Some cases just get “stuck”—treatment is not working. The study of treatment failures is one of the best opportunities for improving the quality of treatment, yet child and adolescent psychiatrists rarely discuss those cases that do not respond to any treatment. This Workshop focuses on helping clinicians think about, recognize, understand, and learn from treatment impasses and failures, organized around five themes: the theory of continuous quality improvement; how to recognize treatment impasses; factors that can contribute to treatment failure and algorithms that can help in the analysis of “stuck” cases; the importance of knowing trajectories of chronic and persistent psychiatric illnesses and how to track long-term treatment; and how our thinking about failure and success in treatment affects clinical practice.