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On Therapeutic Failure…

Therapeutic failure…Yep, it happens to the best of us.

A friend emailed me with the question, “how do you assess when you have failed? Because the client leaves? Because of client feedback?”

A client leaving doesn’t mean failure to me, even if they leave against my judgment. People have all kinds of reasons for leaving.

Client feedback about problem resolution and goal achievement or lack of absolutely goes into the mix of assessing effectiveness. Keeping my eye on that ball is a cornerstone of AAIT. Those failures are fairly infrequent due to the reliability of the methods But they happen. In that case, I review the work itself – did I make mistakes, where? If I’m stuck, I seek consultation.

The most significant factor in considering a therapeutic failure, IMHO, is looking at the relationship. Where did things go awry in the relationship? When the relationship feels frayed and the client has no interest in mending the tear, I would call that a therapeutic failure, maybe preventable, maybe not. Regardless, it is ALWAYS worth doing a kind of “post-mortem” on the relationship.

Though I KNOW the therapeutic value of AAIT, nothing will work if the crucible of the relationship is cracked and not mended. There’s no where to go then. So tending to the relationship, making sure that the collaboration is strong and on track – making sure we are all still on the same page, it matters.

What have your biggest lessons from therapeutic failures? How do you assess them?