This was my “puzzle” (the paradoxical Tuesday tip) for yesterday:
The failure to set the agenda is the cause of nearly all therapeutic failure.
Several of you commented, and a couple of you nailed it. This one was, perhaps, a bit too easy or obvious.
But what it means is that we all have mixed feelings about recovery, or change. If you’re depressed or anxious, you may be miserable, but a part of you may want to hang on to your depression and anxiety. One of the key features of TEAM-CBT is that we bring the patient’s resistance to conscious awareness quickly, and before using any M = Methods to help the patient change. The methods I have developed will be unfamiliar to most therapists, but they can be incredibly helpful and can greatly accelerate recovery.
But most therapists do not know how to reduce resistance, and may not even know that they need to do this. So they jump right in to help, save, or rescue the patient. But if the patient has ambivalent feelings about change, he or she will probably resist the therapist’s efforts. And this is why therapy fails.
Hundreds of therapists have approached me during breaks at workshops, or during my training groups at Stanford, and asked for help with this or that challenging patient who appears to be stuck in therapy. In 100% of these cases, the therapist did not know how to address resistance and did not know how to make the patient accountable.
In all of the many controlled outcome studies for depression that I’m familiar with, using any school of psychotherapy, it seems that a good 50% of the patients, or even more, do not reach the criteria for improvement during the study. I believe this is because tools to deal with resistance are almost never included in these studies.
Well that’s it for today!
Next Tuesday, look for “Tip / Puzzle #3!”
* Copyright © 2018 by David D. Burns, MD.
Coming Soon! Live Session Sold Out! Still space online. Register now!
I warmly invite you to attend this fabulous, one-day workshop by Drs. David Burns and Jill Levitt on Sunday, May 20th, 2018. Click on the link above for registration information.
- 6 CE Credits
- The cost is $135
- You can join in person or online from wherever you live!
You will enjoy learning from David and Jill, working together to bring powerful, healing techniques to life in a clear, step-by-step way. Their teaching style is entertaining, funny, lucid, and inspiring. This is a day you will remember fondly!
In the afternoon, you will have the chance to do some personal healing so you can overcome your own feelings of insecurity and self-doubt. David and Jill promise to bring at least 60% of the audience into a state of spiritual and psychological enlightenment, WITHOUT years of meditation. That’s not a bad deal!
You will leave this workshop with renewed confidence as well as specific, powerful tools that you can use right away to improve your clinical outcomes!
You will LOVE this workshop. Seating for those who attend live in Palo Alto will be strictly limited, and seats are filling up fast, so move rapidly if you are interested. Online slots are also limited.
Jill and I hope you can join us!