Speaking from experience, you analysis is spot on and this is a very common coping method in social work as well. It is done because otherwise in the 9/10 case

Speaking from experience, you analysis is spot on and this is a very common coping method in social work as well. It is done because otherwise in the 9/10 cases where things do not improve, you feel you have failed. Much easier if the client fails you instead. You can tell yourself, "well, maybe next time they'll get better -- after all, it takes many relapses before people kick a drug habit!" This is a lot easier to swallow than "Oh god this stuff barely is working at all, I'm mostly just a gigantic resource suck and the money I'm paid would be much better spent getting this person stable housing and other support--but that's a lot less attractive to tax payers." I got out of social work when I had that realization. Initially I coped by saying I was a "Good Person" in a helping profession, so I never looked too deeply into whether any of this horse shit actually was "evidence-based." Every Psych 101 class should cover the current findings on efficacy of psychotherapies. But they never do, for obvious reasons.