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This book examines therapeutic failures in psychotherapy. Despite
the consistent positive outcome findings and psychotherapists’
best intentions in their efforts to help their clients,
psychotherapy simply does not work in all cases. In fact, 5-10% of
adult clients deteriorate during psychotherapy. Although not
exclusively due to treatment failures per se, almost a fifth of
clients terminate their therapy prematurely and findings suggest
that that between 20 and 30% of clients do not return after the
first session with half terminating after just two sessions.
Therapeutic failures could include a range of negative therapy
outcomes, such as harm, deterioration, client non-response,
premature termination, or dropout, as well as process factors, such
as negative therapy experiences, impasses, or alliance ruptures.
Investigating therapeutic failures holds the key to improving the
effectiveness of psychotherapy as well as understanding some of the
fundamental conditions that need to be in place for the change
mechanisms of psychotherapy to take effect. Although psychotherapy
has made many strides over the last few decades to improve research
rigour and to promote evidence-based practices, it is a profession
that is still growing. By embracing the opportunity to learn from
therapeutic failures the profession will continue to refine its
practices to better serve clients and to strive toward developing
ethical and effective practices. Both comprehensive and accessible,
this book will be of great interest to psychotherapists in
practice, therapists-in-training, as well as students and
professionals in psychology and mental health in general. The
chapters in this book were originally published in Counselling
Psychology Quarterly.
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