Download How to Fail as a Therapist: 50+ Ways to Lose or Damage Your Patients (Practical Therapist)
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How to Fail as a Therapist: 50+ Ways to Lose or Damage Your Patients (Practical Therapist)
Download How to Fail as a Therapist: 50+ Ways to Lose or Damage Your Patients (Practical Therapist)
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Review
“...provides useful information and shares numerous lessons of relevance for all psychotherapists.” —Jeffrey E. Barnett, PsychCRITIQUES, APA Review of Books“Practical advice on how to bypass obstacles and sidestep pitfalls that cause clients to drop out of therapy.” —Behavioral Science Book Service“... If you treat, coach, or counsel people or engage in clinical supervision, it will make your work a lot easier and more effective.” —Arnold A. Lazarus, PhD, ABPP, Distinguished Professor Emeritus of Psychology, Rutgers University“...a must read for therapists starting out in private practice and a gem for clinicians already working in the field.” —R. Chip Tafrate, PhD, Psychologist, co-author, Anger Management: The Complete guidebook for Practitioners“...a superb and exceptionally practical book that addresses issues relevant for all psychotherapists to consider.” —John Preston, PsyD, ABPP , Professor, Alliant International University“...a wealth of valuable information that should be readily implemented by readers... and shares numerous lessons of relevance for all psychotherapists...” —PsycCritiques, APA Review of Books“...for both the novice therapist and the more seasoned of us who want a nice check list to make sure we stay at the top of our game.” —Richard Landis, PhD,The Milton H. Erickson Foundation Newsletter
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About the Author
Bernard Schwartz, PhD, has written a number of books, including the highly successful How to Get Your Children to Do What You Want Them to Do. He has specialized in the fields of sports psychology, and child custody evaluations, and has written extensively on both subjects.John V. Flowers, PhD, (1936-2012) was a professor of psychology at Chapman University and a clinical psychologist in private practice. His research focused on psychotherapy process and outcome, and psychotherapy in the cinema. He authored dozens of journal articles, seven prior books and made hundreds of presentations to scientific societies.
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Product details
Series: Practical Therapist
Paperback: 192 pages
Publisher: Impact; Second Edition, Revised edition (August 1, 2010)
Language: English
ISBN-10: 1886230986
ISBN-13: 978-1886230989
Product Dimensions:
6 x 0.5 x 8.8 inches
Shipping Weight: 9.6 ounces (View shipping rates and policies)
Average Customer Review:
4.7 out of 5 stars
23 customer reviews
Amazon Best Sellers Rank:
#679,707 in Books (See Top 100 in Books)
This book deals concisely with what it says on the cover and make specific recommendations based on the mistakes it identifies.SUMMARY=========The 50 mistakes are as follows1 Failing to recognise our limitations as therapists2 Failing to address client expectations about therapy3 Failing to inspect the client’s previous experience with psychotherapy4 Failing to explain the therapist’s expectations regarding the therapeutic process5 Failing to prepare clients for the variety of emotions that therapy can evoke6 Failing to enhance client expectations of success7 Failing to understand how our assumptions affect (sic) therapeutic practices8 Ignoring the client’s “state-of-change†or commitment level9 Failing to assess psychological reactance (the patient’s receptiveness/resistance to the therapist’s formulations)10 Underutilising clinical assessment instruments11 Failing to challenge client “self-diagnosisâ€12 Failing to assess for the possibility of organic medical conditions13 Ignoring patient resources14 Disregarding the data15 Attending to the messenger and not the message16 Achieving theoretical rigor mortis17 Setting goals unilaterally18 Failing to Develop Collaborative Goals in Early Sessions19 Failing to include the client in setting session agendas20 Emphasising technique over relationship building21 Failing to communicate sufficient empathy and other signs of support22 Believing that empathy and unconditional positive regard means liking your patient23 Failing to elicit feedback on the alliance24 Ignoring the patient’s verbal and nonverbal feedback25 Responding defensively to negative patient feedback26 Overidentifying with the patient27 Allowing inappropriate levels of physical intimacy28 Having boundaries that are too rigid29 Making inappropriate levels of therapist self-disclosure30 Failing to set boundaries for out-of-session client therapist contact31 Developing the “Out of session activity†unilaterally32 Failing to adequately prepare clients for the assignment33 Failing to provide backup support to increase compliance34 Failing to prepare the patient for attitude change35 Relying on passive learning strategies36 Failing to attend to the client’s core beliefs37 Failing to explain that attitudes are not fixed beliefs38 Responding passively to the client’s unproductive behaviours39 Responding in an aggressive or insensitive way40 Failing to prepare clients in advance for the possibility of medication41 Failing to be prepared for client objections, concerns and resistance to medication42 Failing to discuss termination early in therapy43 Failing to follow proper termination procedures44 Confusing termination with abandonment45 Failing to be prepared to deal with the myth of time limited therapy46 Failure to monitor one’s own well-being47 Failure to balance work and leisure48 Ignore the comfort zone of the environment49 Overspecialising50 Undervaluing the power of human resiliencyThe ways, that I found helpful, to avoid the mistakes are summarised below.HISTORY• Ask about the good/bad bits of the last session (23)• Ask about good elements of the session (2, 23)• Ask about bad elements of the session (2, 23)• Past experiences media and friends who have had therapy (2)• Past experiences with other therapists: duration, ending, relationship, best bit, worst bit, what should be changed, treatment too fast/slow (3)• “What do you think is likely to happen as a result of your treatment?†(6)• Assess change stage: “Who in your life is most concerned about this problem?†“What have you done or thought about doing about this problem.†“How long has this problem been a concern?†Use a “readiness ruler†(actually a visual-analogue scale) of the patient’s commitment to change• Methodological search for patient’s strengths (13)• To prioritise treatment goals: what difficulties are the problems causing, what might happen in the future, what goals might someone in your position have, which goal fit/do not fit you? (17)• To increase personal efficacy: when have you been able to shake off the problem, how have other people you have seen done it, in your fantasies how did you tackle the problem? (17)• To increase commitment to change: how would life be better/worse, get support from? (17)MENTAL STATE EXAMINATION• Assess for reactance: interruptions, arguing, off-task comments, negative responses.• Note what is not being said (17)• Note: eye contact, disclosing less, greetings warmth (24)FORMAL TESTING• State of change assessment tool McConnaghy et al (in the book) (7)• The Hong Kong Scale of Psychological Reactance (in the book) (9)• Use a counselor satisfaction questionnaire (one in the book and other suggestions) (23)ASSESSMENT• Discloser/nondiscloser person (5)• Shutdown/unaware of their feelings (5)• Distraction used to cope with emotions (5)• Belief system: people trustworthy/not trustworthy, locus of control, altruism/selfishness, people complex/simple• Use the HRS instrument to assess homework barriers (33)MANAGEMENT• Inform a trusted colleague when you feel you made an error (1)• Educate about collaboration (2, 17), treatment approach, duration, termination (2, 42), door-knob disclosures (4), painful emotions might be evoked (5), exposure therapy (32)• Identify obstacle to exposure (32)• Prioritise session goals (4)• Set treatment goals (17) early in treatment (18) and early in sessions (19)• State the goal even if it seems very obvious (19)• Recognise that for some patients the goal is to develop a goal (19)• Leave time at the end of sessions to clarify goals (18)• Do not assume that the obvious goal is the patient’s goal (18)• Accept “baby steps†(6)• Low directiveness and high collaborative for those with high psychological reactance and vise versa (9)• Identify times when the patient has been successful, in therapy and life (13)• Have the patient record how many times they resisted the impulse to drink and not just if they drank or not (for example) (13)• Enhance your credibility by describing experience with other cases (20)• Do not be overly formal (20)• Convey positive regard (20)• Carl Rogers 3 imperatives: unconditional pr, therapist congruence and empathic understanding (21)• Act in accordance with the fact that you probably feel you are being more empathic than the patient thinks you are (21)• Ask oneself: do I need to hear more of what the patient is feeling and do I need to imagine how I would feel in this situation in order to connect? (21)• Connect with the person behind the repulsive behaviour (22)• Recognise that from strengths, not weakness, change will come (22)• Imagine the emotion leading to a different outcome (22)• Make patient feel safe to voice their concerns (25)• Admit your fallibility (25)• Use any rupture in the relationship (25)• Do not attempt to rescue (ie do more than is appropriate) (26)• Some self-disclosure but stop a LONG way short of matching the patient (29)• Brainstorm the hierarchy then the patient orders it (31)• Enhance compliance with home work with: post it notes, getting someone else to encourage them, do the activity with someone else, frame the assignments as experiments, leave little to chance (33)• Made assertive communications as needed• Make firm rules for therapy behaviour especially for couples therapy (39)• Tell people if their behaviour will not help treatment (39)• Terminate if: poor progress, patient not willing, patient too hard, conflict of interest (42)• Do a summary session no matter who decides to terminate therapy of if it is planned (42)• Do not terminate during a crisis, for your sake alone or quickly (44)• Note that with the exception of father daughter incest, as a group, those with traumatic events are only slightly worse off than those without the events• Have a phone call made to patients to confirm the (first) appointment.PROFESSIONAL DEVELOPMENT• Compare your termination rate with the norm (1)• Remember “Perfection is the enemy of the good.â€â€¢ Do we believe people can change? (7)• What is our belief system/how do we regard strangers (7)• Use Wrightsman’s Philosophy of Human Nature Scale (in the book) (7)• Remember that charismatic teacher are not always right (14, 15)• Humility (1, 16)• Read stuff (16)• Get therapy (26)• Identify the patients who push your buttons (39)• At professional development meetings, share how you are coping (46)• Take the Maslach Burnout Inventory (1981)• Note if you are irritable with patients, have less interest in your profession, procrastinate at work or have scheduling with no breaks• Don’t overspecialiseREVIEW=======Like the person who wrote the person who wrote the foreword, I do not agree with everything in the book. For example, they say not to give out your mobile number, they make a scatty troubleshoot of rational emotive therapy (the difference between attitudes and core beliefs in not important, and doing RET well will avoid the pitfalls they mention), their retelling of the African Violet Queen story is almost certainly inaccurate (I suspect they did this to avid exaggeration).Their treatment of countertransference was a bit scatty too. They do not use the term “identify†correctly or define it. They state “recognise that working effectively with patients does not mean that you ‘feel their pain.’†It is not made clear if this statement is an ideal or a likely outcome of treatment. Unfortunately it is the human condition that unless you are profoundly autistic you will find yourself mirroring the patient’s emotions – it is silly of them to deny this fact.On page 50, they state “the misconception here is that having positive regard for someone equates to liking the person.†Well, technically that true. But the authors ignore the fact that its pretty damn close. I think the authors own boundaries are too rigid. They discuss a junior therapist getting (psychodynamic sounding!) therapy for overidentification or fusion with a patient but steer clear of pointing out that therapists enter into a real, emotional relationship with their patients and that this can be done safely. In most settings, if you don’t like someone, you don’t have to and/or should not treat them.
Excellent book for conscientious therapists. This book really made me think about what I might be doing right and wrong with my clients, and how I might improve my practice. Highly recommended.
I have not finished this book, but as a new therapist, I am finding it to be incredibly helpful and informative. It is the perfect blend of research and experience from seasoned practitioners. This book should be on every therapist's bedside table, and is a book a therapist should probably read again and again! Just get it already!
Lots of good info
Got it quickly. Great read!
This is a book for every intern/trainee. A must! very informative and simple to read. Enjoyed it a lot. Will definitely go back and read it all over again. Thanks
The concepts presented in this book are extremely valuable for therapists, I highly recommend this book for all new therapists and those preparing in college.
Very good read
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