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Very Bad Therapy

Very Bad Therapy is a closer look at what goes wrong in the counseling room - and how it could go better - as told by the clients who survived.

Weekly hand curated podcast episodes for learning

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The best episodes ranked using user listens.

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4. Race, Rupture, and Repair (with Dr. Dana Stone)

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

53mins

10 Jun 2019

Rank #1

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26. "If You Say Yes to This..."

"If you say yes to this, we'll have to end our therapeutic relationship." The context of this quote is explained in this week's episode about therapist self-disclosure, dual relationships, and a much-deserved misconduct report. Seriously y'all, be aware of how your social and political identities have the potential to impact clients and don't burst through boundaries like the Kool-Aid Man. Even Woebot gets sad when therapists act on self-interest. Support Very Bad Therapy on Patreon Show Notes: Donate to Mental Health America Woebot Therapy robots are already here The Truth About The Codes Of Ethics: Dispelling the Rumors that Dual Relationships are Unethical Opening Up: Therapist Self-Disclosure in Theory, Research, and Practice The role of therapist self-disclosure in psychotherapy: A qualitative review Self-Disclosure Very Bad Therapy: Website / Facebook / Tell Us Your Story

44mins

11 Nov 2019

Rank #2

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41. Less Advice, More Transparency

This week’s story from Farah touches on many common themes of bad therapy: disempowerment, unsolicited advice, misrepresenting qualifications, and more. We explore how early-career therapists can be transparent about their lack of experience while still creating client buy-in, what research suggests about giving advice to clients, and the importance of feedback. Plus, Carrie reflects on the gender power dynamic on this podcast and between male therapists and female or non-binary clients. Stay tuned afterward for a teaser of the most recent VBT Patreon episode! Thank you for listening. Support the show by becoming a monthly subscriber on Patreon to receive access to bonus episodes or by making a one-time contribution via PayPal. Show Notes: Donate to Angel City Pit Bulls Do psychotherapists improve with time and experience? A longitudinal analysis of outcomes in a clinical setting. Advice Giving in Psychotherapy Solicited and Unsolicited Therapist Advice in Psychodynamic Psychotherapy: Is it Advised Where is the Evidence for "Evidence-Based" Therapy Dr. Nathan Castle's Wesbite and Data Visualization Very Bad Therapy: Website / Facebook / Tell Us Your Story

1hr 18mins

24 Feb 2020

Rank #3

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20. When Therapists Need Therapy

Your therapist is having a bad day. Will this impact the quality of counseling? If you ask the therapist, probably not. But what does the research suggest about clients' perceptions of therapists who are riding the struggle bus? Today's guest Allison describes her increasingly bizarre experience with a clinician who wasn't quite able to bring her 'A' game to the counseling room. Do you have a story of very bad therapy? Send us a message to share it on the show! Show Notes: Donate to International Rescue Committee Blog post: 4 Lessons from 20 Weeks of Very Bad Therapy The Contribution of the Quality of Therapists' Personal Lives to the Development of the Working Alliance Very Bad Therapy: Website / Facebook

44mins

30 Sep 2019

Rank #4

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31. How Important is Therapist Attachment Style? (with Jon Hook)

Jon Hook, PhD student at Western Michigan University, is contributing to research on how the coding of session transcripts to determine therapist attachment styles can be used to facilitate better client outcomes. He joins us to discuss the significance of therapist attachment and shares his story as a client of two therapeutic alliances that were anything but securely attached. Show Notes: Support Very Bad Therapy on Patreon Donate to Sojourner Truth House Therapist Attachment-Related Behaviors and Their Effects on Psychotherapy Process and Outcome ResearchGate: Alessandro Talia / Eric Sauer / Jon Hook Division 29: Society for the Advancement of Psychotherapy Jon Hook on Twitter Very Bad Therapy: Website / Facebook / Tell Us Your Story

42mins

16 Dec 2019

Rank #5

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11. The Intake Process is a Mess (with Dr. Daryl Chow)

Gathering client information: good. Transcribing client responses into a computer while facing a wall: not good. It is estimated that 34% of clients don’t return after their first session, a strong indication that the traditional intake model is in need of repair. Dr. Daryl Chow joins us to discuss our guest Bryan’s bad intake experience, the importance of focusing intakes on giving rather than taking, and we explore how psychotherapists can achieve better outcomes over the long-term future. Show Notes: Is Dropout After a First Psychotherapy Visit Always a Bad Outcome? The First Kiss: Undoing the Intake Model and Igniting First Sessions in Psychotherapy Beyond Measures and Monitoring: Realizing the Potential of Feedback-Informed Treatment Daryl's Website Daryl's Blog: Frontiers of Psychotherapist Development Very Bad Therapy: Website / Facebook

1hr 4mins

29 Jul 2019

Rank #6

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33. Boundary Entanglements

Today’s story from T is a cautionary tale about a therapist causing harm by blurring boundaries around texting, personal space, and self-disclosure. Carrie and Ben attempt to hold space for T’s experience while seeking a middle ground in their differing perspectives about her therapist’s behavior. One thing is certain: if a therapist has a sexual dream about a client, the therapeutic relationship is not the place for processing. Thank you for listening. Support the show by becoming a monthly subscriber on Patreon to receive access to bonus episodes or by making a one-time contribution via PayPal. Show Notes: Very Bad Therapy: Website / Facebook / Tell Us Your Story

41mins

30 Dec 2019

Rank #7

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23. Very Bad Graduate School

On today's episode, our guest Ashley recalls her experience as a graduate psychology student looking for therapy in part to process feelings of disappointment with her education. We take this opportunity to get intimate with the research on graduate psychology programs and confront the elephant in the room: these programs don't seem to work. If you have ever doubted the usefulness of your graduate education, this episode is for you. Support Very Bad Therapy on Patreon Show Notes: Donate to Global Empowerment Mission How Cognitive Biases Impact Therapist Development: The Importance of Self-Awareness in Graduate Psychology Education (Ben's Thesis) Specific vs Nonspecific Factors in Psychotherapy: A Controlled Study of Outcome Outcome and Process Differences Between Professional and Nonprofessional Therapists in Time-Limited Group Psychotherapy Does Psychotherapy Supervision Contribute to Patient Outcomes? Considering Thirty Years of Research Perceived Impact on Client Outcomes: The Perspectives of Practicing Supervisors and Supervisees Inside the Practicum in Professional Psychology: A Survey of Practicum Site Coordinators Graduate Study in Psychology: 1971-2004 Administering Practicum Training: A Survey of Graduate Programs' Policies and Procedures Very Bad Therapy: Website / Facebook / Tell Us Your Story

46mins

21 Oct 2019

Rank #8

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5. Please Don't Tackle Your Clients (with Dr. Ben Caldwell)

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

47mins

17 Jun 2019

Rank #9

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How Should Therapists Respond to Coronavirus?

An urgent conversation about the role of therapists in doing the most public good during the coronavirus outbreak. Pat Wiita, MD and Farah Zerehi, MS explore the science, needed actions, and social justice implications of the pandemic, and Ben Caldwell, PsyD discusses what you need to know about shifting your practice to telehealth services. Please share this episode anywhere you feel it might make an impact. If you have expertise or information related to the pandemic that you feel is important to share with the psychotherapy community, email us at vbtpodcast@gmail.com. Note: A previous version of this episode contained information about Zoom being HIPAA compliant. This is only true for the Zoom for Healthcare option ($200/month), not the free and low-tier paid options.

50mins

13 Mar 2020

Rank #10

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30. The Money Episode

Do client fees impact therapy outcomes? How should therapists talk with their clients about money? Should mental health care be a basic human right? We have lots of questions and few answers as today’s guest Arianne joins us to share her story of money tension in therapy. Plus, Carrie and Ben read listener mail, gripe about therapist Facebook groups, and debate the ethics of prioritizing income maximization over all else as a mental health professional. VBT Copenhagen meetup: Ruby, tirsdag 17. december kl. 16:30 Show Notes: Support Very Bad Therapy on Patreon Donate to Karsh Center The Money Taboo: Its Effects in Everyday Life and in the Practice of Psychotherapy Treatment Effectiveness and Its Correlates in a Marriage and Family Therapy Training Clinic Does paying a fee for psychotherapy alter the effectiveness of treatment? Quid pro quo: fee for services delivered in a psychology training clinic Very Bad Therapy: Website / Facebook / Tell Us Your Story

54mins

9 Dec 2019

Rank #11

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8. Projections of Body Image Bias (with Rachel Coleman, LMFT, CEDS)

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

46mins

8 Jul 2019

Rank #12

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9. Empathy First, Paperwork Later

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

45mins

15 Jul 2019

Rank #13

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39. Making Sense of Mean Therapy

Today’s guest Kat shares her experience with a therapist who was unnecessarily cruel in her approach to treatment. In trying to make sense of this behavior, Carrie and Ben consider the research on how and when therapeutic relationships get fractured as a result of divergent interpretations of the same significant events in therapy. Thank you for listening. Support the show by becoming a monthly subscriber on Patreon to receive access to bonus episodes or by making a one-time contribution via PayPal. Show Notes: Donate to Save the Children Book Review: All Therapy Books Significant events in psychotherapy: An update of research findings The first sessions of psychotherapy: a qualitative meta-analysis of alliance formation processes Very Bad Therapy: Website / Facebook / Tell Us Your Story

51mins

10 Feb 2020

Rank #14

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6. Zimbabwean Granny Wisdom

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

49mins

24 Jun 2019

Rank #15

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27. The Negative Effects of Therapy (with Jørgen A. Flor)

A small percentage of clients experience negative effects from therapy. Why is it so difficult for therapists to identify this phenomenon when reflecting on past or present work? Norwegian psychologist and author Jørgen A. Flor joins us to explore the myth of side-effect free therapy and discuss a moving story from today's guest Jamie about unambiguously harmful treatment. Show Notes: Support Very Bad Therapy on Patreon Donate to NARAL Skadelige samtaler - myten om bivirkningsfri terapi Jørgen A. Flor's Website Very Bad Therapy: Website / Facebook / Tell Us Your Story

54mins

18 Nov 2019

Rank #16

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22. A Clinic On Unprofessionalism (with Katie Vernoy, LMFT)

Professionalism in psychotherapy is often hard to define, but it probably doesn't include being twenty minutes late to a client's first session and sharing unwanted Bible passages. Katie Vernoy joins us in advance of the Therapy Reimagined Conference to share her knowledge and make sense of all the confusing therapist behavior we hear in today's interview with Ofra. Support Very Bad Therapy on Patreon Show Notes: Donate to the ACLU Katie Vernoy's Website Therapy Reimagined Conference 2019 Very Bad Therapy: Website / Facebook / Tell Us Your Story

53mins

14 Oct 2019

Rank #17

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40. Exploring Bad LGBTQ+ Therapy (with Dr. Joe Kort)

Today’s guest Danny shares his outrageous experience of being told to urinate in a cup so his therapist could test if he was really gay. And that’s just the beginning of the story. We also speak with Dr. Joe Kort to explore best practices for working with the LGBTQ+ community, the need for humility and curiosity in a time of rapidly changing relationships to identity, and the diagnoses that stigmatize and marginalize members of this population. Thank you for listening. Support the show by becoming a monthly subscriber on Patreon to receive access to bonus episodes or by making a one-time contribution via PayPal. Show Notes: Donate to Teen Line Exploratory study on the role of emotion regulation in perceived valence, humour, and beneficial use of depressive internet memes in depression Conversion therapy (Wikipedia) Award-Winning Social Worker Caitlin Ryan Discusses Her Groundbreaking Research On Family Acceptance of LGBTQ Children Modern Sex Therapy Institutes LGBTQ Clients in Therapy: Clinical Issues and Treatment Strategies Dr. Joe Kort's website Very Bad Therapy: Website / Facebook / Tell Us Your Story

1hr 4mins

17 Feb 2020

Rank #18

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18. VBT in Focus: Dr. Scott Miller on Better Results

What is at the root of very bad therapy? The common feeling that something is lacking in the education, training, development, and services provided by psychotherapists is backed by a wealth of research supporting the notion that a paradigm shift is sorely needed. Dr. Scott Miller is leading this movement with his work in the areas of routine outcome monitoring and deliberate practice. VBT in Focus is a series of sporadic episodes in which Carrie and Ben have the privilege of chatting with their favorite thinkers in the field of psychotherapy. Thank you for listening. Show Notes: Dr. Scott Miller's Website International Center for Clinical Excellence Scott Miller, PhD - The Evolution of Psychotherapy: An Oxymoron (2013) The Heart & Soul of Change: Delivering What Works in Therapy Beyond Measures and Monitoring: Realizing the Potential of Feedback-Informed Treatment Very Bad Therapy: Website / Facebook

58mins

16 Sep 2019

Rank #19

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43. Specialization and Ethical Responsibility (with Curt Widhalm, LMFT)

This week’s captivating story from Paloma brings together themes of postpartum depression and therapist specialization. Paloma offers insight into the harmful impact of societal narratives about motherhood and Curt Widhalm rejoins the podcast to explain what specialization actually means – and when it’s just a marketing tool with dangerous consequences. Thank you for listening. Support the show by becoming a monthly subscriber on Patreon to receive access to bonus episodes or by making a one-time contribution via PayPal. Show Notes: Donate to Project NATEEN Dog ownership might reduce loneliness Are You Sure You are a Specialist? Very Bad Therapy: Website / Facebook / Tell Us Your Story

54mins

9 Mar 2020

Rank #20