Can therapists do harm? Views from a Trainee Clinical Psychologist

Can therapists do harm? I'm a Trainee Clinical Psychologist and have been providing therapy for a couple of years now, but this question can be an uncomfortable one to think about. As mental health professionals, many of us come into the profession hoping to do good and the idea that we could do quite the opposite is really(!!!) unpleasant.

We have our codes of ethical practice and conduct, but I've found that these don't go into the more nuanced aspects of harm, which I hope to discuss in today's videos. My current ideas and thoughts have been heavily shaped by other therapists, psychologists, and people who access mental health services - some of whom I have mentioned in this video (go give them a follow on Twitter, you won't be sorry ;) )

ABOUT ME
Hello! My name is Miranda and I am a second year Trainee Clinical Psychologist. Every Sunday at 2pm I share videos on clinical psychology and mental health. These are sometimes serious, sometimes less serious, but always have the intention of making you smile!

SOCIALS:
Twitter: @theworrypeople

TIMESTAMPS:
0:00 Introduction
1:52 The Power Differential
5:12 Western-centric psychology
9:18 Academia & Research
12:17 Therapist presence online
17:02 Closing comments

RESOURCES:
BPS Code of Ethics

HCPC Standards of Performance, Ethics and Conduct

Conceptual framework for personal recovery in mental health (Leamy et al. 2011)

Key Concepts and Issues in African Black Psychology (Dereef Jamison, 2018)

Social GGGRAAACCESSS and the LUUTT model (can be used help to develop cultural competence and initiate conversations around intersectionality 😊)

MUSIC (Thanks to the creators)

Creative Commons — Attribution 3.0 Unported — CC BY 3.0

Creative Commons — Attribution 3.0 Unported — CC BY 3.0

[TheWorryPeople]

I think it's worth me saying that I am a big fan of therapy (and therapists!) - this discussion is not designed to put anyone off either. With that said, we are in a role that requires sensitivity and involves a lot of responsibility, so the risk of harm will always be present. For this reason we have to keep talking about these issues, to make sure we keep evolving our practice and stay aware of our biases/limitations.

[DrMelodySmith]

Some excellent reflections here particularly about intersectionality and online presence. Love the editing too! Many thanks for sharing.

[cadmantheaviator]

40% of people won’t be helped by therapy and 5-15% harmed. “Harm” covers a lot of things. For me the worst offender is psychoanalytic therapy that relies on client ignorance of the process and sidesteps issues like informed consent. Wanting to leave being reduced to resistance. Madness. It is incredibly dangerous to leave harm out of training. It’s not even in most textbooks.

[SharonB]

HECK this is a lot of food for thought but I'm here for it.

[bowlace]

Hi Miranda! Just discovered you recently and immediately subscribed. The topics you talk about are so interesting and ones which have crossed my mind at some point, but have not really been addressed in my classes. I think you touch on very important and practical issues.

Thank you for sharing your knowledge through this platform!

[asweeni]

Hi Miranda, I really liked this video and feel it is so important right now and have learnt more about different ways therapist can cause harm instead of those that immediately come into our mind. very insightful and hope you make more videos like this. Thank you for attaching the resources - such an interesting paper to read xx

[marianna]

Excellent video, thank you! I am excited for a sequel :) The therapist/ social media thing does not get talked about enough: when it is mentioned, the conversation seems to revolve around therapists personal life/ past professionalism (i.e. whether there is footage of them in freshers week many years ago), rather than about the iffiness of alluding to various clients in success stories!

[PsychologyCast]

Interesting video and I like the way you framed your points. I've learned a lot, particularly around representation and understanding.

[palisadessilver]

Some very thoughtful points in this video..The worst therapist I saw had a degree in "Cross Cultural Counseling" but was constantly making racist comments, slurs and microaggressions towards minority groups during the session. I'm white and come from a western background, but this (and countless other things) made me extremely uncomfortable during the session. Some people just never learn despite any training they might have.

[TheOxfordPsych]

Re therapist presence online; defos wasn't unsatisfactory at all! What amazing insights and really helped me think as well. I guess the same happens on a smaller scale in clinical settings; i.e. you can be disseminating clinical ideas/techniques evidenced based now, that may be refuted in the future. Can't control everything aha

[vickymay]

What worries me most is that therapist isn’t a legally protected term. Anyone, without the relevant qualifications, can call themselves a therapist and not be held accountable!

[WriterK]

YOU scare me, the way you stress certain letters such harshly, and the way shout the words instead of calmly speaking, the way you move so aggressively, and the overall jumpy jumping behaviour that yo portray, just elevates my anxiety and panic!! I have to block your channel in order not to see you again, really.