When Therapy Harms: Dr. Kirk Honda on Preventing and Addressing Harm in Therapy

The Reluctance to Discuss Therapy Harm

• 💡 Many clinicians are hesitant to discuss therapy harm due to self-protection, loyalty to colleagues, fear of deterring clients, or the belief that client complaints are symptoms of their illness.
• 🎯 Dr. Kirk Honda is an exception, openly discussing the realities of harm within the therapy profession and advocating for a complete picture, even the uncomfortable parts.
• 🧠 He created a Facebook group, "Clients Harmed by Therapy," to provide a platform for shared experiences, which grew significantly.

Competency and Learning in Therapy

• 📈 It takes approximately 5 years after graduation to feel truly competent in therapy, a realization that often comes with a decrease in feelings of worthlessness.
• ⚠️ Therapists often grapple with insecurity due to the difficulty in measuring outcomes and the vastness of the profession.
• 📚 Education on preventing harm and working with clients harmed by previous therapists is often minimal in training programs, sometimes limited to basic ethical self-protection.

Inadvertent Harm and Trauma Disclosure

• ⚠️ A personal example highlights how a therapist's lack of understanding of trauma, PTSD, and exposure therapy can lead to inadvertent harm, such as overwhelming a client with a traumatic disclosure.
• 🧠 Dr. Honda learned that clients need to be slowed down when disclosing severe trauma, especially if they haven't spoken about it before, to prevent triggering and potential decompensation.
• 🛠️ Proper preparation for trauma disclosure involves emotional awareness, regulation, and assessing distress levels, a complex process requiring specialized knowledge and supervision.

Gatekeeping and Therapist Accountability

• 🎓 As a professor, Dr. Honda has personally "gatekept" students, removing them from programs when there are concerns about their suitability to practice, despite potential administrative pushback.
• ⚖️ Complaints about therapists are often dismissed by licensing boards, and legal repercussions for severe violations can be minimal, such as suspended licenses or small fines.
• 🚫 The system often favors therapists over clients, with diagnoses like Borderline Personality Disorder (BPD) being used to discredit clients' complaints, and therapists having legal and financial advantages.

Traits of Harmful Therapists and Systemic Changes

• ⚠️ Therapists who cause repeated harm may exhibit personality disorders like narcissism, borderline, histrionic, or antisocial psychopathy, often showing a distorted perceptual system and lack of insight.
• 🎯 While personality disorders don't automatically disqualify a therapist, the degree of the disorder, insight, and management systems are crucial factors.
• 🚀 Beneficial changes include more education on harm in graduate school, greater willingness among therapists to acknowledge their own mistakes, increased public and professional outrage regarding board inaction, and clearer guidelines for disciplinary actions.
• 🔍 Licensing boards need more time, funding, and public interest to effectively investigate and sanction therapists who commit violations.