Monster links list around harmful therapy

[disequilibrium1]

Eve and I recently collaborated to compile eight year's worth of links from my wordpress blog. I also added more from here and elsewhere. This is a fluid list, which I can continue to add to or subtract from as needed.  A thousand thanks to Eve for getting this started.
https://disequilibrium1.wordpress.com/links-and-resources/

[Mary S]

Thanks for this!

I haven't looked over the entire list yer, but I heartily recommend the resource  "How to Spot Hype in the Field of Psychotherapy: A 19 - Item Checklist", and  especially its emphasis on skepticism and humility on the part of the therapist

[disequilibrium1]

Mary, I deliberately scouted for your links, but couldn’t find all. Feel free to add suggestions. Lilienfeld seems about the most effective fraud buster around, but I wish he went further.

Edited December 30, 2018 by disequilibrium1

[Mary S]

Here's a really distressing story about a very sick sounding therapy that is based on the idea that when kids of a failing marriage prefer to have one parent have custody because the other parent is abusive, it's really the parent whom the kids prefer who has been abusive.

https://www.revealnews.org/episodes/bitter-custody/

[disequilibrium1]

On 3/11/2019 at 1:18 AM, Mary S said:

Here's a really distressing story about a very sick sounding therapy that is based on the idea that when kids of a failing marriage prefer to have one parent have custody because the other parent is abusive, it's really the parent whom the kids prefer who has been abusive.

https://www.revealnews.org/episodes/bitter-custody/

A horrifying example of a therapist playing God. The folly is the number of people who believe humans can be oracles.

Edited March 13, 2019 by disequilibrium1

[disequilibrium1]

Among additions to the Monster list, an article about ethical lapses of several of therapy's iconic figures. It's interesting how some therapists compartmentalize this as the admired person's "shadow side."
http://openknowledge.nau.edu/2346/7/Thomason_T_2016_The_Shadow_Side_of_the_Great_Psychotherapists(1).pdf

Edited March 30, 2019 by disequilibrium1

[Mary S]

Wow, they really sound like arrogant perverts.

[disequilibrium1]

What is a mental health pioneer after all but a good publicist and showman. They use clients as guinea pigs, then hurry scurry to prove their modality’s efficacy.

[Eve B]

"The theorists who became influential were often  those who had great personal charisma and worked hard to popularize their work. Regarding the history of psychotherapy, according to Cummings and O’Donohue (2008): Since the psychology profession had no scientific base, we had nothing else with which we could prove to the world that our work was psycho-therapeutically credible and worthy of respect other than to quote the Great One, be it Sigmund Freud, Carl Jung, Karen Horney, B. F. Skinner, Carl Rogers, or Albert Ellis. It worked, and the public followed us in worshipping at the shrines of those we had elevated to near sainthood. (p. 39)."

The above is a direct quote from Disequilibrium's "The Shadow Side of the Great Psychotherapists" link. The author actually admits that psychology has no real scientific base?

[disequilibrium1]

Another new link. Oh tosh.
https://www.theguardian.com/education/2001/dec/28/research.highereducation

[Mary S]

Thanks for the link.

For anyone interested in more detail: You can also download both the full report (on which the Guardian article is based) and a summary of the findings of the report from https://www.jrf.org.uk/report/self-esteem-costs-and-causes-low-self-worth

Also, note that the report and Guardian article are from 2001, 17 plus years ago. So what I wonder is if people have been heeding what the report says.

[Mary S]

I've done a brief web search to look for places that have cited Emler recently. Here are a couple I came up with:

https://www.managers.org.uk/insights/news/2018/january/why-low-self-esteem-could-be-good-for-leadership

https://www.theguardian.com/lifeandstyle/2017/jun/03/quasi-religious-great-self-esteem-con

[disequilibrium1]

Self esteem is a big item at the mental health industry store. I’ve never seen iexplored thoughtfully the difference between quiet assuredness and superficial grandiosity and bluster. I think the former has is earned, not installed by hired stroking and flattery.

[Mary S]

One of the links on the “monster links list” is to http://forums.phoenixrising.me/index.php?threads/psychological-treatments-that-cause-harm.25417/, which is a discussion of a paper by Scott Lilienfeld. Here is a link to that paper:

http://users.ipfw.edu/young/350-Abnormal/assignments/Psych-treatments-that-cause-harm.pdf

In the paper, he uses the abbreviation PHT for “Potentially harmful therapy”. On

p. 57, he defines how he used this term as follows:

 

“I operationalize treatments as PHTs if they fulfill the following three conjunctive criteria:1. They have demonstrated harmful psychological or physical effects in clients or others (e.g., relatives) 2. The harmful effects are enduring and do not merely reflect a short-term exacerbation of symptoms during treatment 3. The harmful effects have been replicated by independent investigative teams“

 

On p. 58 he provides his provisional list of PHT's, which I quote here:

“Table 1): Provisional List of Potentially Harmful Therapies:

            Critical incident stress debriefing

            Scared Straight interventions

            Facilitated communication

            Attachment therapies (e.g., rebirthing)

            Recovered-memory techniques

            DID oriented therapy

            Grief counseling for individuals with normal bereavement reactions

            Expressive-experiential therapies

            Boot-camp interventions for conduct disorder

            DARE programs”

 

I am posting this list here, because I think it is important to have the list posted widely so that prospective or current therapy clients can more easily find out that the therapies listed here have been classified as potentially harmful. The term does not mean that they are harmful in all cases -- they may be helpful in some cases, but there is also evidence that they have caused harm. So I see the label PHT as an analog to a “Black Box Warning” for a drug. I would be extremely cautious in using such a drug myself, so I strongly recommend that therapy clients at least think twice before trying a therapy on Lilienfeld’s PHT list. I would not recommend any of these therapies to anyone, and would not try any of them myself.

 

[disequilibrium1]

Google searching Lilienfeld +harm is a very fruitful for finding reading reading around therapy's risks.
I found another article about potentially harmful and unsupported modalities.
Some of these therapy schools have fanatical adherents, so as usual, mileage may vary. (I personally found acupuncture relaxing, but not miraculous.)
https://files.eric.ed.gov/fulltext/EJ911995.pdf

Here's another Lilienfeld article urging students and clinicians to be cautious about "breakthroughs.
https://teachpsych.org/page-1784686/6375500

And here's a book chapter about science and pseudoscience.
https://www.guilford.com/excerpts/lilienfeld.pdf?t

And bad news, dolphins aren't therapy.
https://www.sciencedaily.com/releases/2007/12/071218101131.htm

[Mary S]

Thanks for these links. I looked at https://teachpsych.org/page-1784686/6375500 and definitely recommend it.

[Mary S]

One thing that really bothered me in my (mostly counterproductive) attempts at therapy were the value conflicts between me and most of the therapists I tried. In my background in the STEM fields, backing up your statements with reasoning or evidence (or else providing some modifying words to indicate that you are speculating) is an important value. But therapists didn't seem to care about this at all, and I think one even said "You don't have to justify yourself" when I was giving reasons for something.

Yesterday I decided to see if I could find anything on the web about therapist-client value conflicts. I found this: https://www.researchgate.net/publication/257958560_A_Model_for_Addressing_Client-Clinician_Value_Conflict , and was even able to get a copy through a library. It is perhaps the best thing I have found so far that addresses this type of conflict. Some  quotes and comments:

p. 207 “The APA ethics code acknowledges that both practitioners of psychology and their clients come with diverse sets of cultural and individual values and warn against the former imposing their “biases” upon the latter (APA, 2010, p.3), but he code does not clarify what would constitute such an imposition.”

“The authors suggest that supervisors and trainees would benefit from practical guidelines to help them navigate value conflicts with clients in a way the prioritizes the clients’ welfare while still balancing respect for the clinician’s personal values, as this need is currently going largely unmet (see Hage, 2006 for a review) … of particular importance for such frameworks is that they address the appropriate conditions for client referral.”

p. 210: “As one important function [of?] therapy is to enhance client awareness of viable and safe alternatives, trainees experiencing an operational value conflict may need to make special efforts to present a wide range of alternative to clients, including those outside of their personal preferences. It may be particularly important for the trainee to expand his or her understanding of the client’s cultural, religious, or social context in order to explore alternative that are compatible with the client’s preferences. Exploration should take place in a respectful and open-minded way that communicates appreciation for the client’s background…. Throughout this process, deference to the client’s preferences should remain of central importance whenever ethically possible.”  Wow! This sounds great! I don't recall a therapist's ever presenting "a wide range of alternatives" to me -- they typically took an authoritarian attitude of "This is what you should do,'" or "You shouldn't do this".

p. 211: "If for some reason, a clear understanding of the trainee's discomfort in session is not forthcoming and the trainee and supervisor have reasonable evidence that the competency of services is at risk, it may be acceptable to refer the client to competent services elsewhere. However, it is important to note that a referral does not remove the obligation from the trainee to understand the nature of the conflict  and make efforts to reduce its impact on future clients. Thus, even when making referrals for unarticulated value conflicts, the trainee retains the responsibility to understand why the referral was necessary. If similar feelings of discomfort continue to require the referral of clients, the trainee might also consider receiving focused individual therapy to assist in the process of value examination. "

One big concern I have with the article is that it focuses on trainee therapists, whereas I believe that a lot of practicing therapists need to develop awareness of client-therapist value conflicts, and change their practices to take these into account. In particular, trainers need to be aware of such conflicts and of how to deal with them in ways that do not harm clients; but I suspect that many trainers would be resistant to caring about value conflicts. (This is a particularly relevant concern for me, because my worst therapist was a trainer when I was her client. I hate to think of the harmful attitudes she may have passed on to her trainees.)

 

 

Edited July 2, 2019 by Mary S

[Mary S]

In connection with the above article, I looked at the vita of the second author (Callahan), and found some things that might also be of interest. I haven't had a chance to look at them yet, but here are some that might be of interest -- in particular, it seems that there is a growing interest in taking client preferences into account (Duh!).

Tompkins, K. A., Swift, J. K. & Callahan, J. L.(2013). Working with clients by incorporating their preferences. Psychotherapy,50, 279-283. doi: 10.1037/a0032031

Swift, J. K., Callahan, J. L., Ivanovic, M., & Kominiak, N. (2013). Further examination of the psychotherapy preference effect: A meta-regression analysis. Journal of Psychotherapy Integration, 23,134-145. doi: 10.1037/a0031423

Fellers, C., Davidson, C. L., Almstrom, C. M. & Callahan, J. L.(2009). Cheat and hope for the best: The unspoken undergraduate mantra? Journal of Scientific Psychology, 4, 24-29.

Borja, S. E., Callahan, J. L.,& *Rambo, P. L. (2009). Understanding negative outcomes following traumatic exposures: The roles of neuroticism and social support. Psychological Trauma: Theory, Research, Practice, and Policy, 1, 118-129. doi: 10.1037/a0016011

Callahan, J. L.,Hogan, L. R., & Connor, D. R. (2011). Becoming competent in the competencies movement [Review of the book Core competencies in counseling and psychotherapy: Becoming a highly competent and effective therapist, by L. Sperry]. PsycCRITIQUES, 56(18). doi:10.1037/a0023203

Swift, J. K.,Callahan, J. L., Cooper, M., & Parkin, S. R. (2018). Preferences. In J. C. Norcross, & B. E. Wampold (Eds.) (2018).Psychotherapy relationships that work (3rded., Vol.2). New York: Oxford University Press. [I think I may have read an earlier edition of the book. ]

 

 

 

 

 

 

 

 

 

 

 

 

 

Edited July 2, 2019 by Mary S

[Mary S]

I realized that I (presumably unintentionally) included one paper in the above list that was not really relevant to the topic. However, since the topic was interesting, I just looked it up and found it online (https://www.psyencelab.com/uploads/5/4/6/5/54658091/cheat_and_hope_for_the_best_the_unspoken_undergraduate_mantra.pdf ). It does end with something interesting:

"One possibility for why the cheating rate on this campus is so high is that our method may have made acknowledgement of cheating behavior more likely. A very recent study by Burrus and colleagues (2007), found that students often do not understand what behaviors constitute cheating and report higher rates of cheating if they are first educated about what constitutes cheating. In the present study, we did not ask students whether or not they “cheated”, per se. Rather, we asked participants whether they engaged in specific behaviors that have been considered illustrative of cheating in the established literature. Had we simply asked participants whether or not they had cheated, without operationalizing the cheating construct into clear behaviors, we might have observed a lower prevalence rate of self-reported cheating. However, we consider the findings from the present study to be cleaner as a result of this methodology. By defining cheating in behavioral terms we were able to cleanly identify a homogenous Never Cheated group, as opposed to a more heterogeneous group that would have included these individuals in addition to those that did not consider themselves to be “cheaters,” when in reality they had engaged in cheating behavior. Similarly, the “cheaters” used in analyses for this study were those that not only acknowledged cheating behaviors but also had external validation that they were cheating by having been caught. As such, our two groups of Never Cheated and Caught Cheaters were behaviorally distinct from one another and appropriate for analyses. It should be noted however, that the largest volume of data was associated with neither of these cleanly identified conditions. The overwhelming majority of the recruited individuals (n = 272) acknowledged engaging in cheating behaviors but were not identified as “cheaters” by the institution because they had apparently evaded detection by instructional staff"

This actually makes a good impression on me for doing good research (Making sure you have good measures of what you are measuring!), so makes me think that Callahan has high standards (which the other paper by her  suggested also, at least compared to other papers on psychotherapy that I've read).

[zygomaticus]

Hello, I'm new, I hope to register after posting this and hopefully it'll work as I've been having a few problems.

I just wanted to extend heartfelt thanks for the compilation of this list. It's a wonderful resource and I aim to work my way through it. It's the kind of endeavour I've wanted to focus on myself, with a particular focus on behaviour modification, as this is ubiquitous in mental health services here in the UK and it's something that I've found especially galling and ethically problematic.

[Eve B]

Glad to see here, zygomaticus!  I hope you're finding our topic threads to be informative and thought-provoking. I don't know if the mental health services are better or worse in the UK than the US, but the psych profession, as a whole, really needs to improve their standards of care if they're serious about helping people.