Is therapy a scam?

[sweeteviljesus]

@shiftless

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.

So, ultimately, it’s an art not a science? How does one decide whether a practitioner has the knack? For the record, this is a hypothetical question. I am not personally seeking a therapist.

Rob

[Hentor_the_Barbarian]

@sweeteviljesus

So, ultimately, it’s an art not a science? How does one decide whether a practitioner has the knack? For the record, this is a hypothetical question. I am not personally seeking a therapist.

Rob

It’s an art AND a science, just like any other profession: heart surgeon, plumber, lawyer, opthalmologist… You have to know what to do and also do it well.

You find them as you would other health providers - start with those within your network, depending on your health care coverage, talk with others, look online for others opinions, look up their license for any actions against it…

[shiftless]

@sweeteviljesus

So, ultimately, it’s an art not a science? How does one decide whether a practitioner has the knack? For the record, this is a hypothetical question. I am not personally seeking a therapist.

Rob

Depends on if the professional has the knack and if the two (or more) of you connect, IMO. My issue is that therapy necessarily goes on behind closed doors and it is difficult for anyone outside to measure the ability and effectiveness of the therapist and, as far as I can tell, the industry isn’t very interested in monitoring itself. So, it may be a science or it may be an art. Except for the therapy I have personally been to I have no way of knowing.

When you look at the results, it’s an art. When they bill you, it’s an exact science.

[Half_Man_Half_Wit]

@Learjeff

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.

Well, obviously, double-blind studies would be relatively hard to implement in this field, seeing as how one would expect the therapist at least to know whether the therapy he administers is supposed to be effective or not… But my question actually didn’t concern double-blind studies at all. Put as simply as I can, I’m just asking: 1) How do you scientifically validate the effectiveness of therapy (in whatever form)?, and 2) What are the results of the studies that have been done?

Really, I’m just posing what seems to me to be a completely straightforward question from a position of near-total ignorance. I’m not looking to validate any preconceptions, I don’t have an agenda, I just want to be pointed to the research.

[Hentor_the_Barbarian]

@shiftless

Depends on if the professional has the knack and if the two (or more) of you connect, IMO. My issue is that therapy necessarily goes on behind closed doors and it is difficult for anyone outside to measure the ability and effectiveness of the therapist and, as far as I can tell, the industry isn’t very interested in monitoring itself. So, it may be a science or it may be an art. Except for the therapy I have personally been to I have no way of knowing.

When you look at the results, it’s an art. When they bill you, it’s an exact science.

Is the therapist practicing empirically validate techniques? That’s the application of science. A great deal of effort has gone into evaluating intervention strategies. It’s a specific objective of the National Institue of Mental Health and a primary focus of many journals. People aren’t just pulling shit out of their asses (as a rule).

Now, is a given practitioner using these techniques and doing it well? That’s variable. Ask your prospective therapist to explain his or her orientation and approach.

Oversight of ethical practices (not of whether the therapist is using a particular strategy) is carried out by the state licensing board (in the U.S., anyway).

[Fotheringay-Phipps]

@Half_Man_Half_Wit

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…

I’ve read several articles about such studies over the years, but I can’t come up with anything with a bit of googling - sorry.

Best I got was the Dodo Bird Verdict - relevant and worth reading, but not precisely the same thing as my recollection and claim. See also: Psychotherapy - Wikipedia

@tim314

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.

Both valid points.

[Foxy40]

I am not sure what you mean by talk therapy. In my experience, therapists generally give you tools and suggestions on how to better your issues in the real world. I feel it has worked for me in the past and my daughter is currently seeing a therapist twice a week and I’ve noticed a big improvement with her therapy from when she was using meds alone.

It never once occurred to me that behavioral or emotional therapy was a scam.

[Modern_Master]

@Foxy40

I am not sure what you mean by talk therapy. In my experience, therapists generally give you tools and suggestions on how to better your issues in the real world. I feel it has worked for me in the past and my daughter is currently seeing a therapist twice a week and I’ve noticed a big improvement with her therapy from when she was using meds alone.

It never once occurred to me that behavioral or emotional therapy was a scam.

To a lot of people, scam translates to ineffective treatment.

I think a better question to pose would be this: How effective is therapy?

The answer is that it depends. It’s effective when people are open and honest. Also, there has to be a strong level of trust between patient and therapist. Some therapists are good at establishing trust, and some aren’t.

[Namkcalb]

@shiftless

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.

Just be glad he wasn’t a ghost

[Hershele_Ostropoler]

@Nature_s_Call

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.

My gastroenterologist is not, with current science, going to tell me “you’re cured, don’t come back.”

What is the difference? Why do we not even just ask the question of whether my GE is using a treatment designed to keep me dependent? What makes that a sign of woo but not asking it about psychological therapy?

After all, the goal of treatment of mental 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 medical treatments designed to keep a “patient” dependent on the “doctor” for as long as they can milk’em has the feature of a never-ending, never-curing series of prescriptions.