Psychotherapy failures: to err is human

ABSTRACT Despite the consistent positive outcome findings and psychotherapists’ best intentions in their efforts to help their clients, psychotherapy simply does not work in all cases. There are a variety of reasons why there may be treatment failures in psychotherapy that may be observed at multiple levels: (a) the treatment in question (e.g. the choice of intervention for a given presenting concern), (b) the individuals involved (e.g. therapist and client factors), and (c) the system in which the work of therapists is nested (e.g. the governance of the profession, jurisdictional laws, among others). The field has not fully developed adequate procedures and mechanisms for addressing treatment failures, which is at the core an ethical imperative. Although psychotherapy has made many strides over the last few decades to improve research rigour and to promote evidence-based practices, it is a profession that is continually growing. By embracing the opportunity to learn from therapeutic failures the profession will continue to refine its practices and ultimately better serve clients.