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 an...
Aug 22, 2022•58 min
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 ...
Aug 15, 2022•56 min
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 relat...
Aug 01, 2022•2 hr 2 min
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 re...
Jul 18, 2022•1 hr 18 min
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 ...
Jul 04, 2022•1 hr 28 min
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...
Jun 20, 2022•1 hr 7 min
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 ...
Jun 06, 2022•1 hr 23 min
We’re back with Dr. Ben Caldwell to conclude our thoughts on grad school and the surprising reality that it isn’t meant to make you a good therapist. We talk about starting supervision, avoiding moral injury, and most importantly, all the things that graduate education does very well in supporting early-career clinicians. Plus, we share our best advice for anyone getting started in their career in mental health. Thank you for listening. To support the show and receive access to regular bonus epi...
May 23, 2022•1 hr 15 min
Dr. Ben Caldwell joins us to discuss everything you need to know about going to school to become a therapist. His most important message? Treat grad school like a convenience store – get in and get out. We explore how to choose a school, how to get the most out of the experience, and where to focus your energy along the way. This episode is for anyone interested in becoming a therapist or for those already in grad school – especially if some of your experiences don’t seem to make sense. Thank yo...
May 16, 2022•1 hr 16 min
Of course we were going to end up doing an episode about CBT eventually. Emily describes visiting a CBT therapist who seemed uninterested in doing any real work, and Alyssa Davis joins us to cognitively restructure our beliefs about therapy models. Plus, some notes on EMDR, common factors, and deliberate practice. This episode has a bit of everything. Thank you for listening. To support the show and receive access to regular bonus episodes, check out the Very Bad Therapy Patreon community . Toda...
May 02, 2022•1 hr 37 min
Ben and Carrie have a new podcast! It’s called Learn Psychotherapy, and we’re inviting you to listen and practice along to develop your therapy skills. Learn Psychotherapy: Website / YouTube / Apple Podcasts / Spotify Skill Criteria for Soliciting Client Feedback: Begin with a short response, reflection, or validating comment. Ask the client for feedback about some aspect of therapy that is related to the subject of the client statement. Thanks for joining us to develop your therapy skills just ...
Apr 25, 2022•41 min
We’re long overdue for a good old-fashioned Q&A episode. You’ve sent in your questions, and we’re here to opine about everything from the importance of therapists getting their own therapy to the curious reluctance of the mental health field to embrace social psychology. Plus, we begrudgingly discuss the latest TikTok therapist drama to make a point about when it might be better to actually reject client preferences in session…or something like that. Social media is the worst. Thank you for ...
Apr 18, 2022•1 hr 19 min
What happens when a therapist and client have two very different conversational styles? Therapists can try to build rapport in many ways, which unfortunately is reflected in our guest Ben’s experience of being given terrible advice mislabeled as psychoeducation. Whether a client is talkative or reserved, one thing is for sure: randomly praising Donald Trump as a paragon of confidence is curious at best. Thank you for listening. To support the show and receive access to regular bonus episodes, ch...
Apr 04, 2022•1 hr 15 min
Dr. Robin Hanson is an associate professor of economics at George Mason University and the coauthor of The Elephant in the Brain: Hidden Motives in Everyday Life. He joins us along with guest host Dr. Alex Williams to explore what clients are subconsciously signaling when they seek therapy – and what therapists are signaling to others when they enter the field. Plus, why is feedback-informed treatment similar to paying a friend $100 for a home-cooked meal? Thank you for listening. To support the...
Mar 21, 2022•1 hr 18 min
When does somebody officially become a client of therapy? And what happens if, before that distinction is made, crises occur and the therapeutic relationship unravels? Our guest Neith shares her experience navigating this scenario, and Dr. Ben Caldwell explains why little of this is clear cut, but some of it is clearly bad. Plus, we introduce a new segment: Is It Bad Therapy? Thank you for listening. To support the show and receive access to regular bonus episodes, check out the Very Bad Therapy...
Mar 07, 2022•1 hr 28 min
On Very Bad Therapy, we seek to understand what it’s like for clients to have bad therapeutic experiences. Should we focus more on the therapists’ side of the story? Dr. Patrick Wiita joins us to continue our conversation from the end of episode #72 to discuss some very interesting questions: Are we doing a disservice to our listeners by not considering the “bad” therapists’ point of view? What are we suggesting by being unquestionably validating of our guests’ stories? Is it even possible to ha...
Feb 21, 2022•53 min
Dialectical behavior therapy (DBT) is considered the front-line treatment for borderline personality disorder. What exactly is DBT, and why is it nothing like the invalidating experience that Amy describes in today’s episode? To accept and change the reality of bad DBT, we speak with Fred Kutnick, LCSW about the propositions of good DBT. 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...
Feb 07, 2022•1 hr 26 min
Thomas Lennon is an acclaimed actor and screenwriter, best-selling novelist, and most importantly, Carrie’s long-time friend. We break from our usual format to chat with Tom about his good experiences in therapy, the impact of fame on mental health, and Metallica getting family counseling together. This was a fun conversation – maybe next time we can talk with Paul Rudd! Thank you for listening. To support the show and receive access to regular bonus episodes, check out the Very Bad Therapy Patr...
Jan 31, 2022•48 min
Carrie and Ben are joined by Dr. Will Dobud to discuss two burning questions: is good therapy just the absence of bad therapy, and should we ban the use of cognitive behavioral therapy? We explore the importance of teaching people to think about psychotherapy models differently, the appeal of bringing therapy back to its pragmatist roots, and what the biased origins of personality tests can teach us about taking precautions when using theories of pathology. Plus, what can we learn from the wonde...
Jan 17, 2022•1 hr 8 min
Beth is a self-described therapy failure expert. She joins us for the whole episode (and more!) as we discuss her personal bad therapy experiences, what therapists think of clients who disclose their stories of bad therapy, why therapists often struggle to provide specialized services, and the fact that some therapists simply aren’t good at making their clients feel understood. Thank you for listening. To support the show and receive access to regular bonus episodes, check out the Very Bad Thera...
Jan 03, 2022•1 hr 45 min
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 goodbye. Thank you for listening. To support the show and receive access to regular bonus episodes,...
Dec 20, 2021•1 hr 17 min
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. Thank you for listening. To support the show and receive access to regular bonus episodes, check out...
Dec 06, 2021•1 hr 11 min
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. Thank you for listening. To support the show and receive access to regular bonus episodes, check out...
Nov 22, 2021•1 hr 31 min
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 iatrogenic exclamation point. Thank you for listening. To support the show and receive access to regular bo...
Nov 08, 2021•1 hr 12 min
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 listening. To support the show and receive access to regular bonus episodes, check out the Very Bad Therapy ...
Oct 25, 2021•1 hr 20 min
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 Your Story Show Notes: Donate to SPCA International Episode 82 – Predatory Therapists (with Dr. Diane Gehar...
Oct 11, 2021•1 hr 18 min
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 support the show and receive access to regular bonus episodes, check out the Very Bad Therapy Patreon c...
Sep 27, 2021•1 hr 30 min
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 listening. To support the show and receive access to regular bonus episodes, check out the Very Bad Ther...
Sep 13, 2021•1 hr 25 min
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 through Starbucks and the hospitality industry. We want to hear your feedback on this one! VBT in Fo...
Aug 30, 2021•1 hr 50 min
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. Thank you for listening. To support the show and receive access to regular bonus episodes, check ou...
Aug 16, 2021•1 hr 25 min
