When psychotherapy doesn't work

Why do some clients not improve with psychotherapy? In this video, Dr. Nili Solomonov from Weill Cornell Medical College discusses the topic: What happens when psychotherapy doesn’t work? What are some warning signs, and what can you do about them?
References used in this video:
* Cuijpers, P., Quero, S., Noma, H., Ciharova, M., Miguel, C., Karyotaki, E., Cipriani, A., Cristea, I. A., & Furukawa, T. A. (2021). Psychotherapies for depression: a network meta‐analysis covering efficacy, acceptability and long‐term outcomes of all main treatment types. World Psychiatry, 20(2), 283-293. doi.org/10.100...
* Cuijpers, P., Reijnders, M., Karyotaki, E., de Wit, L., & Ebert, D. D. (2018). Negative effects of psychotherapies for adult depression: A meta-analysis of deterioration rates. Journal of Affective Disorders, 239, 138-145. doi.org/10.101...
* Solomonov, N., Lee, J., Banerjee, S., Flückiger, C., Kanellopoulos, D., Gunning, F. M., Sirey, J. A., Liston, C., Raue, P. J., Hull, T. D., Areán, P. A., & Alexopoulos, G. S. (2020). Modifiable predictors of nonresponse to psychotherapies for late-life depression with executive dysfunction: a machine learning approach. Molecular Psychiatry. doi.org/10.103...
* Newton-Howes, G., Tyrer, P., Johnson, T., Mulder, R., Kool, S., Dekker, J., & Schoevers, R. (2014). Influence of personality on the outcome of treatment in depression: Systematic review and meta-analysis. Journal of Personality Disorders, 28(4), 577-593. doi.org/10.152...
* Heinonen, E., & Nissen-Lie, H. A. (2019). The professional and personal characteristics of effective psychotherapists: a systematic review. Psychotherapy Research, 30(4), 417-432. doi.org/10.108...
* Hayes, J. A., Gelso, C. J., Goldberg, S., & Kivlighan, D. M. (2018). Countertransference management and effective psychotherapy: Meta-analytic findings. Psychotherapy, 55(4), 496-507. doi.org/10.103...
* Solomonov, N., & Barber, J. P. (2018). Patients’ perspectives on political self-disclosure, the therapeutic alliance, and the infiltration of politics into the therapy room in the Trump era. Journal of Clinical Psychology, 74(5), 779-787. doi.org/10.100...
Credits: Nili Solomonov (presenter)
Serena Z. Chen (editor) and Kim de Jong (supervisory editor)
Joeri de Jong (leader composition)

[@thomasnienow2249]

I think therapists should have an ethical obligation to proactively take steps to terminate therapy when it doesn't seem to be working. But I think therapists have a very glaring conflict of interest in this regard and allow therapy to go on when it is unproductive.

[@gmansard641]

I keep hearing about how therapy works if you stay with it, but I have never gotten much if anything from it. NO I do NOT enter expecting it to fail! I have generally begun with optimism, ant I enjoy the chance to express myself. But every time, after several months, I realize that I am going nowhere. I can't think of much they observed that I hadnt already seen for myself, nor anything they suggested that I had not already tried.
I don't see any evidence that therapy ever does much of anything for anyone.

[@hunnybSue]

It is making me so angry, I can't handle it anymore . I just want to be left akone.

[@sinforoso1974]

@gmansard641, therapy is a was te of time and money, therapist are hustlers of Human suffering

[@indiplum]

You are exactly right, their job is to give you basic coping skills any preteen would know 😂 basket cases love it. The media horribly romanticizes it, it’s not going to give you a “Eureka” moment and they’re not there to affirm or comfort you, or give you hope. 😂😂😂

[@hunnybSue]

I've been in and out of therapy for a long time. I can't let my guard down, so I can't learn to trust my therapist. Even thinking about therapy just makes me angry.

[@indiplum]

Sounds like you need an authentic connection in your life that will allow you to let your guard down and a space you can carve out to be vulnerable with yourself to provide a degree of protection

[@user-nd9xw8fm9c]

The video is very interesting thank you! Unfortunately, the background noise made it very hard to understand, especially for someone with hearing impairments.

[@SilentRunningRedux]

Psychotherapy and medication work for only a small percentage of people. It’s time to be honest about this and the role of financial incentives particularly in the US(A) “health care system.”

[@earlgrey2130]

Your video only has audio in the left channel and feels equally low passed and distored because its too loud. Im barely able to endure this on headphones..
And its a shame because the content is actually good. But your videos would be 10x more succesful if you get the audio right ;)

[@noelwass4738]

Could have gone much better, psychotherapy ended in 2020. Misunderstandings were prevalent. Would have preferred psychotherapist to ask why I give a response instead of changing topics after questions with a yes/no response. There were misunderstandings that if these misunderstandings were not present the patient psychotherapist relation would have improved. Misunderstandings occur because the psychotherapist says something that I misinterpret and does not ask if I know what she was talking about but assumes that I do. Transference happened at the end that gives a negative outcome. Many zoom sessions occurred at the end, due to lockdowns at the time together with a 2-week period between sessions meant a long time before I could see the psychotherapist face to face. The ending was too abrupt with no chance to talk, the psychotherapist was diagnosing Aspergers that I was not interested in such a diagnosis. The abrupt ending with no chance to resolve difficulties at the end made it difficult for me.

[@cadmantheaviator]

5-15% are harmed by psychotherapy. Comparing therapy to medication is quite misleading as medication is tested by the drug companies. Both are only “effective” some of the time.