(1 min read) When a therapist fails you, offends you, or outright misleads your treatment, there is little a patient can do. This assumes they even notice these mistakes at all. This a huge industry problem (imo).

Seeking treatment peer review or managerial intervention is not always practical or effective (for me). Internal damage control quickly boxes any patients out raising red flags. In some cases, independent contractors work alone. This makes accountability hard to find let alone enforce.

Mandatory treatment peer review would mitigate this problem painlessly. Operating in a vacuum is dangerous, leading to ignorance & bias drift no one is above.

Tied to this issue is the busted (dogma) narrative that therapy is a zero-risk service always helpful. Indeed, trusting another stranger with your emotional leadership has many risks, even when operating perfectly. Risks are often not spoken about or considered at all.

I’ve never heard one provider in 20 years say anything like “here’s how I mitigate bias and quality control”. But I have heard many times “This is what it means to be a great therapist”.

That said, I am pro therapy and pro psychiatry (choice). I’m also pro better data.

Creative solutions include speaking to your therapist(s) about implementing peer review protocols, if not internally, then externally via appropriate 3rd parties (avoid treatment conflicts).

If they bark “HIPAA”, Jon Doe your data and keep trucking. No system is above the benefits of peer review, especially data-driven sciences. The advice given inside therapy can drastically shift lives. Sometimes that’s the point. Other times the aim gets sketchy.

Hold providers accountable to good data you can count and analyze. Putting all your therapy eggs in one basket is infamously dicey.

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