Pseudoscience in the Field of Psychotherapy
Orlando CBT Therapist Shares Information
Just recently a conversation on a Cognitive Behavioral Therapy discussion board piqued my interest. The participants of the lively and often humorous dialogue were all certified CBT therapists and the conversation focused on pseudoscience in the field of psychotherapy. Merriam-Webster dictionary defines pseudoscience as: a system of theories, assumptions, and methods erroneously regarded as scientific. Cognitive behavioral therapists tend to take great pride in providing evidence-based therapy and CBT is considered the gold-standard of treatment for anxiety, OCD and depression.
A CBT therapist colleague shared a particularly relevant story about a client with severe Obsessive Compulsive Disorder (OCD) symptoms. Although Exposure and Response Prevention (ERP) has long been considered the treatment of choice for OCD, many individuals with OCD do not receive ERP. As a matter of fact, they often receive treatment that actually worsens symptoms. This particular client was advised by various practitioners to treat his OCD with neurofeedback, chiropractic treatments, Emotional Freedom Therapy, a variety of expensive supplements and allergy testing. Of course none of these methods reduced the clients symptoms of OCD even though all of these interventions were time consuming and expensive.
There are literally hundreds of different methods of therapy advocated by thousands of dedicated, well-meaning clinicians. It can therefore be confusing and tricky to differentiate between effective therapies that are evidence-based and those that are without true evidence. In addition, many therapists who feel that their current treatment method is effective enough are often reluctant to learn a new treatment method that is different from the theoretical framework in which they were trained.
Before the 1970s, very few studies had been conducted to evaluate psychotherapy outcomes, but since this time, literally thousands of research studies have been performed and there are now evidence-based treatments for many mental health disorders. However, not much emphasis has been given on the importance of not utilizing interventions that are ineffective, or even harmful.
Scott Lilienfield, who is a professor of psychology at Emory University, as well as a researcher and advocate for evidence based treatments, states that “science and pseudoscience exist along a continuum” and that features of pseudoscience include the following:
1) The overuse of ad hoc hypotheses to account for negative research findings.
2) Avoidance of peer review.
3) Emphasis on confirmation rather than refutation.
4) Lack of connection with basic or applied research.
5) Overreliance on anecdotal evidence.
6) Reversed burden of proof in which proponents of a technique demand that critics refute claims of treatment efficacy.
He writes that the greater the number of these features, the more likely it is that the practice is based on pseudoscience rather than actual science. For example, Lilienfeld et al. (2015) consider EMDR a “highly controversial treatment”. Eye Movement Desensitization Reprocessing (EMDR) is a type of therapy that pairs eye movements with cognitive processing of traumatic events as well as relaxation. While moving his/her eyes back and forth by following the clinicians’ finger or finger-tapping, the individual is asked to describe traumatic memories. Although EMDR has become very popular in recent years, its effectiveness remains an exceptionally controversial subject among researchers. According to scientific literature, it appears that describing traumatic imagery without eye-movements results in the same change. This means that exposure therapy (ERP), long believed to be the gold-standard for the treatment of trauma, is the catalyst for change in EMDR.
Thought Field Therapy (TFT) also known as Emotional Freedom Therapy is an example of pseudoscience, according to Lilienfeld and other researchers. TFT/EFT is based on the premise that bodily energy imbalances cause negative emotions. Treatment is claimed to repair imbalances by tapping on acupuncture meridians. Lilienfeld wrote in the March 2016 issue of Forbes magazine that “there is no good evidence supporting this ‘therapy,’ which draws vaguely on the traditional Chinese idea of a life force. Moreover, there is not a shred of evidence that invisible energy fields exist in the human body, let alone that manipulating them helps to treat psychological problems.” No peer-reviewed research supports this type of treatment and the so-called science cited to support TFT is subjective and unreliable and does not rule out placebo effects. Yet Roger Callahan, the clinical psychologist who invented thought field therapy, said his tapping treatment has a 98 percent success rate and works for “almost everything.”
Lilienfeld, Lynn & Bowden (2018) list the following as “highly dubious interventions” that are now eagerly claiming to be evidence based: therapeutic drumming, animal-assisted therapy for eating disorders, Thought Field Therapy, Emotional Freedom Techniques, Imago Relationship Therapy, Jungian sandplay therapy, primal therapy, dance movement therapy, acupuncture for clinical depression and neurolinguistic programming.
Although it sounds wonderful to quickly cure anxiety disorders by rhythmically tapping on assorted body parts, and overcome depression or autism by having a therapist apply gentle pressure on your shoulders or cure your child’s ADHD symptoms by having him focus on a computer image that will retrain his brain waves, getting better is, unfortunately, not that easy. At GroundWork Counseling in Orlando, our Cognitive Behavioral Therapists take great pride in utilizing interventions that are guided by scientific theory and strong research.
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