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What to do when treatment doesn’t work

Harry O’Hayon

20 Jun 2023


Treatment failures in psychotherapy is unfortunately not an uncommon phenomena. Even the most experienced, seasoned and skilled clinicians encounter clients for whom traditional treatment approaches do not work.  As clinicians we have the opportunity to learn a lot when treatment doesn’t work. Understanding why some psychotherapeutic treatments don’t work for some of our clients is extremely important as long as we are willing to explore their reasons. By understanding the reasons we can develop strategies to deal with those treatment failures early on.  The number of patients reporting unwanted effects of psychotherapy is between 3% and 15% of cases (Berk and Parker, 2009). Swift and Greenberg (2012), through a meta-analysis study they conducted, suggested that approximately one in every five clients drop-out of therapy prematurely. Lambert (2013) has demonstrated that 5% to 10% of patients deteriorate in therapy whilst 35% to 40% do not improve. There appears to be several key reasons for these unfortunate numbers. In this workshop participants will be presented with strategies to prevent treatment failures, learn how to identify some of the early signs that clients are not progressing as expected, and the collaborative process of developing a hypothesis of why treatment isn’t helping. Strategies to overcome the issues preventing progress will be presented. 

The event will be equivalent to 1.1/2hrs of CPD.


This one and a half hour workshop will:
1. Provide the state of research on key factors that influence treatment failures.
2. Consider ways of engaging clients in a collaborative discussion on why treatment is not progressing as intended.
3. Provide strategies to overcome treatment failures.

Learning Objectives

You will learn:
• What research shows are some of the most common reasons for treatment failures in psychotherapy.
• How to recognise early on in treatment the issues preventing progress.
• How to facilitate and promote a collaborative discussion on why treatment isn’t working.
• Learn strategies to help reverse treatment failures.

Training Modalities

Didactic content, interactive components, polls, Q&A.

Key References

Ahn H & Wampold B (2001) ‘Where oh where are the specific ingredients? A meta-analysis of component studies in counseling and psychotherapy’, Journal of Counseling Psychology, 48(3), 251–257
Asay T & Lambert M (1999) ‘The empirical case for the common factors in therapy: Quantitative findings’, In Hubble M, Duncan B & Miller S (Eds.) The heart and soul of change: What works in therapy, 23–55), American Psychological Association
Beck, J. S. (2005). Cognitive Therapy for Challenging Problems: what to do when the basics don't work. New York: Guilford.Google Scholar

Berk, M., and Parker, G. (2009). The elephant on the couch: sideeffects of psychotherapy. Aust. N. Z. J. Psychiatry 43, 787–794. doi: 10.1080/00048670903107559

Cooper M (2008) Essential Research Findings in Counselling & Psychotherapy: The Facts Are Friendly, Sage
Lambert, M. J. (ed.). (2013). “The efficacy and effectiveness of psychotherapy”, in Handbook of Psychotherapy and Behavior Change, 6th Edn (Hoboken, NJ: John Wiley and Sons), 169–218
Swift, J. K., and Greenberg, R. (2012). Premature discontinuation in adult psychotherapy: a meta-analysis. J. Consult. Clin. Psychol. 80, 547–559. doi: 10.1037/a0028226 Werbart, A., Hägertz, M., and Borg Ölander, N. (2018). Matching patient

About the presenter

Harry O’Hayon is originally from Canada and is trained in both Cognitive Behavioural Psychotherapy, and in Counselling Sciences. He is accredited with the British Association of Behavioural and Cognitive Psychotherapies (BABCP). He is a practicing clinician with extensive experience working with people who have a mood disorder. His previous role as Clinical Lead and Head of Prevention Services in a major NHS Trust in London involved leading an Improving Access to Psychological Therapies – IAPT service; a Self-Management & Behavioural Change Specialist Service for people with chronic long term physical health conditions; and a Smoking Cessation Service.

His work experience at The University of Reading with The Charlie Waller Institute for Evidence-based Psychological Treatments has given him a solid understanding, and hands on experience, of the development and dissemination of evidence-based psychological treatments, and the challenges and opportunities associated with translating research and science in clinical practice. He regularly trains mental health clinicians on how to deliver evidence-based psychological treatments using CBT approaches both in the UK and internationally. Clinically he also offers consultation, supervision, training, and advice to various NHS Trusts and private organisations on delivering evidence-based psychological treatments. His clinical specialism is the assessment and treatment of post-traumatic stress disorder (PTSD), resulting from either type 1 or 2 trauma. His previous role in a dual-diagnosis in-patient rehabilitation service for people with PTSD and substance dependency provided him with an opportunity to develop a wide repertoire of approaches to treat complex developmental trauma.

Who should attend

This webinar is most suitable for any clinical practitioner working with clients in a psychological or counselling setting, regardless of their therapeutic orientation.

Low Intensity clinical contact hours survey - BABCP Low Intensity Special Interest Group

Please click below if you are interested in contributing to the survey.


The BACP Low Intensity SIG are interested in the impact of clinical contact hours on Low Intensity/Wellbeing Practitioner wellbeing. This questionnaire contains six multi-choice questions and a free text box for you to share your experiences. The answers to these questions will help the BABCP SIG plan how to meet CPD topics and other developments within the SIG.  The SIG hope to produce a write up of the answers to this questionnaire to be shared with SIG members and to be used in training.

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This FREE conference is for Psychological Wellbeing Practitioners working in Talking Therapies for Anxiety and Depression services and is brought to you by Bespoke Mental Health in collaboration with the NHS England Talking Therapies National PWP Leads Network

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