Forsidebilde av showet How Psychotherapy Fails -- A Case Study

How Psychotherapy Fails -- A Case Study

Podkast av Dr. Jack Bugas, Dr. Trevor Arendt, and Dr. Jim McCollum.

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A real-session deep dive into why therapy breaks down—and how it could go better. How Psychotherapy Fails -- A Case Study is podcast that pulls back the curtain on what happens when therapy doesn’t work—and why. Clinical psychologists Dr. Jack Bugas, Dr. Trevor Arendt, and Dr. Jim McCollum take you inside a real first session from a failed psychotherapy (with identities changed), using actors to read the transcript and then pausing to analyze the missed moments, ruptures, and turning points that derail the therapeutic alliance. You’ll hear how common “stuck” patterns form in real time—misstatement, overly technical interviewing, defensiveness, and unmet needs for warmth and trust—and what skilled clinicians might do differently. If you’re a therapist, trainee, or a client who’s ever wondered “Why didn’t therapy help me?”, this show offers an honest, compassionate, and practical look at therapeutic failure so we can learn from it and improve care. What you’ll learn / keywords to help discovery psychotherapy fails, therapeutic alliance, therapy rupture, therapist–client mismatch, empathy, attunement, case study, psychotherapy process, clinical supervision, training, session transcript analysis, psychotherapy research, therapist mistakes, what to do when therapy isn’t working.

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episode Episode 1: A Failed First Session — When Questions Replace Connection cover

Episode 1: A Failed First Session — When Questions Replace Connection

In the premiere of How Psychotherapy Fails, the hosts walk through a real first therapy session (reenacted from a transcript) and pause to unpack the subtle moments where trust, clarity, and connection start to slip. Along the way, they highlight common patterns that can derail therapy early, especially when curiosity turns into interrogation and the client’s core needs don’t feel met. Timestamps  * 00:05 — Welcome + why this podcast exists * 01:00 — Meet the hosts + what “therapy failure” means here * 01:22 — The case-study format: transcript + pauses for analysis * 01:58 — Session begins: setting the tone in the first minutes * 03:00 — Therapist stance: “essential question” and early framing * 10:03 — First big pause: what’s already gone off-track? * 14:56 — “I wish he would just pause…”: missing the emotional moment * 19:44 — Dream material + how the therapist follows (or doesn’t) * 29:49 — Client history + past treatment experiences surface * 59:54 — Somatic symptoms, numbness, and what’s underneath * 1:15:01 — Zooming out: what this case shows about the era/style * 1:39:56 — Escalation cycle: how both people get “on their heels” * 1:59:52 — Preliminary interview mention + implications for trust * 2:19:49 — What the client seems to want vs. what she’s getting * 2:44:29 — Final takeaways: how to avoid intimidation/defensiveness * 2:46:02 — Wrap + what’s coming next

19. feb. 2026 - 2 h 46 min
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