At least they’re consistent. During the penultimate Sopranos, Melfi, the psychiatrist, is outed at a dinner party, by her consultant/therapist, as the therapist of the notorious Tony Soprano. (I’m thinking that Tony ought to whack the consultant for breach of confidentiality.) The discussion at the party is about therapy for sociopaths. According to "research", criminals become stronger in their criminality, and learn to rationalize better. They practice manipulation on the therapist and get better at that. And they don’t change in any substantive way in therapy. So at the next session, Melfi, visibly cold and angry, fires her client of 7 years, by shaming him and throwing him out of the session in the first 5 minutes.

My first question: "What kind of psychotherapy doesn’t work?" Other questions: What if Melfi had consistently confronted Tony about the effects of his lifestyle on his family and himself? What if she had guided him through imagining the emotions of his victims? (It works with many sexually abusive people.) What if she had done values clarification and explored where his values came from? What if she had fired him, in a discussion of her moral stance of not condoning/supporting his immoral behavior? Better therapy, worse TV.

I once fired a client, who had become a (non-using) drug dealer. I explained that my brother had died of drug addiction (true) and that I couldn’t,  emotionally, and in conscience, continue to work with him. I referred him to a colleague. My former client was moved by our session, and according to the colleague, quit selling shortly thereafter.

Here is a link to a good article about Tony Soprano’s chances for redemption and the appeal of the Sopranos:

Somebody sent me an email about therapy and the media. There was a show called "Starting Over" in which women worked with a "Life Coach"/therapist to change their lives. Here’s an excerpt from the email: 

"Six women, each of whom were stuck in some way in their lives and wanted to change or do something.  Two life coaches supported them, and in seasons 2 and 3 they added a therapist. 
Most of the women stayed for at least 8 weeks and some stayed for perhaps as much as 16 weeks.  The show was on 5 days a week for an hour and, over time you saw each of the women change.  There were small and large steps forward and some backing up, also.  Of course the viewers became attached to some of the women and were irritated by others. 
While the coaches were only supposed to be doing life coaching, by seasons 2 and 3, I would expect that some therapists would say that some of what they were doing was therapy.

As each of them graduated, and you saw a flashback of what they were like when hey entered the house and some of the major exercises that they accomplished and how they changed, well it was powerful.

Unlike many other reality shows, no one was playing for $1,000,000 or voting people out, etc.  Just 6 women supporting each other as best as they knew how and 2 life coaches guiding them, mainly with a group meeting each day, some specific exercises, and some 1-on-1 talks."

To learn more about Starting Over, click on its website: