FAMOUS THERAPIST ERRORS Presented by CONTINUING PSYCHOLOGY EDUCATION INC. 6 CONTINUING EDUCATION CONTACT HOURS “Such self-honesty and internal clarity are prerequisites for a serious analysis of therapists’ flaws and imperfections.” Kottler and Blau (1989, p. 127) Course Objective Learning Objectives This course examines the prevalence of Upon completion, the participant will understand therapeutic errors and how we may learn the nature and prevalence of therapeutic errors from the process. A number of prominent and the learning potential inherent in examining practitioners disclose their counseling one’s mistakes. A number of influential mistakes allowing the reader to gain psychotherapists-theorists examine the concept of from their experience. Albert Ellis, William therapeutic errors facilitating the reader to integrate Glasser, Arnold Lazarus, Gerald Corey, and these principles into his or her own practice. others disclose their therapy failures for our benefit. Faculty Neil Eddington, Ph.D. Accreditation Richard Shuman, LMFT Continuing Psychology Education Inc. is recognized by the New York State Education Department’s State Board for: Social Work as an approved provider of continuing education for licensed social workers #SW-0387; Mental Health Practitioners as an approved provider of continuing education for licensed mental health counselors #MHC-0080, and licensed marriage and family therapists #MFT-0043; Psychology as an approved provider of continuing education for licensed psychologists #PSY-0006. Mission Statement Continuing Psychology Education Inc. provides the highest quality continuing education designed to fulfill the professional needs and interests of mental health professionals. Resources are offered to improve professional competency, maintain knowledge of the latest advancements, and meet continuing education requirements mandated by the profession. Copyright ≤ 2021 Continuing Psychology Education Inc. 1 Continuing Psychology Education Inc. P. O. Box 12202 Albany, NY 12212 FAX: (858) 272-5809 Phone: 1 800 281-5068 Email: [email protected] www.texcpe.com FAMOUS THERAPIST ERRORS INTRODUCTION Lazarus, Gerald Corey, and others shared some of their imperfections allowing us to learn from their mistakes and to Understanding therapeutic errors may lead to improved be more disclosing of our own. future performance through refinement of our strategies and the necessary implementation. Therapists grow by ALBERT ELLIS demonstrating what works and by identifying what does not work. Lapses in judgment, mistakes in timing and pace, and Ellis is known for developing Rational Emotive Therapy mis-use of techniques and interventions are instructive (RET), an action-oriented therapy designed to make because they are fundamental errors suggesting the need to emotional and behavioral change through challenging self- utilize basic therapeutic strategies. defeating thoughts. He died on July 24, 2007, at age 93. The A good indication of therapy failure is “when both parties American Psychological Association, in 2003, named Dr. Ellis the second-most influential psychologist of the 20th agree there has been no apparent change” (Kottler & Blau, th 1989, p. 13). Uncertainty of therapy effectiveness may still century, second to Carl Rogers. In 2005, his 78 book, The occur though given clients not disclosing truthfully about Myth of Self-Esteem, was published. their satisfaction level. Further, Kottler (2001) reminds us He remembered working with Jeff, a young man who was that we may receive completely different feedback from the very depressed. Client had responded well to active-directive client’s significant others compared to the client him/herself. therapy with Ellis in the past but after a number of years he Keith and Whitaker (1985) indicate that therapy may appear returned to therapy with severe depression. Therapist worthless in the short-term but can result in long-term disputed client irrational beliefs and used a variety of benefits. Defining bad therapy is difficult, in fact, Bugental behavioral imagery and RET interventions. (1988) believes that every session includes elements that are Client depression occasionally improved but as business both good and bad. slowed down he regressed into severe despair and self- Hill, Nutt-Williams, Heaton, Thompson, and Rhodes downing. After 23 RET sessions client’s wife insisted that (1996) examined factors that lead to impasses in therapy by something other than his desire to succeed was troubling him; interviewing twelve experienced therapists who were she became upset with therapist for not helping her husband working with relatively severe cases in long-term treatment. and coerced him to attend psychoanalysis. Eight months Variables most associated with impasses included client later he attempted suicide and was hospitalized for several characteristics (severity of pathology, history of interpersonal weeks. Since that time he has maintained a marginal conflict), therapist characteristics (therapist mistakes, existence. Client would like to return to RET but wife counter-transference), and problems with the therapeutic prevents this and she encourages him to take antidepressants, contract yielding disagreement about treatment goals. Stiles, which help moderately. Gordon, and Lani (2002) reviewed empirical studies Ellis concludes that he made at least the following three differentiating good from bad therapy and found the errors: 1) He diagnosed Jeff as a severe depressive but he did following two most significant factors: the depth or power of not rule out endogenous depression. He knew client’s father the therapy, and how smoothly things proceed. These experienced depression but he did not investigate other close researchers note that often therapists and clients do not agree relatives. “I now think that endogenous depression probably about how smoothly or deeply the therapy is proceeding runs in the family.” 2) During the second round of therapy, which may result from different treatment expectations. Ellis did not urge client strongly enough to try antidepressant Hollon (1995) suggests that insight regarding therapy medication concomitant with the therapy. “I misled myself impasses may be attained not only from a supervisor but also by remembering the good results we had obtained without from the client. Whether accurate or not, Hollon believes medication. I now believe that Jeff could have profited most that client feedback is the perception most influencing the from psychotherapy and pharmacotherapy combined.” result. 3) He did not urge client to bring his wife fully into the therapy, in fact, she attended only one session. “Instead, I The following section examines the self-admitted probably should have arranged continuing sessions with her therapeutic errors of prominent practitioners. The goal is for and with both of them.” all of us to learn from their mistakes and to confront our own. Ellis concluded by stating, “As a result of my failing with Jeff and with several similar cases of severe depression, I now take greater care to look for evidence of endogenous THE ERRORS OF PROMINENT depression, to enlist other family members in the therapeutic PRACTITIONERS process, and to ferret out and actively dispute – and teach my clients to dispute – their dogmatic shoulds, oughts, and Kottler and Blau (1989) and Kottler and Carlson (2003) musts.” interviewed noteworthy practitioners and asked them to describe an experience with therapy failure due to their own error, what they learned from the experience and how it has impacted their life. Albert Ellis, William Glasser, Arnold 2 Continuing Psychology Education Inc. FAMOUS THERAPIST ERRORS WILLIAM GLASSER asked about his weaknesses, he revealed that sometimes his impatience led to pushing someone faster than expected, Glasser is the creator of reality therapy and has written fortunately, he learned from his mistakes, was quick to numerous books, including the classics, Reality Therapy, apologize once awareness set in and then he moved at an Choice Theory, and Reality Therapy in Action. appropriate pace. He described a case regarding a woman in therapy who eventually decided to leave her husband. The husband, a ARNOLD LAZARUS wealthy man used to getting his way, convincingly threatened to kill himself if she left him unless his wife agreed to live Lazarus, a Rutgers University faculty member, coined the with him for two months a year. Glasser noted, “I just didn’t term “behavior therapy” then combined cognitive therapy know what to do, or whom to call. I mean the man was not and other interventions with his behavioral approach to insane. In those days, there was no chance whatsoever of become the founder of multimodal therapy. He has written getting someone committed who was reasonably sane. I numerous books, including The Practice of Multimodal thought of calling the police. I didn’t even know what to say Therapy, Brief but Comprehensive Psychotherapy: The to him.” Multimodal Way, I Can If I Want to, and The 60 Second Therapist confronted the man, tried to negotiate a suicide Shrink: 101 Strategies for Staying Sane in a Crazy World. contract and attempted to convince him to check into a He has won many honors, including the Distinguished hospital – but unsuccessfully. He then asked the wife to Service Award of the American Board of Professional write a letter stating that she was aware of the situation but Psychology in 1982 and the Distinguished Psychologist chose to leave her husband. Award of the Division of Psychotherapy