# Is therapy a scam? **URL:** \ **Category:** Great Debates\ **Created:** [December 10, 2012, 3:29pm UTC](https://boards.straightdope.com/t/is-therapy-a-scam/643603 "2012-12-10T15:29:06Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![Fotheringay-Phipps](https://avatars.discourse-cdn.com/v4/letter/f/d9b06d/32.png) [@Fotheringay-Phipps](https://boards.straightdope.com/u/Fotheringay-Phipps)\ **Post date:** [December 10, 2012, 7:51pm UTC](https://boards.straightdope.com/t/is-therapy-a-scam/643603/21 "2012-12-10T19:51:45Z")
I believe there have actually been studies of this matter, and that they’ve found that therapy is, on average, about as effective as talking over your problems with a lay “good listener”. [I should qualify that this may not apply to all types of therapy.] Re some of the anecdotes offered above, it’s worth noting that virtually every sort of quack medicine and therapy out there has any number of similar successes. Notwithstanding the above, I think it’s a mistake to call it a “scam”, since the practitioners genuinely believe it’s helpful, and society as a whole tends to accept their claims. ---
**Author:** ![Nature\_s\_Call](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/nature_s_call/32/19006_2.png) [@Nature\_s\_Call](https://boards.straightdope.com/u/Nature_s_Call)\ **Post date:** [December 10, 2012, 9:44pm UTC](https://boards.straightdope.com/t/is-therapy-a-scam/643603/22 "2012-12-10T21:44:35Z")
> [@Fotheringay-Phipps](#): > > Re some of the anecdotes offered above, it’s worth noting that virtually every sort of quack medicine and therapy out there has any number of similar successes. This is a very important point - thanks for raising it! > [@sweeteviljesus](#): > > Is it effective either as a primary or complementary treatment for things like OCD or depression? I found this [peer-reviewed meta-analysis from NIH](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2933381/) concluding cognitive behavioural therapy (CBT) is “efficacious in the acute treatment of depression” and “may be of use as an adjunct to medication treatment for bipolar patients, although the studies are few and not wholly consistent” ---
**Author:** ![sweeteviljesus](https://avatars.discourse-cdn.com/v4/letter/s/898d66/32.png) [@sweeteviljesus](https://boards.straightdope.com/u/sweeteviljesus)\ **Post date:** [December 10, 2012, 10:18pm UTC](https://boards.straightdope.com/t/is-therapy-a-scam/643603/23 "2012-12-10T22:18:35Z")
> [@Nature\_s\_Call](#): > > I found this [peer-reviewed meta-analysis from NIH](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2933381/) concluding cognitive behavioural therapy (CBT) is “efficacious in the acute treatment of depression” and “may be of use as an adjunct to medication treatment for bipolar patients, although the studies are few and not wholly consistent” It’s effective, but it might be effective? ---
**Author:** ![Nature\_s\_Call](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/nature_s_call/32/19006_2.png) [@Nature\_s\_Call](https://boards.straightdope.com/u/Nature_s_Call)\ **Post date:** [December 10, 2012, 10:19pm UTC](https://boards.straightdope.com/t/is-therapy-a-scam/643603/24 "2012-12-10T22:19:45Z")
> [@sweeteviljesus](#): > > It’s effective, but it might be effective? For depression: effective. For bipolar: might be effective. ---
**Author:** ![LibrarySpy](https://avatars.discourse-cdn.com/v4/letter/l/f9ae1b/32.png) [@LibrarySpy](https://boards.straightdope.com/u/LibrarySpy)\ **Post date:** [December 10, 2012, 10:36pm UTC](https://boards.straightdope.com/t/is-therapy-a-scam/643603/25 "2012-12-10T22:36:12Z")
My therapist would prefer I focus on CBT exclusively, but I also do a lot of traditional talk therapy. i.e. whining at her while reading self-help books. Focusing on my parents, my grandparents, divorce, trauma, PTSD, meaning of life issues, etc. Plenty of Freud. A lot of it is awareness of my behaviors, and depersonalizing overly personal events. It’s helped immensely. But I had to say, “This is my fault, I’m fucked up, and I don’t want to be, and I need outside help to change because I can’t do it.” Just this week I was told by my therapist I’m healthy enough not to come as often. So, to the OP. However, there is something very wrong physically with my brain that’s being treated through antidepressants, as well as physically in general–panic attack, fight or flight responses, etc, which has to be treated while I address emotions and thoughts. I can’t just say “Yay talk therapy” because I got a lot of help, including getting religion. But dealing with those pathetic, whiny, “traditional” issues feels great. I have radically changed who I am. An anecdote is not data. Per **Nature’s Call** ’s experience, 8-12 sessions of CBT is the guideline. 3-4 months. It’s not supposed to last forever. Hard to comprehend when you’re just starting and you just know you’re incurably wrong. ---
**Author:** ![sweeteviljesus](https://avatars.discourse-cdn.com/v4/letter/s/898d66/32.png) [@sweeteviljesus](https://boards.straightdope.com/u/sweeteviljesus)\ **Post date:** [December 10, 2012, 10:37pm UTC](https://boards.straightdope.com/t/is-therapy-a-scam/643603/26 "2012-12-10T22:37:35Z")
> [@Nature\_s\_Call](#): > > For depression: effective. > > For bipolar: might be effective. One of these days I will learn how to read. ---
**Author:** ![Half\_Man\_Half\_Wit](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/half_man_half_wit/32/21766_2.png) [@Half\_Man\_Half\_Wit](https://boards.straightdope.com/u/Half_Man_Half_Wit)\ **Post date:** [December 10, 2012, 11:29pm UTC](https://boards.straightdope.com/t/is-therapy-a-scam/643603/27 "2012-12-10T23:29:48Z")
> [@Fotheringay-Phipps](#): > > I believe there have actually been studies of this matter, and that they’ve found that therapy is, on average, about as effective as talking over your problems with a lay “good listener”. Could you point me to some of these studies? Because this is something I’ve been wondering about: how exactly is the efficacy of talk therapy assessed? How does one control for placebo effect – I mean, essentially the whole symptomatic is subjective, so how can you tell whether any subjective increase in well-being is due to the therapy actually touching on some true, underlying mechanism, or it being effective solely because the patient believes it to be? (Though of course, one could argue it hardly matters.) Of course, one could vet some particular style of therapy against simple non-systematic talking to the patient, but I don’t think I’ve ever seen any such studies… ---
**Author:** ![even\_sven](https://avatars.discourse-cdn.com/v4/letter/e/dfb087/32.png) [@even\_sven](https://boards.straightdope.com/u/even_sven)\ **Post date:** [December 11, 2012, 12:54am UTC](https://boards.straightdope.com/t/is-therapy-a-scam/643603/28 "2012-12-11T00:54:55Z")
> [@Half\_Man\_Half\_Wit](#): > > How does one control for placebo effect – I mean, essentially the whole symptomatic is subjective, so how can you tell whether any subjective increase in well-being is due to the therapy actually touching on some true, underlying mechanism, or it being effective solely because the patient believes it to be? (Though of course, one could argue it hardly matters.) Of course, one could vet some particular style of therapy against simple non-systematic talking to the patient, but I don’t think I’ve ever seen any such studies… It’s measured the same way that it is diagnosed- through mood assessments, surveys of depression-related behaviors, and other methods. This is also the way that drug-based interventions are measured. ---
**Author:** ![Cayuga](https://avatars.discourse-cdn.com/v4/letter/c/3e96dc/32.png) [@Cayuga](https://boards.straightdope.com/u/Cayuga)\ **Post date:** [December 11, 2012, 1:03am UTC](https://boards.straightdope.com/t/is-therapy-a-scam/643603/29 "2012-12-11T01:03:55Z")
> [@sweeteviljesus](#): > > I don’t know anyone who says, “thanks to my therapist, I don’t have to go to therapy anymore.” Well, you don’t know me, but you can add me to the list of people responding here who say it. OK, I don’t think I’ve ever _actually_ said it. But if asked, I could say it truthfully. ---
**Author:** ![Hentor\_the\_Barbarian](https://avatars.discourse-cdn.com/v4/letter/h/8edcca/32.png) [@Hentor\_the\_Barbarian](https://boards.straightdope.com/u/Hentor_the_Barbarian)\ **Post date:** [December 11, 2012, 2:13am UTC](https://boards.straightdope.com/t/is-therapy-a-scam/643603/30 "2012-12-11T02:13:41Z")
> [@ITR\_champion](#): > > Our society has built up an exaggerated view of what psychotherapy can accomplish. In reality it is simply talk. A good therapist is simply a skilled talker. In other words, he (or she) is somebody who’s good at drawing out relevant information from the patient and leading the patient to important self discoveries. Such things can be useful; extremely useful, in some cases. However, we should not expect psychotherapists to have some sort of magical ability to solve problems that’s in an entirely different class from the abilities of regular people. You’re mostly wrong. Psychotherapy is not simply talk, at least if the therapist is using empirically validated treatments. The evidence is clear and robust that cognitive behavioral therapies are the most effective treatment strategies for many disorders. You are right that these aren’t magic. However, it’s not something that can simply be done by the layperson. It takes training, experience, and the use of sound empirical practices. ---
**Author:** ![monstro](https://avatars.discourse-cdn.com/v4/letter/m/ba9def/32.png) [@monstro](https://boards.straightdope.com/u/monstro)\ **Post date:** [December 11, 2012, 3:23am UTC](https://boards.straightdope.com/t/is-therapy-a-scam/643603/31 "2012-12-11T03:23:36Z")
Therapy is so variable that it’s really hard to generalize. CBT is just one avenue. I think it’s great for many issues, but it’s not the end-all, be-all for everyone. For instance, many people who are child abuse victims don’t like CBT. Maybe they have problems forming relationships with people, so their therapy focuses on transference and all that kind of stuff. The therapist-patient relationship is important in CBT, but it’s not THE therapy itself. CBT is designed for certain problems, not all of them. Some therapists give advice and act as coaches or teachers. Other therapists think it is not their place to give advice and leave it up to the client to direct their therapy. Some therapists do much of the talking, while other therapists are willing to spend the whole session in silence if their client doesn’t know what to say. May therapists don’t do long-term work, whereas others relish it. Even the ethics aren’t the same amongst different modalities. Some therapists consider physical touch a vital part of the process, whereas others have strict policies against it. All this heterogeneity mirrors that found in people’s preferences and problems. It’s strange to link the effectiveness of therapy with how long it lasts. Some diseases/conditions are chronic/life-long and you wouldn’t expect them to be resolved quickly. As far as psychiatric disorders like OCD or schizophrenia, CBT has been found to have some efficacy in the treatment of both. But it’s not likely that therapy will “cure” either one of them. Rather, therapy will help the individual cope with their problems better than if they were treated with drugs alone. If someone has a very severe disease, likely medication isn’t really going to lick it completely. So psychotherapy can help pick up any slack. Furthermore, a good psychotherapist can help the individual with maintenance by mitigating the harmful effects of social isolation and stress. They also provide a valuable service to a patient’s family by giving that person an emotional outlet so they don’t overburden people. Some therapists are scammers, and some approaches are definitely more “woo” than others. But psychotherapy certainly helps millions of people. I don’t see how anyone can deny this. ---
**Author:** ![Hershele\_Ostropoler](https://avatars.discourse-cdn.com/v4/letter/h/e47c2d/32.png) [@Hershele\_Ostropoler](https://boards.straightdope.com/u/Hershele_Ostropoler)\ **Post date:** [December 11, 2012, 3:35am UTC](https://boards.straightdope.com/t/is-therapy-a-scam/643603/32 "2012-12-11T03:35:56Z")
> [@sweeteviljesus](#): > > This may belong in GD, but I am curious if there is any evidence that talk therapy (not sure if I have the term correct) does any good? It seems like a lot of money is spent, but I don’t know anyone who says, “thanks to my therapist, I don’t have to go to therapy anymore.” I have a chronic physical illness. Is my treatment a scam because it isn’t a cure? If that’s your definition of “scam” there’s an awful lot of quackery out there calling itself medicine. Unless my hidebound Western so-called doctors are under orders from Big Pharma to tell me it’s a chronic illness so they can sell me toxins. But that’s not how I understood the OP. ---
**Author:** ![Half\_Man\_Half\_Wit](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/half_man_half_wit/32/21766_2.png) [@Half\_Man\_Half\_Wit](https://boards.straightdope.com/u/Half_Man_Half_Wit)\ **Post date:** [December 11, 2012, 10:34am UTC](https://boards.straightdope.com/t/is-therapy-a-scam/643603/33 "2012-12-11T10:34:55Z")
> [@even\_sven](#): > > It’s measured the same way that it is diagnosed- through mood assessments, surveys of depression-related behaviors, and other methods. This is also the way that drug-based interventions are measured. I imagine so, and I have no qualms with the effectiveness of therapy; my issue is merely how one assesses the effectiveness of that particular style of therapy versus some sort of ‘placebo’ – how does one do ‘sugar-pill’ therapy? With any sort of drug-based approach, it’s straightforward: just leave out the active ingredient. But what’s the active ingredient in, say, CBT? And what kind of ‘pseudo-therapy’ fulfills the same role as the sugar-pill in drug trials – that is, it’s non-harmful, but also known to be non-efficacious? I’m just asking these things out of curiosity; I’m sure these issues have been thought through and resolved ages ago, I’m just not aware of that. So, what are the accepted protocols and standards in this case? ---
**Author:** ![Dangerosa](https://avatars.discourse-cdn.com/v4/letter/d/22d042/32.png) [@Dangerosa](https://boards.straightdope.com/u/Dangerosa)\ **Post date:** [December 11, 2012, 1:03pm UTC](https://boards.straightdope.com/t/is-therapy-a-scam/643603/34 "2012-12-11T13:03:02Z")
Therapy is supposed to help you learn to cope, learn to think rationally. That doesn’t mean that it will “cure” you, and it doesn’t mean it will work. CBT is particularly focused on this idea (rather than say, psychoanalysis). And, of course, if you don’t have the sorts of skills CBT teaches, and you learn them, it will actually help. I’ve had bad luck with therapy and find it to be mostly a waste of time. I don’t know if that is me or the therapists, but I don’t think its a condemnation of therapy. (Medication on the other hand, works for me). ---
**Author:** ![kayaker](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/kayaker/32/441_2.png) [@kayaker](https://boards.straightdope.com/u/kayaker)\ **Post date:** [December 11, 2012, 1:24pm UTC](https://boards.straightdope.com/t/is-therapy-a-scam/643603/35 "2012-12-11T13:24:05Z")
My gf saw a therapist when she was going through her divorce. At the conclusion of the third session, the therapist suggested she not come back, as she was doing so well and the therapy was unnecessary. I thought that was pretty cool. ---
**Author:** ![Nature\_s\_Call](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/nature_s_call/32/19006_2.png) [@Nature\_s\_Call](https://boards.straightdope.com/u/Nature_s_Call)\ **Post date:** [December 11, 2012, 2:38pm UTC](https://boards.straightdope.com/t/is-therapy-a-scam/643603/36 "2012-12-11T14:38:07Z")
> [@monstro](#): > > It’s strange to link the effectiveness of therapy with how long it lasts. Some diseases/conditions are chronic/life-long and you wouldn’t expect them to be resolved quickly. > [@Hershele\_Ostropoler](#): > > I have a chronic physical illness. Is my treatment a scam because it isn’t a cure? If that’s your definition of “scam” there’s an awful lot of quackery out there calling itself medicine. It’s not that therapy must be finite and short to be effective. The essential meausre is “did it achieve the patient’s goals?” The goal of treatment of a chronic illness is to alleviate the suffering on an ongoing basis. If life is better with treatment, the fact that the treatment never ends does not impinge its effectiveness. But therapy designed to keep a “patient” dependent on the “therapist” for as long as they can milk’em has the feature of a never-ending, never-curing series of sessions. This is what is meant when considering length of time and absence of “cure” as potentially a scam. If a therapist says, “You’re cured, don’t come back” at least we know the therapist is not one of those. ---
**Author:** ![tim314](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tim314/32/3468_2.png) [@tim314](https://boards.straightdope.com/u/tim314)\ **Post date:** [December 11, 2012, 2:40pm UTC](https://boards.straightdope.com/t/is-therapy-a-scam/643603/37 "2012-12-11T14:40:09Z")
To me it seems almost obvious that discussing one’s problems with someone can help get things in perspective, see things in a different light, come up with ideas of ways to tackle those problems, etc. Especially if the person has talked to a lot of other people who may have been dealing with similar problems, and seen what worked for them. Or if they’ve studied research on what methods of dealing with these sorts of problems tend to be the most effective. In fairness, my wife is a former therapist, so I have a pro-therapy bias. But still, if the person is smart and experienced, why _wouldn’t_ you think they could at least be helpful? Nobody is saying therapy is a magic cure-all (or if they are, then yeah, they’re scamming you). Regarding the question of whether anyone is ever cured (i.e., whether they feel better to the point where they no longer seek therapy), sure, some people are. But really, even if it makes you feel better but not “cured”, that’s still a win right? At least if you can afford the cost. ---
**Author:** ![tim314](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tim314/32/3468_2.png) [@tim314](https://boards.straightdope.com/u/tim314)\ **Post date:** [December 11, 2012, 2:44pm UTC](https://boards.straightdope.com/t/is-therapy-a-scam/643603/38 "2012-12-11T14:44:13Z")
> [@Fotheringay-Phipps](#): > > I believe there have actually been studies of this matter, and that they’ve found that therapy is, on average, about as effective as talking over your problems with a lay “good listener”. This might be true, but I question how many “lay ‘good listener’”'s would be willing to let you talk about nothing but your own problems for an hour a week. Therapists get paid for a reason; because treating your “good listener” friend like a therapist is not any way to be a good friend. And on the flip side, a lot of people wouldn’t be willing to treat a friend that way, but the fact that you’re paying for someone to listen means you don’t have to feel bad about it. ---
**Author:** ![shiftless](https://avatars.discourse-cdn.com/v4/letter/s/e9c0ed/32.png) [@shiftless](https://boards.straightdope.com/u/shiftless)\ **Post date:** [December 11, 2012, 3:01pm UTC](https://boards.straightdope.com/t/is-therapy-a-scam/643603/39 "2012-12-11T15:01:34Z")
> [@tim314](#): > > To me it seems almost obvious that discussing one’s problems with someone can help get things in perspective, see things in a different light, come up with ideas of ways to tackle those problems, etc. Especially if the person has talked to a lot of other people who may have been dealing with similar problems, and seen what worked for them. Or if they’ve studied research on what methods of dealing with these sorts of problems tend to be the most effective. Exactly. Of course therapy works, sometimes. My wife and I found that a skilled neutral party allowed us to discuss some touchy issues that we couldn’t seem to discuss effectively by ourselves. On the other hand, we had our son talk some things over with another therapist. Basically we paid huge amounts of money for a ham-fisted charlatan to rummage around in our child’s brain. Caution is advised. ---
**Author:** ![Learjeff](https://avatars.discourse-cdn.com/v4/letter/l/94ad74/32.png) [@Learjeff](https://boards.straightdope.com/u/Learjeff)\ **Post date:** [December 11, 2012, 4:12pm UTC](https://boards.straightdope.com/t/is-therapy-a-scam/643603/40 "2012-12-11T16:12:22Z")
> [@Half\_Man\_Half\_Wit](#): > > I imagine so, and I have no qualms with the effectiveness of therapy; my issue is merely how one assesses the effectiveness of that particular style of therapy versus some sort of ‘placebo’ – how does one do ‘sugar-pill’ therapy? With any sort of drug-based approach, it’s straightforward: just leave out the active ingredient. But what’s the active ingredient in, say, CBT? And what kind of ‘pseudo-therapy’ fulfills the same role as the sugar-pill in drug trials – that is, it’s non-harmful, but also known to be non-efficacious? > > I’m just asking these things out of curiosity; I’m sure these issues have been thought through and resolved ages ago, I’m just not aware of that. So, what are the accepted protocols and standards in this case? While double-blind studies are the gold standard for health research, they’re not applicable to all cases. There have been no double-blind studies of efficacy for cardiac bypass surgery. [Previous page](https://boards.straightdope.com/t/is-therapy-a-scam/643603.md?page=1) [Next page](https://boards.straightdope.com/t/is-therapy-a-scam/643603.md?page=3)