It is not just clients who fall for promising advertisements. Psychotherapists, counsellors, and psychologists, even those with post graduate degrees seem to buy into the new, or very old but sounding new and improved, therapy approaches.

Even professional organizations fail to distinguish between solid evidence and the active ingredients and the so-called serving suggestions, the added fluff that sells. Just have a look at the courses they promote on their websites that provide their members with the sought-after professional development hours.

A quick background:

Professionals working in MH may have different academic backgrounds. The most common training MH professionals have done is in psychology, counselling, and social work. Training can be done on different levels from diploma courses to Ph.Ds. 

Adequate knowledge is based on both, a solid theoretical background and hands-on experience (obtained during practicums and internships). 

Research conducted on the effectiveness of psychotherapy failed to demonstrate superiority of one discipline over others and although most therapists have master’s degrees, others can be equally effective. Similar conclusions are drawn about approaches in therapy (CBT, humanistic, psychodynamic, systemic,…). 

The main reason of both findings is that those working in psychotherapy are more similar than different and that good therapy shares common factors. 

But… this does not mean that every therapist is equally effective and therefore when searching for a good fit, read their website critically to find out more about a therapist’s training, experience and approaches. A professional therapist is transparent and open about their background. 

When starting with a new therapist, clients need to feel confident to ask questions, and only commit when they obtain the answers they need to continue. 

When a therapist cannot explain the essence of their preferred approach and indicates that it is too complicated and multifaceted to explain, you might want to shop around a bit longer.

Now…I am getting the core of this post:

There is so much fluff around…and no it is not innocent as people pay for this!

It is frustrating as courses in many if not all bachelor and master’s degrees in psychology and counselling include research methods and statistics. Students are trained in scrutinizing research and writing research papers looking for peer-reviewed journal articles about a variety of approaches and how these compare with each other and to what extent these are tested on effectiveness.

Here is a quote from Quackwatch:

“Many sources of error can mislead people who rely on intuition or informal reasoning to analyze complex events. Before agreeing to any type of treatment, you should feel confident that it makes sense and has been scientifically validated through studies that control for placebo responses, compliance effects, and judgmental errors. You should be very wary if “evidence” consists merely of testimonials, self-published pamphlets or books, or items from popular media.” 

Barry L. Beyerstein, Ph.D. Quackwatch, 2003. 

You can forgive, to a certain extent those who did not study research methodology and who do not know what a sample size or an effect size or a control group is or what constitutes a placebo effect. I write “to a certain extent” as I wonder whether those who are so clever to market and sell their products are really that naïve and what about those who should know better?

Here is a list of red flags:

• The treatment offers fast results 

• The treatment is effective for many if not all Mental Health issues 

• The website includes many testimonials of happy customers 

• Training is expensive and a basic course is never enough. There will be advanced and enhanced training… 

• The treatment has not or hardly been subjected to research 

• Evidence based therapies are mentioned but the advertised approach is NOT an evidence-based practice 

• The words “proven” “effective” and “rapid” are used

• Sciency language is used that is fuzzy and unfalsifiable 

• The training offers to therapists certification and listings to attract more clients 

• The websites look like an advertisement with glossy photos 

• There is an absence of references to published research studies 

And… it still sells ! 

BUT…I hear you say….

Many approaches used in counselling therapy have never been subjected to formal research! This does NOT mean that they are bogus treatments. There can be reasons such as lack of research interest and funding. 

All true, but what is concerning however, is when those providing mental health services make far reaching claims about the benefits of their approaches without any solid evidence. You find that when the “science talk” enters the field with references to neurological and brain processes and when mystic “traditional “quotes are thrown in.  

What is also concerning is when therapists state that they don’t know how it works, but it seems to help clients…stating with a saintly face, that is all that counts for them…. This sounds like a placebo, and you can get those cheaper than a therapy session! 

My conclusions:

Many therapy approaches are based on solid research, and these are a safe choice. 

No therapist can predict individual outcomes as every client brings in a different history but a good client-therapist relationship includes reciprocal feedback making the working alliance stronger. 

Seemingly new or “alternative” approaches might be helpful but be critical of claims made. Often the “active ingredients” are the common factors in therapy.  

Last, but not least, and I am sorry to disappoint you: There is no quick fix!

Dr. Elisabeth

• Are we all f..k..g kidding ourselves?
• How well do you understand placebo effects? — The Logic of Science
• The Love-Bomber’s Con: Why Already Believing You’re Special Can Make You His Victim — Leon’s Existential Cafe
• How the wife of a happy husband realized that she was protecting the status quo
• Bogus therapies….and what to watch out for