Very Bad Therapy

A therapist's job is to help their clients. But what does "help" mean when a client has been diagnosed with an incurable disease? In this episode, Cassie shares her story of seeking emotional support for her diagnosis of metastatic breast cancer only to receive unhelpful fixes instead. Plus, Jill Johnson-Young returns to talk about supporting clients who are experiencing the grief of having to say...

Dual relationships can be perfectly fine in therapy. But imagine if your therapist was also working with your good friend… and that friend's girlfriend… and the therapist hired your friend to be her dog walker… and everyone's private information was shared in session with no concern for confidentiality. That's the first ten minutes of Anna's story, and it gets worse from there. So, so much worse....

What does it mean if a therapist suddenly changes their behavior? In this episode, Katie shares her experiences with two therapists who made significant adjustments and left her (and Ben and Carrie) confused about what happened. Plus, Dr. Ben Caldwell returns with fantastic metaphors about ethical gray areas and how therapists can adjust their boundaries and clinical style in a compassionate way....

Post-Traumatic Stress Demonology   The cause of psychological distress is often complex and unknowable. There are many helpful theories to explain depression, anxiety, and trauma, but in this episode, Maria shares her bewildering experience with a therapist who had some less conventional ideas. This story features many different examples of bad therapy with a freaking exorcism included as an iatro...

Lots of therapists describe themselves as "trauma-informed." Very few fail to live up to that title as inexplicably as what we hear in this episode, as Sarah shares her unfortunate therapy experience following a sexual assault. We also talk with Dr. Chelsea Kilimnik to learn more about how therapists can actually be trauma-informed when supporting survivors of sexual trauma.   Thank you for listen...

Therapists have a lot of power. This episode is about a therapist who leveraged that power to abuse his clients.   Thank you for listening. To support the show and receive access to regular bonus episodes, check out the Very Bad Therapy Patreon community .   Introduction: 0:00 – 3:40 Part One: 3:40 – 1:03:16 Part Two: 1:03:16 – 1:18:18   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Y...

Can wearing a cross be considered a type of bad therapy? This episode features a conversation with Johannah Song, LPC about the positive and negative ways therapists of faith can impact treatment by disclosing their religion. Plus, we talk about the right balance between expertise and curiosity, and why seeking consultation from a specialist is like baking a quiche.   Thank you for listening. To s...

This episode's interview with Sara is about two therapists – one who was too friendly, and another who wasn't friendly enough. What should therapists consider before using risky interventions such as guilt, self-disclosure, or icy behavior? We try to answer these questions and more as we go back down the rabbit hole of using service-dominant logic to make therapy more effective.   Thank you for li...

Who should we talk to next about how to break the decades-long plateau of client outcomes in psychotherapy? Short on ideas, we take it upon ourselves to try and crack the 45-year-old riddle about how to make therapy more effective. Ben has another existential crisis, Carrie converts to the religion of customer service, and we (eventually!) explore why the path to better outcomes might go directly...

Jill Johnson-Young is an expert in the areas of dying, death, and grief. She also has the personal experiences that come with having been widowed twice, including stories of the bad grief therapy that followed. In this episode, Jill shares what therapists and clients should know about working with grief and all the reasons why the conventional wisdom about grief therapy is often counterproductive....

What is the role of a couples therapist in deciding whether a couple stays together or separates? In this episode, Sade Kammen shares their experience trying to navigate the impact of racism in their relationship, only to be met with unusual and unhelpful therapeutic interventions. Plus, we familiarize ourselves with the wonderfully curious idea of empirically-supported bullshit.   Thank you for l...

Halina Brooke rejoins us to share her story of bad therapy and resulting experience with the board complaint process. This episode is a bingo card of what not to do as a therapist: drink alcohol in session, send barrages of shaming texts to a client, weaponize client disclosures against them, cyberstalking, and more. When an interview begins with a legal disclaimer, you know some very bad therapy...

When things go very wrong in therapy, clients often have the option of filing a complaint with the therapist's licensing board. In this episode, Rebecca shares her experience of bad therapy and subsequent frustrations with the board hearings, and Halina Brooke joins us to talk about what clients and therapists need to know about the complaint process.   Thank you for listening. To support the show...

What can therapists do to provide culturally humble services to clients? Being curious is a good start, and not asking for evidence of racial bias should be an easy next step. In this episode, Grace shares her experience as a woman of color having to justify the impact of racism to her white therapist, and Farah Zerehi joins us to discuss the social justice critiques of "expert" approaches to ther...

Attachment theory is one of the most credible areas in the field of psychotherapy. It is not, however, an excuse for a therapist to presume to be a substitute parental figure for a client. In this episode, Monika describes working with a therapist who talked about reparenting but undermined therapeutic progress with inconsistent boundaries and unethical behavior. Plus, Carrie takes a deep dive int...

In this episode, our guest Maryellen shares her bad experience with a Dialectical Behavior Therapy (DBT) specialist. But was it bad therapy? Was it therapy at all? Dr. Ben Caldwell joins us to share his thoughts on loosely regulated mental health services, and we explore the unfortunately relevant ethics of having sessions with clients while visiting the Dunkin' Donuts drive-thru and getting tatto...

A small percentage of therapists do bad things – not tiny ruptures in the therapeutic alliance or scheduling errors, but truly exploitative practices. This is a story about the latter. Courtney describes her experience with a therapist who groomed her for inappropriate sexual contact, and we speak with Dr. Diane Gehart about the prevalence and tendencies of predatory therapists.   Thank you for li...

Marissa Esquibel, LMFT joins us to talk about codependency – the tendency to let another person's behavior affect your own while obsessing over trying to control that person's behavior. What happens when this dynamic shows up in the therapeutic relationship and gets reinforced by well-intentioned caretaking? How can offering a reduced fee undermine therapeutic progress?   Thank you for listening....

Kenneth R. Rosen is an author and journalist with firsthand experience in what is colloquially called the Troubled Teen Industry. This industry – a dubious version of wilderness therapy – often includes coercion, legal kidnapping, and manipulation. Kenneth joins us to talk about these harmful practices and his new book, Troubled: The Failed Promise of America's Behavioral Treatment Programs.   Tha...

Having a severe and persistent mental illness is difficult – especially when the stigma of certain diagnoses negatively influences treatment. On today's episode, Ann discusses her up and down experiences in the mental health system and her important perspectives on how therapists talk about their clients. Plus, we explore the landmark research on first impressions that explains how the therapeutic...

Building a good therapeutic alliance in couples therapy can be tricky with multiple people in the counseling room. This is especially challenging when the therapist is consistently late or not present at all. Today's guest Maria shares her frustrating experience with an absentee therapist, and Dr. Bonnie Kennan joins us to talk about using feedback-informed treatment to provide very good couples t...

Rehab facilities can be life saving for many people. This is a different kind of story. Jen shares her experience of 2.5 years in inpatient and outpatient treatment centers trying to overcome unhelpful therapy and victim blaming before leaving against medical advice and reclaiming her life. Plus, Carrie and Ben take some time to discuss the philosophy of Very Bad Therapy and interviewing guests.  ...

The more you learn about psychotherapy research, the less it all seems to make sense. Dr. Alex Williams and Dr. John Sakaluk are working to change that by researching the research itself. We discuss two of their latest papers on empirically supported treatments and potentially harmful therapies. Which modalities can we be confident about? Which psychological interventions appear to cause harm? Wha...

The cost of therapy, like most everything else, increases over time. This can lead to some difficult conversations about money and rate changes. How should therapists talk with their clients about fee increases? In today's episode, Marwa shares her experience of very good therapy that ended very poorly when her therapist used Hunger Games logic to determine her new sliding scale availability.   Th...

Conversations about sex – even in therapy – are often constrained by harmful cultural narratives. In today's episode, Leah describes her experience of being shamed and blamed by her sex therapist, and Danielle Kramer provides an expert perspective on how therapists can prevent their sexual biases from negatively influencing clients. Plus, Carrie passionately revisits the topic of silence in therap...