" therapists aren't alone in making mistakes, of course; even seasoned professionals can benefit from discovering the 50+ most common errors therapists make, and how to avoid them. Newly revised and updated, this indispensable guide includes more case examples and adds seven ways "to fail" with child patients, too. How to Fail... details how to avoid errors such as not recognizing limitations, performing incomplete assessments, ignoring science, ruining the client relationship, setting improper boundaries, terminating improperly, therapist burnout, and more.
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.
Empirical evidence shows that treatment failure is a significant problem and one that practitioners routinely overlook. A substantial minority of patients either fail to gain a benefit from the treatments offered to them, or they outright worsen by the time they leave treatment. Intervening in a timely fashion with such individuals cannot occur if practitioners are unaware of which cases are likely to have this outcome. Prevention of Treatment Failure describes procedures and techniques that can be used by clinical practitioners and administrators to identify patients who are at risk for treatment failure. The book summarizes evidence that convincingly shows that a shift in routine care is needed, and that such a shift can be accomplished easily through integrating specific methods of monitoring patient treatment response on a frequent basis in routine care. Treatment response is placed in the context of historical views of healthy functioning and operationalized through the use of brief self-report scales. Providing alert-signals to therapists, along with problem-solving tools, is suggested as an evidence-based practice that substantially reduces patient deterioration and increases the chances of the return to normal functioning. The book also provides illustrations on how accumulated data resulting from monitoring patient treatment response can be used to improve systems of care.
Brainblocks are the mental obstacles that keep people from achieving success, defined as setting, pursuing, and achieving a goal. Managing the brain is the solution to preventing mental blocks from interfering with achieving your goals. And neuropsychologist Dr. Theo Tsaousides gives you the tools to improve: Awareness: • the seven brainblocks to success (self-doubt, procrastination, impatience, multitasking, rigidity, perfectionism, negativity) • the characteristic feelings, thoughts, and actions associated with each brainblock • the brain functions involved in goal-oriented action • brain glitches and how they create setbacks • the cost of not removing brainblocks • the best strategies to remove the blocks Engagement: • actively search for brainblocks in your actions, thoughts, and feelings • recognize and label each brainblock as soon as it is identified • practice each strategy consistently until it becomes second nature • track your progress toward a goal Through these strategies you will learn to overcome these cognitive obstacles and harness the power of the brain to achieve success in any endeavor.
This book illustrates the myriad of ways in which hurt was created. It presents an integrative picture of relational psychotherapists working analytically, dynamically, and somatically with therapeutic failures.