Very Bad Therapy

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Carrie and Ben create their own model of therapy. Goal setting! Psychoeducation! Exploitation and worrisome sales tactics! What does it say about psychotherapy when our progressively cynical efforts to develop a modality end up mirroring some of the norms in our field? This episode is evidence-based and supported by neuroscience.   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 – 5:13 Part One: 5:13 – 1:08:54 Part Two: 1:08:54 – 1:11:44   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes: Mental health clinical exams’ evident adherence to industry standards for testing How to Spot Hype in the Field of Psychotherapy The efficacy of non-directive supportive therapy for adult depression: a meta-analysis Insight Exchange: Guide to Selecting a Counsellor The Radical Therapist #094 – Response-Based Practice w/ Dr. Allan Wade Organized Abandonment and Systemic Harm: A Conversation with Therapist & Educator Kimberly Chiswell

All therapy books have an oddly similar message: *This* form of therapy is the one that truly matters, and *this* science/philosophy/whatever is the key to understanding how human psychology actually works. These narratives can’t all be true, so are they all simply bullshit instead? We read through Scott Alexander’s legendary blog post, Book Review: All Therapy Books, and discuss whether therapy gurus really believe the answers they are selling.   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 – 10:36 Part One: 10:36 – 1:29:35 Part Two: 1:29:35 – 1:31:55   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes: ‘The Body Keeps the Score’ offers uncertain science in the name of self-help. It’s not alone. Book Review: All Therapy Books  Astral Codex Ten  Slate Star Codex  An Investigation of Self-Assessment Bias in Mental Health Providers 

Life can be hard at times. Do you want to feel more visible and important in your relationships? Are you curious about why every Psychology Today profile looks the same? We get silly with the incredible Therapist Generator and learn all about treating sunroof addition with truckload therapy and registered turtleneck therapy. The therapist profiles are fake, but our desire to meet you where you are on your journey is very real.   Thank you for listening. To support the show and receive access to regular bonus episodes, check out the Very Bad Therapy Patreon community. Today’s episode is sponsored by Sentio Counseling Center – high-quality, low-fee online therapy in California with immediate availability for new clients.   Introduction: 0:00 – 26:05 Part One: 26:05 – 1:14:55 Part Two: 1:14:55 – 1:17:35   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes: Therapist Generator Kaylen Dwyer: Twitter This Person Does Not Exist Go open: A plea for transparency in psychotherapy Talking more about talking cures: cognitive behavioural therapy and informed counsent Informed Consent in Psychotherapy: Implications of Evidence-Based Practice Evidence-Based Practice and Psychological Treatments: The Imperatives of Informed Consent Informed consent for psychotherapy: still not routine

Social proof has become a crucial element of consumer decision making in the Internet era. So why don’t the vast majority of therapists ask their clients to give testimonials or leave reviews? We ponder the frustrating tension between psychotherapy ethics codes and literature on marketing in the 21st century, and we do our best to advise therapists about what to do in response to a bad online review.   Thank you for listening. To support the show and receive access to regular bonus episodes, check out the Very Bad Therapy Patreon community. Today’s episode is sponsored by Sentio Counseling Center – high-quality, low-fee online therapy in California with immediate availability for new clients.   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes: Work and Identity in an Era of Precarious Employment: How Workers Respond to “Personal Branding” Discourse To Solicit or Not to Solicit? Key Issues to Consider Before Soliciting Testimonials and Reviews from Patients How Did It Go? A Comparison of Experience and Outcome-Focused Online Reviews on Treatment Expectations Change My Mind: The Impact of Online Client Ratings and Reviews on Perceptions of Therapists Yelped: Psychotherapy in the time of online consumer reviews. Digital Marketing Excellence: Planning, Optimizing, and Integrating Online Marketing The Truth About Using Testimonials to Market Your Practice Scope and Ethics of Psychologists’ Use of Client Testimonials on Professional Websites Navigating the ethics of soliciting reviews for mental health professionals Responding to a Yelp review can cost you Psychotherapists in danger: The ethics of responding to client threats, stalking, and harassment. New Orleans psychologist sues over negative Angie’s List comments

What is religious trauma, and why do some therapists refuse to work with clients who use that language? In today’s episode, Jeremy speaks about his experiences with therapists who felt the need to defend their faith in session, and we are joined by Josh Foster, LCPC to discuss the complicated intersection between evangelical Christianity and ethical psychotherapy.   Thank you for listening. To support the show and receive access to regular bonus episodes, check out the Very Bad Therapy Patreon community. Today’s episode is sponsored by Ben Caldwell Labs – training, advocacy, books, and additional resources for counselors and therapists. Today’s episode is also sponsored by Sentio Counseling Center – high-quality, low-fee online therapy in California with immediate availability for new clients.   Introduction: 0:00 – 11:11 Part One: 11:11 – 50:09 Part Two: 50:09 – 1:28:44   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes: Support the Secular Therapy Project Jeremy Magin: Website Josh Foster: Website / Email Religious Trauma Syndrome

Trauma-informed therapy is…what, exactly? And is trauma actually stored in the body, or is that just a clever narrative that a few enterprising gurus have used to sell books and trainings? We dig deep into the research on trauma to answer these questions and more, and Carrie introduces her breakthrough trauma-focused treatment: dog therapy.   Thank you for listening. To support the show and receive access to regular bonus episodes, check out the Very Bad Therapy Patreon community. Today’s episode is sponsored by Sentio Counseling Center – high-quality, low-fee online therapy in California with immediate availability for new clients.   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes: Trauma-Informed Care in Behavioral Health Services: Appendix C – Historical Account of Trauma Treating PTSD: A Review of Evidence-Based Psychotherapy Interventions Key Ingredients for Successful Trauma-Informed Care Implementation What Is Trauma-Informed Therapy? Is Your Therapist ‘Trauma-Informed’? (And Why It Matters) Envisioning a trauma-informed service system: A vital paradigm shift Trauma-Informed Care (Encyclopedia of Social Work) Why Trauma-Informed Care Matters Trauma- and violence-informed care (Wikipedia) Trauma-Informed Care in Behavioral Health Services: Chapter 1 – Trauma-Informed Care: A Sociocultural Perspective The relative efficacy of bona fide psychotherapies for treating post-traumatic stress disorder: a meta-analysis of direct comparisons APA Clinical Practice Guidelines for Treatment of Posttraumatic Stress Disorder in Adults APA Clinical Practice Guidelines PTSD Treatment Recommendations Clinical Practice Guidelines: Beneficial Development or Bad Therapy? Relationships and Responsiveness in the Psychological Treatment of Trauma: The Tragedy of the APA Clinical Practice Guideline Our Primitive Response to Stress Debunking Myths About Trauma and Memory The Return of the Repressed: The Persistent and Problematic Claims of Long-Forgotten Trauma Belief in Unconscious Repressed Memory Persists Exploring the Controversy of Polyvagal Theory The Brilliant Marketing of Bessel van der Kolk and Stephen Porges and His Polyvagal Theory Polyvagal Theory – Useful Narrative but Still Just a Theory The Problem with The Polyvagal Theory Domestication of the dog (Wikipedia) Dogs as Pets: How Dogs May Have Helped Homo Sapiens Triumph Over Neanderthals What Happened to Mirror Neurons? What is Interpersonal Neurobiology (IPNB)?

Let’s get controversial! Is it a good idea for a therapist to project their own political views onto a client? For today’s guest Ruth, the answer is a resounding “no.” We hear her story of a therapist who took her political advocacy too far, and Dr. Ben Caldwell rejoins us to explore the ethics of discussing politics in therapy. Plus, how can therapists know if they are trauma-informed enough for their clients?   Thank you for listening. To support the show and receive access to regular bonus episodes, check out the Very Bad Therapy Patreon community. Today’s episode is sponsored by Journal Party.   Introduction: 0:00 – 8:55 Part One: 8:55 – 44:33 Part Two: 44:33 – 1:24:21 Part Three: 1:24:21 – 1:27:42   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes: Donate to Samaritan’s Purse (Ethiopia Projects) Ben Caldwell Labs Think Like the Test Podcast Marketing of professional counselors: A Q-Sort study of best practices. Da Poetry Lounge

No, EMDR is not a cultish pyramid scheme. With that out of the way, why is EMDR training so expensive when its theoretical foundations are supported by dubious (at best) research? In this clickbaity-titled episode, Angela Nauss, EMDRIA-certified LMFT, joins us to describe the experience of paying thousands of dollars to “watch the dumpster fire from inside the dumpster.” Please direct all angry emails to vbtpodcast@gmail.com.   Thank you for listening. To support the show and receive access to regular bonus episodes, check out the Very Bad Therapy Patreon community. Today’s episode is sponsored by Sentio Counseling Center – high-quality, low-fee online therapy in California with immediate availability for new clients.   Introduction: 0:00 – 9:40 Part One: 9:40 – 1:12:13   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes: Angela Nauss’ Website A Review of EMDR Literature: A Clinician’s Skepticism Spreadsheet of EMDR Training Costs

How do we know which psychotherapy research is trustworthy? Dr. Alex Williams and Dr. John Sakaluk help us search for evidence in all the logical places: the replication crisis, RCTs, qualitative studies, dolphin therapy, Canadian football, researchers fighting Connor McGregor, and of course, EMDR. This episode is brought to you by MR. BEAR (Meta-analysis, Registered, Big sample size, Experiment, Active control group, Replicated).   Thank you for listening. To support the show and receive access to regular bonus episodes, check out the Very Bad Therapy Patreon community. Today’s episode is sponsored by Sentio Counseling Center – high-quality, low-fee online therapy in California with immediate availability for new clients.   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes: Alex Williams’ Twitter John Sakaluk’s Twitter The Heart and Soul of Change: Delivering What Works in Therapy Feeling the Future: Experimental Evidence for Anomalous Retroactive Influences on Cognition and Affect Telling More Than We Can Know: Verbal Reports on Mental Processes (Nisbett & Wilson, 1977) Pim Cuijpers’ Publications

What makes for effective group therapy? Cohesion, expectation setting, and as today’s guest Thomas can attest to, not having the therapist give the middle finger to a group member. We try to make sense of Thomas’ experience by looking into research on group therapy, and we also try to make sense of our own experience of failing to find a single group therapy expert.   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 – 9:57 Part One: 9:57 – 46:11 Part Two: 46:11 – 1:18:17   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes: Donate to Heifer International I Misplaced My Phone For Forty-Five Minutes, And Now I’m A Mindfulness Expert Personalizing Psychotherapy: Assessing and Accommodating Patient Preferences Patient perspectives on working with preferences in psychotherapy: A consensual qualitative research study Group therapy is as effective as individual therapy, and more efficient. Here’s how to do it successfully Recent Developments in Group Psychotherapy Research

What exactly is treatment planning and why do some therapists dread having to do it on a regular basis? This episode is Carrie’s love letter to treatment plans – why they are used, how they can improve therapy outcomes, and why Ben is wrong in his stubborn resistance to writing out a detailed plan for every client.   Thank you for listening. To support the show and receive access to regular bonus episodes, check out the Very Bad Therapy Patreon community.   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes: Mastering Competencies in Family Therapy: A Practical Approach to Theory and Clinical Case Documentation FREE Clinical Forms from Diane’s Textbooks Effective Psychotherapists: Clinical Skills That Improve Client Outcomes Theory-Based Treatment Planning for Marriage and Family Therapists: Integrating Theory and Practice Contra Costa Behavioral Health Clinical Documentation Manual Los Angeles County Department of Mental Health Treatment Plan Navigating the Insurance Maze: The Therapist’s Complete Guide to Working with Insurance – And Whether You Should Personalizing Psychotherapy: Assessing and Accommodating Patient Preferences

What’s so important about a diagnosis? For neurodivergent clients, it can mean affirmation, community support, and access to much-needed services…if the diagnosis is correct. In today’s episode, we talk to Harley about her challenges in seeking diagnoses of autism and ADHD, and Halina Brooke rejoins us to discuss some of the best practices (and controversies) in supporting autistic 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 – 8:24 Part One: 8:24 – 49:54 Part Two: 49:54 – 1:27:20   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes: Donate to Earthjustice Halina Brooke’s Website Neurodiversity Affirming Practice Workshop neurodiversecounseling.com sensibletherapypractices.com counselingcompact.org

Nothing lasts forever, including therapeutic relationships. Therapy can end in lots of different ways, but what constitutes a good goodbye? We dig into the research on termination and the related ethics codes and come away with a surprising conclusion: firing a client is almost always ethically acceptable.   Thank you for listening. To support the show and receive access to regular bonus episodes, check out the Very Bad Therapy Patreon community.   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes: Ending Therapy: The Therapeutic Relationship During the Termination Phase 6 Strategies for Ethical Termination of Psychotherapy Practice recommendations for reducing premature termination in therapy. A meta-analysis of psychotherapy dropout. Client initiated termination of therapy at NHS primary care counselling services Comparing therapist and client perspectives on reasons for psychotherapy termination. Client and therapist views of contextual factors related to termination from psychotherapy: A comparison between unilateral and mutual terminators The Oxford Handbook of Psychotherapy Ethics The History and Ethics of the Therapeutic Relationship Termination and Abandonment: A Proactive Approach to Ethical Practice How to Fire a Client How to End Therapy the Right Way 7 Tips for ‘Breaking Up’ with Your Therapist

“No bad parts” is a common mantra in therapy – the various parts of ourselves are always working to serve some beneficial purpose. But what happens when a therapist communicates to a client that significant parts of who they are aren’t welcome in the therapy room? Today’s guest Adam describes having to compartmentalize aspects of his identity with his therapist, and Dr. Sheila Addison joins us to discuss how to provide affirming services to all parts of a client.   Thank you for listening. To support the show and receive access to regular bonus episodes, check out the Very Bad Therapy Patreon community. Today’s episode is sponsored by Mental Health Match.   Introduction: 0:00 – 4:53 Part One: 4:53 – 41:18 Part Two: 41:18 – 1:23:05   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes: Donate to Trans Lifeline Dr. Sheila Addison: Website / Twitter

What happens in the first session of therapy? More importantly, why do one-third of clients not come back for the second session? We look for answers in the research on client expectations and consider some creative perspectives on increasing first session effectiveness, including a radical idea that clients dropping out of therapy might actually be a positive outcome.   Thank you for listening. To support the show and receive access to regular bonus episodes, check out the Very Bad Therapy Patreon community. Today’s episode is sponsored by Mental Health Match.   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes: What’s the Smallest Amount of Therapy That’s Still Effective? The Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy Work The First Kiss: Undoing the Intake Model and Igniting First Sessions in Psychotherapy Clinician interventions and participant characteristics that foster adaptive patient experiences for psychotherapy and psychotherapeutic changes. Clients’ pretreatment counseling expectations as predictors of the working alliance. A comparison of client preferences for intervention empirical support versus common therapy variables A prediction of initial appointment attendance and initial outcome expectations Premature discontinuation in adult psychotherapy: A meta-analysis. How to make the most of one session Is Dropout After a First Psychotherapy Visit Always a Bad Outcome? Single-session therapy: Maximizing the effect of the first (and often only) therapeutic encounter. Capturing the moment: Single session therapy and walk-in services. The Radical Therapist #100 – Single Session Narrative Therapy w/ Michael Morar

Is good therapy as simple as whatever activity makes a client feel better? What if that activity is a singular focus on sports betting strategy? In today’s episode, we talk with Christine to learn from her experience of “gambling therapy” and answer the question of whether or not it’s a good thing to be friends with your therapist (spoiler: no, no it is not).   Thank you for listening. To support the show and receive access to regular bonus episodes, check out the Very Bad Therapy Patreon community. Today’s episode is sponsored by Mental Health Match.   Introduction: 0:00 – 5:39 Part One: 5:39 – 46:05 Part Two: 46:05 – 1:23:37   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes: Gamblers Anonymous Buzzfeed: Share Your Therapy Icks, Including The Worst Thing A Therapist Has Ever Said To You Apply to Train at Sentio Counseling Center! 6 Stages of Grooming Adults and Teens: Spotting the Red Flags

Carrie hasn’t worked as a therapist in over a year. Will she ever get licensed, and how is her decision connected to the apparent reality that many therapists are actively trying to not see clients? We explore the interesting trend of therapists looking for side hustles, and Carrie forces Ben to confront his extreme aversion to participating in the real world (aka sales and marketing).   Thank you for listening. To support the show and receive access to regular bonus episodes, check out the Very Bad Therapy Patreon community. Today’s episode is sponsored by Sentio Counseling Center – high-quality, low-fee online therapy in California with immediate availability for new clients.   Introduction: 0:00 – 4:16 Part One: 4:16 – 1:09:53   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story

You’ve already heard that the therapeutic alliance is important to client outcomes, but does anyone actually know why? We dig into the research to figure out if ruptures can be a good thing (yes!), what clients and therapists should know about the therapeutic alliance, and why this topic has been fervently researched over the last half-century.   Thank you for listening. To support the show and receive access to regular bonus episodes, check out the Very Bad Therapy Patreon community. Today’s episode is sponsored by Mental Health Match.   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes: Taylor Tomlinson: Look At You The generalizability of the psychoanalytic concept of the working alliance. Therapeutic alliance (Wikipedia) Studying psychotherapy using the one-with-many design: The therapeutic alliance as an exemplar. What is the Therapeutic Alliance and Why is it Important? The Alliance in Adult Psychotherapy: A Meta-Analytic Synthesis Current concepts of transference. Therapeutic Alliance and Outcome of Psychotherapy: Historical Excursus, Measurements, and Prospects for Research Therapeutic alliance rupture as therapy event for empirical investigation The development and decay of the working alliance during time-limited counseling. Patterns of working alliance development: A typology of client’s working alliance ratings. Clients’ and Therapists’ Views of the Therapeutic Alliance: Similarities, Differences and Relationship to Therapy Outcome The Therapeutic Alliance: The Fundamental Element of Psychotherapy Therapeutic Alliance Ruptures Alliance rupture repair: A meta-analysis.

Many clients want a spiritual component to their therapy, but what happens when a therapist acts more like a theologian than a mental health professional? Today’s guest Kelsey describes her experience of having spirituality weaponized against her in sessions, and Dr. Jim Jobin joins us to discuss how religion can be ethically and effectively incorporated into the therapeutic environment.   Thank you for listening. To support the show and receive access to regular bonus episodes, check out the Very Bad Therapy Patreon community. Today’s episode is sponsored by Sentio Counseling Center – high-quality, low-fee online therapy in California with immediate availability for new clients.   Introduction: 0:00 – 7:22 Part One: 7:22 – 37:54 Part Two: 37:54 – 1:23:15   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes: Effective Altruism Charity Resources: GiveWell / Giving What We Can / The Life You Can Save Pod Therapy ChatGPT