Pamphlet - In all clinics for Survivors of Unethical Therapy; what goes in it?

I also think there should be some form of informed consent. The two Ts I saw never gave me any form. Medical treatments and medications also have side effects, sometimes pretty serious ones. Medical providers and pharmaceutical companies are legally obligated to inform patients about them - that can also make people skittish. I actually prefer the term cautious. I don't see why therapy should be any different, other than it is tricky because it's really not a "treatment", Ts usually don't know what they are going to do, often not when they are actually doing it. It provides easy holes they can argue with and use to avoid responsibility. In any case, if it is considered a professional service, there must be some criteria and clear awareness on the potential risks and benefits. I'm not a T but, even just after reading this forum for several years now, I see very clear patterns and trouble spots that tend to bug clients and it wouldn't be difficult to list common and less common "side effects". It does not matter that not every client will eventually experience them - just like with medications and actual treatments. IMO, many Ts avoid even the awareness of the risks of what they do because it does not only affect their sense of competency but the validity of the whole enterprise as well.

It seems like there are two goals, then:

1. Support for people who have been harmed by therapy

2. Prevention of harm to additional clients.

For support, yes a forum somewhere would be good. Getting the word out through a pamphlet also would be good.

For prevention, some kind of thorough informed consent is essential, I think. Can one consumer or a group of consumers do that effectively on our own? I think probably not. So that means organization, and that means we need a place to start talking about how to organize. We could ask PsychCentral for a social group and that would get the comments and discussion into its own place. That's within PC's existing community structure. Among the things we could discuss is how and where to branch out later.

Here's something I came across yesterday that I think supports the idea of the social group here to see if we can organize some collective action.

Collective Action Can Lead to Empowerment and Strengthened Relationships

Also important for prevention is what @sarahsweets mentioned about an effective complaint process and procedure. That's way more that a group of consumers can accomplish on our own but we can certainly start the ball rolling.

So, seems like we'll need to prioritize on goals and subgoals and projects. And in order to do that we'll need to (learn to) discuss and disagree and bash heads sometimes. There may need to be some guidelines. I don't know if many of you have read PC's Community Guidelines. It's pretty thorough. We could develop some of our own, too, specific to the social group, I think, if we decide they are needed. But. . .not to get hung up on the organization and forget the purpose -- that' s certainly something I've seen happen in groups before.

What do other people think?

You could write down a list of concerns as a group of people/mental health consumers, who have been harmed by therapy in the past, and then write collectively to the APA. You could contact the APA to see what avenues you could take to promote prevention, since prevention can be handled in multiple ways by multiple agencies. Here is a link: Contact APA

I've tried a bunch of things in the past. I'm not personally looking for more of that kind thing, I don't think it will do any good based on what I've done and the responses I've gotten in the past. But everybody's experience can be different, times and organizations change. Is it something that you personally would like to do? Spearhead that and see what you can come up with? I'll be glad to provide support when and how I can.

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Originally Posted by here today I've tried a bunch of things in the past. I'm not personally looking for more of that kind thing, I don't think it will do any good based on what I've done and the responses I've gotten in the past. But everybody's experience can be different, times and organizations change. Is it something that you personally would like to do? Spearhead that and see what you can come up with? I'll be glad to provide support when and how I can.

Thank you, @here today

Oh no, it's not something I could do or would like to do, though I don't mind supporting someone else who wants to spearhead that.

I wouldn't know where to start, actually.

All I know is that you all raise some good points, and if you can synthesize them into categories, like I think someone has done on another thread started by HD, then those synthesized points can be placed in a signable petition, which could be created online somewhere. If there are enough signatures and comments regarding what has been listed, given some reasonable limitations (e.g., therapeutic ruptures are not necessarily abuse or harm, though it may feel that way for some), then that petition with all the signatures involved could be shared with the APA.

It would be up to the APA to respond or not, to take that information for future research considerations or not, and to find ways to open up the dialogue between the community and their own ethics board (which currently holds a policy that redirects most complaints by referring them to look into their own local licensing boards, etc.).

Someone who has the energy, clout, education, support, and leadership skills would be the best fit for spearheading this particular endeavor. -IMHO.

(((safe hugs)))

There are pamphlets that already exist aimed at clients, like,

Professional Therapy Never Includes Sex
https://aspirace.com/wp-content/uplo...cludes-sex.pdf

It’s Never OK: A Handbook For Victims And Victim Advocates On Sexual Exploitation by Counselors And Therapists
https://www.leg.state.mn.us/docs/2007/other/070240.pdf

Good for you empowering and advocating for victims!
Where were you going to hand these out...who will be handing them out?

Have posted this before..still brilliant, imo:

This short article was written in a tongue-in-cheek effort to capture the impact on the patient of sexual intimacy with professional. It was originally written as part of an informal debate between author and a lawyer.
Article printed in Journal of Sex and Education, S.Michael Plaut, Ph.D., 1993.

It brings up some interesting points:

http://www.survivingtherapistabuse.c...-or-Client.pdf

Advocateweb had their own pamphlet years ago about therapist exploitation. I placed a bunch of them on a table every time I visited my PCP’s office. Several PCP’s work out of there...five...maybe six? No therapists worked there.

The pamphlets were always gone by my next visit. My feeling is they were probably dumped bc I hadn’t really asked if I could place them there.

I viewed it as sort of an experiment.
Also wondered if my PCP would ask me about them knowing my history..but nothing was mentioned to me by anyone. Maybe they never figured out an oddball thing like that.

Are there any that don't just talk about sex?

Thanks for mentioning Advocate Web. I've had a hard time over the last 4 years trying to figure out or find where what I felt to be harmful about therapy fit in. It wasn't sexual exploitation, it didn't seem clearly like emotional exploitation, though it felt like that. I felt used and conned.

So I think I'm going to look over that website and some of the resources they have there and see if I can maybe get what seems like a clearer picture of what happened to me. Here is a quote from Advocate web:

That's the key, probably. That the client's dependence can be used and exploited. I wasn't aware of that when I went into therapy. But according to the quote above it was the therapists' jobs to be aware, and they weren't or didn't care or didn't know how to handle it.

I was going to ask the same question. Sexual involvement is one of the most extreme things they can do, something that can be relatively easy to prove. But there are so many cases of emotional abuse and taking advantage of clients that they can get out of relatively easily because there is no practical evidence and/or clients just won't report it, so many of those cases go unnoticed. But so many stories here on PC show those clients can get just as badly hurt, and for a long time. I do believe the dependency therapy can create is a main culprit and many Ts actively encourage it, saying it is a good thing because it models the issues of the client. That aspect of therapy is something I really despise and definitely think the Ts should know better. One problem is, IMO, is that some get hooked just as much and spin out of control - then when things go sour, they just get rid of the client with some rationalization and excuse.

I'll probably get backlash for this but in my own very personal experience, therapy can go bad and become totally freaking traumatic (some of you know my story )

But therapy can also be so healing and beneficial

I find it odd that people seem to think about everything in such black and white terms, these days especially

If I hadn't entered therapy again with my current therapist - I wouldn't be here , point blank

And this is not to say that everyone should just try again

Like I said this is my own experience

But that's the thing isnt it ! We are all individuals and there is no rule book for such thing s.

I encourage people to look at their own situations and experiences. And to not base decisions off of others experiences .

If I hadn't continued therapy, I would have killed myself 10 years ago .

So why come in here to say this?

I feel like personally, one of the biggest barriers is the attitude that anyone who has any criticism at all of therapy or wants any sort of change to the process just wants to do away with the whole system. I don't see people in this thread saying do away with therapy. I see us saying we want to warn people that it's not the perfect panacea that'll always work if you just try hard enough that we were told it was. I know for me that was a major component of harm: the fact that I am living in a society that treats therapy as the only acceptable solution and blames anyone who doesn't get better.

That's the thing - people tell you "don't be so black and white", but then I've literally had people screaming at me just for saying that therapy didn't work for me because "therapy works". The common reaction has been that even telling our own stories is some sort of attack on anyone who has benefited from therapy, like there's no room for both. Or like if people might know that not everyone benefits from therapy and there are ways they could get hurt, then that'll lead to some sort of entire collapse and reversion to when we blamed demons for mental illness or something.

I don't want to get rid of the system. I just want to challenge the dominant narrative that therapy is always a good thing for everyone. I want people to be able to give genuinely informed consent because they know the risks. And I want to end the culture of silence that blames and pathologizes people who don't get better rather than looking at how the system needs to fix itself.

I don't feel that therapy is advertised as risk free. I feel that it is common sense that most important things in life involve some element of risk. I dont feel attacked at all about people saying that therapy didnt work for them , or that it hurt them . Like I said I speak my own truth , from my own experience

Why did I post in here ? Because I've been a victim of therapy gone wrong, therapeutic abuse. And this is my thoughts on the matter

I think the "system" definitely works for many people. I had a bad T myself but wouldn't say I was harmed by him/therapy. However, it may be in part due to these types of discussions here on PC - they made me see problems with that T relatively early on and that kept me from getting in too deep. I think I could have never imagined that many people get so hooked they cannot leave an abusive T and perhaps would have thought there was something really wrong with me specifically if that happened to me. To use an analogy, I think some people are predisposed to get addicted to substances, but they will never be addicted if they didn't use the drug and initially thought it would not harm them seriously. But they don't get addicted to just anything, certain substances have those properties, so are not exactly safe by default.... doctors still prescribe a few of such drugs excessively. It is good to at least know those specific risks in advance, it is not exactly intuitive that a medication for, say, anxiety can get someone severely addicted and can sometimes ruin their lives.

I think there's a difference between "I was harmed" and "You/they are bad". Even when the two thoughts frequently occur together. And that's a different issue than black/white thinking, even though, again, they may be similar.

There's also a difference between "the system is bad, screwed up, etc., " and "stay away from it entirely, even if you're desperate".

I see this thread as focused on trying to reach out to, and support, those who have been harmed by therapy/therapists. And, prevent more harm to other people from happening.

"How to find a good therapist after you've been harmed" is also a good topic for helping people, if that's what somebody wants to try to do. But -- I think it could help them avoid more harmful therapy if the risks were clearly identified, too.

I would argue therapy *is* largely advertised as risk free.

Sure they talk about "risk". But it's mostly superficial drivel like: it might get worse before it gets better, or change is hard.

They use manipulative and vague language that preconditions clients to bear the burden of risk and to accept blame for future problems.

They label potential damaging effects as "side effects" when in reality what's damaging is the relationship itself.

It's the most underhanded, least transparent profession I've dealt with.

I find the below to be a pretty typical summary of how the idea of risks is approached:
Cognitive behavioral therapy - Mayo Clinic
Note that the only "risks" discussed are things like feeling uncomfortable or temporarily being a bit more stressed.

Unfortunately I think this attitude is part of the harm. Not only do clients go in unaware that real harm is possible, but when they do noticed it their experiences tend to get dismissed as just discomfort. It reminds me of the emotional equivalent of how, say, menstrual conditions are often undiagnosed because everyone knows periods are uncomfortable. And then people who say no this is really a problem get treated like a they're just whiny and can't put up with some minor discomfort.

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Originally Posted by OnlyOnePerson I find the below to be a pretty typical summary of how the idea of risks is approached: Cognitive behavioral therapy - Mayo Clinic Note that the only "risks" discussed are things like feeling uncomfortable or temporarily being a bit more stressed. Unfortunately I think this attitude is part of the harm. Not only do clients go in unaware that real harm is possible, but when they do noticed it their experiences tend to get dismissed as just discomfort. It reminds me of the emotional equivalent of how, say, menstrual conditions are often undiagnosed because everyone knows periods are uncomfortable. And then people who say no this is really a problem get treated like a they're just whiny and can't put up with some minor discomfort.

@OnlyOnePerson

You make excellent points here, especially with your analogy at the end regarding menses. I complained about my painful periods since the age of nine. My laments were dismissed. Only years later, after I was hospitalized for four days with a fever of 104 degrees, they found endometriosis, a damaged fallopian tube, and some other issues that warranted surgery (a laparoscopy); I was about 27 y/o when I needed surgery. Once the surgery was done, I felt loads better and have not experienced the same issues. Had it not been caught, I could have died or went through some serious complications.

The mind and body are connected. Those who have repeatedly experienced minimization of their feelings, traumas, and reactions to treatments are not only NOT getting the treatment they need but also experiencing increased distrust in the system. It's so easy for professionals to dismiss those reactions as "difficult clients" or "the effects of personality disorders." Even if clients are "difficult" or struggling with "personality disorders," such populations need different approaches to their treatments, as evidenced by their continuous lamentations on how they are affected by certain treatments and/or approaches to treatments. It's not enough to say that such populations are "not ready for treatment," or are "too treatment-resistant," etc. It's also not enough to place sole responsibility on them to change their attitude or approach to therapy when treatments should involve "meeting the client where he or she is at."

An alternative solution could include a slower, more supportive approach to treatment in the beginning. Some clients need to take more time to establish trust and rapport with their treatment provider. Some clients need more time to express their pain, their life story, their fears, etc. Some clients feel that they need more empathetic feedback to establish trust and rapport with their treatment provider. Additionally, some clients need more precise explanations about what treatments are offered for their particular diagnosis, and to be involved in the diagnostic process. For example, if a diagnosis is presented to a client, as per his/her right, allow the client to provide feedback on whether or not that diagnosis rings true. If the client presents enough good evidence to support that the diagnosis is not a good or adequate representation (e.g., situational factors, adjustment issues, etc., as opposed to long-term dispositions), then taking time to speak about those issues openly and with opened minds would help to maintain trust and rapport. Also, if a diagnosis is true for the client, but the client has a hard time with accepting it, working on the shock of receiving that diagnosis is crucial for some people (in the same way that working on the shock when someone receives a diagnosis of cancer, an incurable disease, etc.). The shock of receiving a diagnosis needs to be processed, too.

If the client has had past negative and/or traumatic experiences with therapy, that should also be processed at the outset, because that is what is going on at the forefront for the client. Understanding the losses, pain, traumas, etc., involved in clinical settings helps to build and maintain rapport and trust. Existentialism is important here.

There are many solutions to this, but a pamphlet is only one small solution. We can ask for what our needs are up front, but sometimes we need therapy for just that - being able to ask for our needs and learning how to identify what exactly our needs are. Thus, pamphlets might be good for some things, but it still places the majority of responsibility on the client.

Additional prevention and protective measures should also be factored in when it comes to problem-solving. Therapists and researchers should also take into consideration their policies, training, approaches to practice, and evidence-based research when it comes to understanding certain client populations. There's no way that could be understood if there's a lack of research and willingness to hear the laments of said special populations.

There also needs to be more accountability in the field. The more accountability, the less the risk of being mishandled, mistreated, abused, harmed, misdiagnosed, etc.

These are just my POVs. There may be other, more appropriate POVs.

It's amazing that the Mayo Clinic has such a minimalist risk statement. They have the same risk statement for Psychotherapy in general, too.