Latest Episode:
Episode 142 - VBT Study Hall: Client Testimonials and Reviews
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.
Episode 139 - Politics in the Therapy Room (with Dr. Ben Caldwell)
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?
Episode 133 - VBT Study Hall: Termination
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.
Episode 132 - Some Bad Parts (with Dr. Sheila Addison)
“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.
Episode 127 - Enlightenment is Not a Treatment Goal (with Dr. Jim Jobin)
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.
Episode 123 - Catching Feelings (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.
Episode 120 - Hard Conversations
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?
Episode 115 - What is Bad Therapy, and Who Gets to Provide It? (with Dr. Ben Caldwell)
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.
Episode 97 - You Have to Hug Me Before You Leave
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.
Episode 96 - New Therapist, Who Dis? (with Dr. Ben Caldwell)
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.
Episode 83 - Drive-Thru DBT (with Dr. Ben Caldwell)
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 tattooed.
Episode 73 - Silence in Therapy: What's the Story? (with Dr. Gene Combs)
Silence in therapy can feel awkward, helpful, expansive, or even punitive. There is no consensus on its usefulness, but it can certainly contribute to very bad therapy. Ella joins us to share her experience of feeling punished by her therapists’ use of silence, and Dr. Gene Combs provides a narrative perspective on silence, sanctity, and power in the therapeutic relationship.
Episode 72 - All About Psychiatry (with Dr. Patrick Wiita)
It’s not a secret that rapport contributes to outcomes in all types of healthcare. How, then, to make sense of our guest C’s story about a psychiatrist who ranted about Christmas, laughed at her suicide plan, and gave terrible marital advice? Dr. Patrick Wiita joins the show to talk about education, training, and ethics in the field of psychiatry and how to make the most out of every session with your patients.
Episode 68 - Misdiagnosing Clients (with Dr. Christine King and Dr. Ben Caldwell)
Dr. Christine King experienced three concussions when she was a child. The symptoms of her brain injury were misunderstood and later assumed to be the result of childhood sexual abuse, sending Christine on a pathologized path that took decades for her to undo. We hear her story and also speak with Dr. Ben Caldwell about how therapists can attune to client symptoms, make good referrals, and avoid misdiagnoses when they lack relevant knowledge beyond their scope of practice.
Episode 65 - When Treatment Fails (with Henk Spierings)
Henk Spierings has had a wide range of experiences in therapy – most of them unhelpful, if not outright harmful. He joins us to discuss his new book, Becoming Compliant, and share the lessons he’s learned from decades of bad therapy. Plus, Ben and Carrie get on their soapbox to explain why it’s necessary to talk with clients about how therapy works and the risks of treatment failure.
Episode 64 - Is Bad Therapy Unethical Therapy? (with Dr. Christopher Taylor)
What’s the difference between very bad therapy and very unethical therapy? Today’s guest Lisa shares her experience with a logotherapist that was many things – insulting, disturbing, oddly prophetic – but did any of it constitute an ethical violation? Dr. Christopher Taylor joins us to answer these questions and more about the surprisingly interesting world of ethics in psychotherapy.
Episode 36 - Please Renew Your License
In America, psychotherapist licensure requirements vary – often absurdly – from state to state. What does not vary is the need for periodic license renewal, an otherwise mundane fact that holds foreboding significance in our guest Dee’s story. Join us for a surprisingly interesting exploration of licensure requirements and the consequences of practicing without authorization.
Episode 35 - What is Pastoral Counseling? (with The Reverend Meredith Harber)
The exploitation of uneven power and emotional vulnerability is, of course, not limited to the field of psychotherapy. Today’s guest Megan shares her experience of very bad pastoral counseling, and we speak with the Reverend Meredith Harber to explore the nuances of Megan’s story and what proper pastoral care looks like with a contemporary understanding of power dynamics, boundaries, and gender norms.
Episode 32 - When No Therapy is Bad Therapy
The absence of evidence is not evidence of absence. In today's episode, the absence of bad therapy is indeed evidence of bad therapy as our guest Eric joins us to discuss the impact of showing up for multiple sessions only to discover that the therapist is nowhere to be found. Plus, we talk about therapists going to prison, cars exploding, and Ben unveils the six-word joke that will single-handedly change the future of psychotherapy.
Episode 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.