by Michael D. Anestis, M.S.
Research on mental health and psychotherapy provides us with remarkably helpful information on a daily basis. Over the past several decades, a number of treatments for specific diagnoses have been rigorously tested in scientific trials, revealing their strengths and weaknesses as methods for helping people with mental illnesses reclaim their lives and avoid relapse. The list of efficacious and effective treatments grows continuously and, although none of the treatments listed are 100% effective, they represent remarkable improvement over the state of the field in even the recent past (click here for a list and description of empirically supported treatments and here for articles we have written about many of them).
Unfortunately, what we have learned from research quite often has little to do with what transpires in everyday practice (link, link, link, link). This is not due to some conspiracy in which practitioners hope to deny their patients treatment; however, it is sustained by ignorance, lack of training, devotion to unscientific or pseudoscientific philosophies, a lack of promotion on the part of scientifically-minded psychologists and psychiatrists, and an enduring belief that the ways of the past remain the cutting edge approaches of the moment.
The results of this gap is a proliferation of treatments that are either harmful (iatrogenic) or ineffective. Given the existence of treatments that are quite effective for a range of diagnoses, this is obviously a real problem. Some of these treatments gain popularity due to wild, unsupported, and untested claims of the individuals selling the idea. Other treatments maintain popularity due to the overstatement of treatment effects (e.g., research shows that the treatment is okay, but not as good as alternatives).
In order for an individual receiving health care to provide true informed consent, they need to be made aware of the evidence for and against the use of a particular treatment, as well as the support for and against alternative approaches. Today, I'd like to link to some articles we have written on treatments that are ineffective or less effective than they are often stated to be and to continue our general conversation on this idea.
- Popular Treatments That Cause Harm (link)
- Thought Field Therapy (TFT:link)
- Equine Assisted Psychotherapy (EAP; link)
- Dolphin Assisted Psychotherapy (link)
- Psychodynamic Psychotherapy (note: the critiques of psychodynamic approaches regard overstatement of results, not evidence that the treatment never works or causes harm; link, link).
As a prelude to whatever conversation may unfold, remember a few things. My point is not that empirically supported treatments (e.g., cognitive behavioral therapy for depression, dialectical behavior therapy for borderline personality disorder) always work or that nobody has ever benefited from the treatments listed above. Instead, I am stating that evidence-based treatments provide the best results for the greatest number of people the highest percentage of the time for specific conditions and that untested treatments or treatments that have been tested and shown to produce inferior results should not be considered front line interventions.
I'm looking forward to hearing your continued thoughts on this issue.
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Mike Anestis is a resident at the University of Mississippi Medical Center and a doctoral candidate in the clinical psychology department at Florida State University
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