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How Therapists Fail: Why Too Many Clients Drop Out of Therapy Prematurely

How Therapists Fail: Why Too Many Clients Drop Out of Therapy Prematurely

by Bernard Schwartz, PhD and John Flowers, PhD

If we could learn from all of our less-than-optimal therapy outcomes, we'd really acquire some true clinical wisdom.  Here are some practical tips to increase your odds of success.
Depending on which study you read, between 20 and 57 percent of therapy clients do not return after their initial session. Another 37 to 45 percent only attend therapy a total of two times. Although many factors contribute to premature client termination, the number one cited reason by clients is dissatisfaction with the therapist. The problem of the “disappearing client” is what Arnold Lazarus has called “the slippery underbelly to the successful practice of psychotherapy that is almost never discussed in graduate programs or medical schools.”
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This article was adapted from the book How to Fail as a Therapist: 50+ Ways to Lose or Damage Your Patients, © 2010, Bernard Schwartz and John. V. Flowers. Reprinted with permission.
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Bernard Schwartz Ph.D. is a licensed clinical psychologist who has a lifetime of experience working with children as a teacher, educational therapist and child psychologist. He is the author of a number of books on child-parent relations including the highly successful How to Get Your Children to Do What You Want Them to Do. His most recent book, How to Fail as a Therapist, describes the most common errors beginning, and even experienced clinicians make. This book, with a foreword by Arnold Lazarus, has been widely adopted as a supplementary text by colleges throughout the country. Dr. Schwartz is a professor of psychology at Brandman University in Orange, California.

Dr. John Flowers was a graduate of and Woodrow Wilson Fellow from the University of Southern California. He is presently a professor at Chapman University, where he has been director of graduate training. He has published dozens of articles in journals such as: Behavior Therapy, Community Mental Health, Journal of Educational Research, Psychotherapy: Theory, Research and Practice, The Counseling Psychologist, and Contemporary Psychology. Dr. Flowers is the author of a number of books including: Help Your Children Be Self-Confident, and most recently Psychotherapists On Film.
These points are really elementary, but they are so relevant! I've met so many therapists as I've tried to find help healing my C-PTSD--16, all told--and most of them have been "infallible," hung up on technique to the point where they have not seen me as an intelligent human being, etc. Worst of all, when our relationships have failed, they have been so arrogant that they have left me to assume the total responsibility for the failure. Not very realistic! It takes two to tango, as they say. Even in therapy! Thus, each failed therapeutic relationship has exacerbated my feeling of being a failure as human being and has led me to get help once again. Now, I finally have a therapist who has given me an accurate diagnosis and knows how to help me. She is also willing to be a human being and take her part of responsibility for our relationship. This has led to a wonderful working relationship, and I'm healing my C-PTSD! I"m happy!
Jean Fairgrieve
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CE credits: 1
Learning objectives:

Learn about five of the most common therapeutic errors made by clinicians—both beginners and “master” therapists.

Describe well-researched strategies which have been proven to reduce dropout rates and increase positive treatment outcomes.

Identify your current strengths and weaknesses as a clinician.
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