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

129. Patreon Selects: Will Carrie Ever Get Licensed?

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.

128. VBT Study Hall: The Therapeutic Alliance

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

127. Enlightenment is Not a Treatment Goal (with Dr. Jim Jobin)

It seems odd that most therapists – us included – aren’t 100% certain about what constitutes an intervention. Are interventions scripted in-session activities? What about the theoretical orientations themselves? There isn’t one single answer, but interventions aren’t that difficult to understand if you zoom out far enough…and get a little bit of help from ChatGPT.   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 couples and individual clients.   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes:  ChatGPT  Effective Psychotherapists: Clinical Skills That Improve Client Outcomes Types of interventions (NIH)  Types of Interventions in Counseling  The Complete Set of Client Handouts and Worksheets from ACT books  Essential Techniques for the Beginning Psychodynamic Psychotherapist  Commonly-Used Intervention Words for Mental Health Progress Notes  Therapy Interventions Cheat Sheet  What is the Change Triangle? Affect Phobia Therapy

126. VBT Study Hall: Interventions

Stereotypes aren’t always a bad thing. That may not be true in therapy, especially when a client is made to feel like they are representing an entire group of people. That’s what we explore with today’s guest Jess, and we’re also joined by Deanna Fierman, LPC, to talk about what therapists should do after their biases about identity lead to clinical errors. Plus, Ben finds a therapist and Carrie gets a mammogram.   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 – 18:09 Part One: 18:09 – 54:04 Part Two: 54:04 – 1:38:02 Part Three: 1:38:02 – 1:40:39   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes:  Support DC Texas Migrant Solidarity All the Colors Counseling and Consulting

125. So You’ve Stereotyped Your Client (with Deanna Fierman, LPC)

There are over 600 types of psychotherapy. What are they, where did they come from, and what makes them important? We dive deep (too deep, probably) into a $900 textbook in an attempt to make sense of the spectacularly confusing topic of theoretical orientations. This is an integrative episode – we integrate a lot of information with even more information.   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:  APA Handbook of Clinical Psychology  Bruce Wampold on What Actually Makes Us Good Therapists  The evidence for evidence-based therapy is not as clear as we thought Evaluating the Evidential Value of Empirically Supported Psychological Treatments (ESTs): A Meta-Scientific Review  Obtaining Consensus in Psychotherapy: What Holds Us Back?  Becoming an Effective Psychotherapist: Adopting a Theory of Psychotherapy That’s Right for You and Your Client Types of Therapy

124. VBT Study Hall: Theoretical Orientations

In the United States, mental health professionals must pass a clinical exam to become licensed in their field. These exams appear to do nothing to make psychotherapy more effective or safe. They are, however, very efficient at furthering structural racism. Dr. Ben Caldwell joins us to make a very compelling, research-based argument for why these clinical exams should be abolished immediately.   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:   Clinical Licensing Exams in Mental Health Care (White Paper)  Report: Clinical exams in mental health licensing are structural racism  2022 ASWB Exam Pass Rate Analysis  org – ASWB: End Discriminatory Social Work Licensing Exams California BBS discussion of the ASWB report Racial Bias and ASWB Exams: A Failure of Data Equity Ben Caldwell: Email / Ben Caldwell Labs / Psychotherapy Notes

Bonus: Clinical Licensing Exams Don't Work (with Dr. Ben Caldwell)

It’s not unusual for clients to develop feelings for their therapist. It’s also not unusual for therapists to develop feelings for their clients. So why is it such a bad idea for a therapist to share (or act) on those feelings? Today’s guest Kate shares a story that illustrates exactly why, and Dr. Ben Caldwell rejoins us to talk about what should happen when clients and therapists develop feelings for one another.   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 The Organized Therapist – Social Media for Therapists and Sentio Counseling Center – high-quality, low-fee online therapy in California with immediate availability for new clients.   Introduction: 0:00 – 8:40 Part One: 8:40 – 44:35 Part Two: 44:35 – 1:30:32   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes:   Donate to NAMI: National Alliance on Mental Illness Ben Caldwell on Authory The Patient on Hulu Mentour Pilot (YouTube) Does sorry work? The impact of apology laws on medical malpractice  “Sorry” Is Never Enough: How State Apology Laws Fail to Reduce Medical Malpractice Liability Risk

123. Catching Feelings (with Dr. Ben Caldwell)

Justin Norris rejoins us to conclude our conversation about the perplexing maze that is the application process for grad school. We use the California State University (CSU) system as a case study to illustrate why program requirements aren’t always what they seem, and Carrie discusses which therapy programs do a great job of defining and providing quality to their students. Plus, Subaru gets lots of free advertising.   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 – 10:35 Part One: 10:35 – 1:10:11 Part Two: 1:10:11 – 1:13:21   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes:  The Patient on Hulu Sentio Counseling Center: Affordable Online Therapy for Californians MFT California Creating Impact: The four pillars of private psychology practice

122. Patreon Selects: Degrees of Confusion (Part II)

Have you ever wondered why the process of applying to grad school is so unclear at times? In part one of two, we are joined by Justin Norris, an expert in systems of higher education, to talk about the surprisingly interesting topics of accreditation, for-profit vs. non-profit designations, and public vs. private universities. If you wanted to become a therapist but ended up in a sales funnel, this episode is for you.   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 – 19:21 Part One: 19:21 – 1:27:53 Part Two: 1:27:53 – 1:31:45   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes:  The Patient on Hulu Sentio Counseling Center: Affordable Online Therapy for Californians Sentio University MFT California Living with Harm OCD  The Secret History of Thoughts (Invisibilia)

121. Patreon Selects: Degrees of Confusion (Part I)

What happens when a therapist doesn’t want to work with a client? What should happen? Tom shares his experience with a therapist who chose avoidance over honesty, and we discuss ten types of hard conversations that frequently give therapists anxiety. Plus, is Steve Carrell a good enough TV therapist to avoid getting murdered?   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 The Organized Therapist – Social Media for Therapists.   Introduction: 0:00 – 11:00 Part One: 11:00 – 37:54 Part Two: 37:54 – 1:37:40   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes:  The Patient on Hulu Sentio Counseling Center: Affordable Online Therapy for Californians  Why Therapy Is Broken  Social Workers’ Ethical Responsibilities to Clients

120. Hard Conversations

Dr. Sally Gibbons is an Oxford-educated philosopher, professor of bioethics and philosophy at UCLA, and licensed professional clinical counselor. We discuss her academic background, what inspired her transition to a career in mental health, and how philosophical thinking informs her humility and curiosity with clients. We also explore the intersections between philosophy and psychotherapy and how this relates to questions about what it means to be a human being and what we owe each other. Plus, Dr. Gibbons shares her own experience of very bad solution-focused brief therapy.   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 – 13:08 Part One: 13:08 – 1:11:38 Part Two: 1:11:38 – 1:16:26   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes:  Sally Gibbons’ Website The Patient on Hulu Sam Morril: Up on the Roof

119. Patreon Selects: The Intersections of Philosophy and Psychotherapy

Psychological testing can be complicated. It shouldn’t have to be hostile, even if the evaluation is not intended to be in a client’s best interest. In today’s episode, Jacob shares his experience of a truly ridiculous psych assessment, and we speak with Rachel Simon, LCSW MEd about how assessors can minimize the harmful impact of their own biases – and the biases built into the psych tests themselves.   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 The Organized Therapist – Social Media for Therapists.   Introduction: 0:00 – 6:49 Part One: 6:49 – 43:54 Part Two: 43:54 – 1:20:49   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes:  Donate to Transgender Law Center Rachel Simon’s Website The Every Body Book  Minnesota Multiphasic Personality Inventory (MMPI) The Gender Affirming Letter Access Project

118. Testing Patients (with Rachel Simon, LCSW)

The history of expertise in medicine and science led the field of psychotherapy to its beloved empirically supported treatments (ESTs). Psychiatrists were prescribing pills, and psychotherapists were offering best practices. But how did these best practices get their reputation, and what happens when clients and therapists alike believe uncertain truths about mental health treatment? We conclude our two-part historical journey with a look at some contemporary alternatives to the medical model and what this all means for the most important aspect of therapy: helping clients get better outcomes.   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 – 3:39 Part One: 3:39 – 58:05   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story

117. Patreon Selects: The History of Expertise in Therapy (Part II)

Therapists are considered mental health experts. How did this come to be, and is it necessary for the future of the field? Join us as we trace the surprising history of the medical model in therapy from its origins in the Scientific Revolution to the evolution of treatment manuals. Part I takes us all the way to 1987, with cameos by the Catholic Church, Ben Franklin, Sigmund Freud, Hans Eysenck, and more. If you’ve ever wondered why psychotherapy seems to have such a confusing relationship with medicine and science, this episode is for you.   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 – 4:02 Part One: 4:02 – 55:39   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story

116. Patreon Selects: The History of Expertise in Therapy (Part I)

Today’s guest Marie shares her thought-provoking story about a preoccupied telehealth therapist, and we drag Dr. Ben Caldwell into another one of our philosophical crises about what constitutes very bad therapy. Is it not following a treatment plan? Having young children show up in session? Ignoring ruptures? Regularly showing up late? And while we’re at it, what even is therapy? Who should get to be a therapist during the pandemic? Join us on the struggle bus as we try to parse out issues related to telehealth, laws, ethics, clinical practices, privilege, social systems…and bullshit.   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 The Organized Therapist – Social Media for Therapists and Empifany (Instagram / Facebook).   Introduction: 0:00 – 11:20 Part One: 11:20 – 54:41 Part Two: 54:41 – 1:57:06 Part Three: 1:57:06 – 2:02:04   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes:  Donate to Cystic Fibrosis Foundation Ben Caldwell Labs Psychotherapy Notes SimplePractice Learning  Calling Bullshit: The Art of Skepticism in a Data-Driven World  Potential fabrication in research images threatens key theory of Alzheimer’s disease  Preventing intrusive memories after trauma via a brief intervention involving Tetris computer game play in the emergency department: A proof-of-concept randomized controlled trial  The Radical Therapist #100 – Single Session Narrative Therapy w/ Michale Morar

115. What is Bad Therapy, and Who Gets to Provide It? (with Dr. Ben Caldwell)

Carrie and Ben are joined by friend of the podcast Rachel Bennett to talk about how their past careers have shaped their identities as therapists. Topics include:  How working in fine dining informs the importance of being of service and providing experiences to therapy clients How very few people in therapy and acting know what they're doing and how this helps with impostor syndrome The humility required to be a successful poker player and therapist, as well as the need to separate short-term results from long-term process The importance of learning how to self-regulate in the presence of others How all of this (as always) relates to feedback-informed treatment    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 Empifany (Instagram / Facebook).   Introduction: 0:00 – 9:03 Part One: 9:03 – 1:17:47   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes:  MFT California The Surprise of Reaching Out: Appreciated More Than We Think  Unexpectedly reaching out to a friend is more appreciated than people assume, new study shows

114. Patreon Selects: An Actor, a Sommelier, and a Poker Player Walk Into a Bar

Consciousness-altering psychedelic drugs have shown tremendous promise in mental health treatment. The future of psychedelic-assisted therapy is uncertain, but one thing seems clear: the psychedelics are for the client, not the therapist. Today’s guest Matthew shares his peculiar experience with a not-quite-levelheaded therapist, and Ben Hearn joins us to discuss everything you ever wanted to know about this emerging pathway to psychological healing.   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 The Organized Therapist – Social Media for Therapists and Empifany (Instagram / Facebook).   Introduction: 0:00 – 3:57 Part One: 3:57 – 35:46 Part Two: 35:46 – 1:26:38 Part Three: 1:26:38 – 1:28:06   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes:  Donate to Multidisciplinary Association for Psychedelic Studies (MAPS) and Decriminalize Nature Michigan Ben Hearn’s Website  Ethical and legal issues in psychedelic harm reduction and integration therapy  Psychedelic Harm Reduction and Integration: A Transtheoretical Model for Clinical Practice Fireside Project Podcast: Cover Story Psychedelics & Counseling Interest Network Chacruna Psymposia  CIIS: Center for Psychedelic Therapies and Research Fluence

113. Psychedelics and Therapy (with Ben Hearn, LPCC-S)

Dr. Andrew Scull is the Distinguished Professor of Sociology, Emeritus, at UCSD. He has written extensively about the history of psychiatry and the treatment of madness. We discuss why it seems like the more you know about mental illness, the less clear things become. We also explore myths about biology and neuroscience, the likelihood of a clear solution for improving psychotherapy, and the politics that have shaped our mental healthcare systems.   Thank you for listening. To support the show and receive access to regular bonus episodes, check out the Very Bad Therapy Patreon community.   Join our charity drive! We are matching up to $6,000 of your donations to the world’s most effective charities. To contribute, visit GiveWell.org and use the fundraising code VBT.   Introduction: 0:00 – 5:18 Part One: 5:18 – 1:07:11   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes:  Andrew Scull: UCSD Bio / Amazon Page Desperate Remedies: Psychiatry’s Turbulent Quest to Cure Mental Illness

112. Patreon Selects: Desperate Remedies for Mental Illness

The field of psychotherapy has increasingly prioritized discussions about issues of oppression and marginalization. This is, of course, a sign of progress. But who gets left out of these conversations? Today’s guest Kaley shares her experience of antisemitism in therapy, and Halina Brooke rejoins us to talk about how Jewish clients are impacted when therapist education reinforces harmful narratives.   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 The Organized Therapist – Social Media for Therapists.   Join our charity drive! We are matching up to $6,000 of your donations to the world’s most effective charities. To contribute, visit GiveWell.org and use the fundraising code VBT.   Introduction: 0:00 – 6:09 Part One: 6:09 – 38:26 Part Two: 38:26 – 1:20:00 Part Three: 1:20:00 – 1:22:52   Very Bad Therapy: Website / Facebook / Bookshelf / Tell Us Your Story   Show Notes:  Donate to Hebrew Immigrant Aid Society Halina Brooke: Recourse Counseling / LinkedIn The Jewish Therapist Collective  The influence of Judaism on American psychology The Liking Gap in Conversations: Do People Like Us More Than We Think? Job Accommodation Network ADA.gov Family and Medical Leave Act

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