I find the part below a bit disturbing. The language is quite paternalistic. Clients are described collectively like impulsive and nasty children.

"At times, they’ve formed a childlike dependence on me, wanting—and sometimes demanding—not only my continual personal reassurance, but also my help in making even small decisions, like whether to get a driver’s license. Some have had tantrums when I’ve left town. Others have wanted regular contact between sessions and asked to know in detail how I felt about them and what my personal life was like. They’ve continually tried to stretch my boundaries by demanding special treatment—such as free sessions and extra time on the phone to talk about every detail of their lives—or violating my privacy by finding out where I live and dropping by unannounced. When I’ve set limits on my availability by telling them when or if they could call me at home, some have responded by implying or stating outright that they might cut or kill themselves."

I'm sure it's not easy to interact, in this context, with people who have history of severe abuse or trauma. But I get the sense that many clinicians do not see that they are driving these behavioral extremes. I get the sense that they are so accustomed to the therapy dynamic that they can't discern its impact anymore. They truly believe that the client is acting out in largely in a vacuum or something.

Example: he says "they've formed" dependence, rather than saying dependence arose naturally from the structure of the therapy relationship, and due to innate attachment needs.

I wonder is there really strong evidence that subjecting people to this experience leads to benefit more often than not?