Kevin McCarthy, one of our Twitter followers, made an interesting point in response to one of our posts about Alternative Medicine Treatments for ADHC.
He raises a very interesting point. Many people in the behavioral health community subscribe to treatments and tests that are closer to paranormal psychology than they are to actual evidence-based practice. In volume 37, No. 5 of Professional Psychology: Research and Practice, researchers published “Discredited Psychological Treatments and Tests: A Delphi Poll.” In this paper, the researchers ranked 59 treatments and 30 assessment techniques and conducted a poll of 101 experts to rate these treatments and assessments on a continuum from not at all discreditedto certainly discredited.
The move towards evidence-based practice (EBP) in mental health has resulted in a drive to promote treatments that are effective based on empirical evidence. As the researchers suggest, this has caused a huge controversy within the organized psychological professions. Not suprisingly, much of the controversy stems from various stakeholders who have a vested interest in a particular treatment or assessment.
Here are few that rank on the “certainly discredited” side of the continuum:
- Angel therapy Use of pyramids for restoration of energy
- Orgone therapy
- Crystal healing
- Past lives therapy
- Future lives therapy
- Treatments for PTSD caused by alien abduction
- Rebirthing therapies
- Color therapy
- Primal scream therapy
- Chiropractic manipulation
- Thought Field Therapy
- Standard prefrontal lobotomy Aromatherapy for treatment of mental/behavioral disorders
- Erhard Seminar Training
- Age-regression methods for treating adults who may have been sexually abused as children
- Craniosacral therapy for treatment of anxiety and depression
- Preventive intervention for “born criminals”
- Sexual reorientation/reparative therapy for homosexuality
- Holding therapy for reactive attachment disorder
- Treatments for mental disorders resulting from Satanic ritual abuse
- Healing touch (not massage therapy) for treatment of mental/behavioral disorders
- Psychological treatments of schizophrenia based on the schizophrenogenic theory of schizophrenia
- Reparenting therapies for treatment of mental/behavioral disorders
- Bettelheim model for treatment of childhood autism
- Dolphin-assisted therapy for treatment of developmental disabilities
- Equine therapy for treatment of eating disorders
See the original paper, linked above, to see the complete list. Essentially, Angel therapy is the closest to “certainly discredited” and as we move down the list, the credability gets stronger. However, I’ve only included the top 25 and all of the items on the list are considered “questionable” (so lower on the list doesn’t mean “credible” just “less discredited.”)
This list also doesn’t conclusively discredit any particular therapy, that wasn’t the intent. The intent was to demonstrate that many so-called “treatments” don’t necessarily pass the evidence-based threshold for being credible treatments. That doesn’t mean they won’t in the future — there is a considerable amount we still don’t know about psychology. That being said, if a physicist were to deny gravity, they do so at their own professional peril. If a therapist were to deny established treatment protocols, they do so at their patient’s peril.
How should a behavioral health therapist respond?
Quite simply, the most important thing for the average private practice therapist to remember is that it’s important to not mislead patients or feed into unproven theories. If you’re actually performing Angel therapy, you could be doing more harm than good. If you’re using Angel therapy, for example, is that patient actually getting the most effective treatment available? Are you using alternative treatments when a more established evidence-based treatment would benefit the patient more? If you are using a questionable treatment, is it because you’re attempting to differentiate yourself and gain more clients or is it because you have evidence the treatments are actually more effective than conventional evidence-based treatments? If you do have evidence a particular treatment is effective, are you publishing those results? Are you willing to submit those treatments to scientific rigor?
Providing anything other than scientifically valid treatments is malpractice.
If a heart surgeon decided to use holy water instead of disinfectants, would that not be malpractice? Even if the surgeon believed that holy water had superior anti-bacterial properties, would she not be negligent in breaking proven protocols without subjecting her theory to scientific review? While mental health is far more nebulous a discipline than microbiology, that doesn’t excuse the rejection of evidence-based science.
Those on the front-lines of providing mental health treatment have an obligation to stick with proven, scientifically supported treatments; anything less puts patients at risk.