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Like the parent mentioned, the reproducibility crisis didn't change anything, we also can't be sure how many doctors actually took these findings into account.
The point I'm trying to make is that it is really difficult to identify bad therapists. It'll take a while before it's reliable enough and that's okay, but therapy gets thrown around as an option like it is.
As "verified" not by hard measurements (like in Physics), proofs (as in math), or specific clinical results (e.g. blood panels in medicine) but with questionaires and "assessments" by the very people whose continued existance and esteem of the field their careers are based on?
"All kinds of evidence that it works" was there for Freudian psychanalysis too.
You could argue it's a coincidence, but it'd seem a highly unlikely one given the therapy was specifically to address that OCD, and the techniques they're using to reduce the frequency were taught by the therapist. And of course it is one anecdote.
I have no doubt there are lots of people for whom therapy is insufficient or doesn't work, but there are also people for whom you can measure the effects in a lot of other ways than the judgment of therapists themselves.
It's that it's scientific and systematic (and not e.g. arbitrary and subjective, whose efficacy is based on methodology but on the specific patient, the specific therapist, their rapport, and such things).
Talking to a friend also helped many a person overcome psychological problems. As did getting a new job, working out, getting laid, and lots of other things. None of those things claim to be scientific fields though.
So the specific theoretical frameworks aren't really scientific, at least for the most part. But you can do research on stuff such as whether outcomes are on the average better than without therapy, or whether modality or individual therapists matter more.
Of course the evidence is largely still from the questionnaires, with all of their problems, but the questionnaires aren't necessarily administered by the people giving the therapy so it may not be as biased as you might think.
For a whole lot of psychological conditions that do not get to the extremes the only reasonable assessment we can do is whether the patient feels there is a problem, or exhibit indicators of distress in relation to the problem.
Are you washing your hands so much it is OCD and a problem, or is it just a preference? At the margins - if you e.g. do it so much your hurt yourself - it becomes possible to argue it is objective, but for most people the answer purely comes down to whether or not it is subjectively a problem to them.
That does not mean we can not systematically measure whether people report an improvement under varying conditions and using varying methods.
It doesn't really matter if it is subjective - when the problem is that the patient feels there is a problem, then if the patient no longer reports feeling a problem, then unless you're prepared to assume that they are all in denial or lying, that is evidence of improvement even if it does not raise to the standard of evidence we would prefer.
It would be unreasonable to overstate what that means, but equally unreasonable to pretend it provides no signal in the absence of higher standard evidence unless you can identify specific problems (lack of ability to reproduce would be one).
Care to enlighten us on a better way? We have people who need help right now, not when (or even if) we find some sort of objective test.
Just because we can’t measure something objectively doesn’t mean it’s not important or useful (McNamara fallacy).
I am a “hard” scientist (physical chemist), and like most (old-ish) scientists I have come to appreciate the “softer” side of life.
Doesn't mean they are getting help. Just means we set up a whole cargo cult field from thin air and on thin premises, and make-pretend we help them.
Meanwhile, more important structural changes to get them help, are of course ignored, because they are bad for bussiness or inconvenient (like better work-life-balance, less stressful educational/work/healthcare/late life prospects, more cohesive communities, better access to nature, less advertising and rage bait, and anything that doesn't help with the corporate mills grinding on).
Not really, which is why it is all but gone from university psychology research.
The psychanalysis institutes at the time had all kinds of papers and results of their huge success...
> ... in 1952 in which H. J. Eyesenck, an English psychiatrist, divided thousands of World War II veterans hospitalized for mental illness into three groups. One group was treated by psychoanalysis, another was given other kinds of therapy, and the third received no treatment at all. The men were then measured on an "improvement scale" with these stunning results: 44 per cent improved with psychoanalysis, 64 per cent improved with other therapies, and 72 per cent got better with no treatment at all.
> More recently, Werner Mendel, professor of psychiatry at the University of Southern California, directed a similar study. Trained psychoanalysts treated the patients in the first group, less highly trained psychologists and psychotherapists treated the second group, and the third group was under the care of employees with no formal training. The improvement ratings showed the following remarkable results: the third group, treated by staff members without formal training in therapy, showed the most improvement, whereas the first group, treated by staff members with the most extensive training in psychotherapy, showed the least improvement. Understandably, Dr. Mendel was startled by the results and repeated the experiment, with the same outcome.
Now, I'm not going down this rabbit-hole (I did once and wasted a lot of time!) but there is a lot of evidence that just a bit of attention from another person may be helpful, and affective attention may work wonders.
[0] https://www.religion-online.org/article/sin-guilt-and-mental...
Anecdotally, this matches my second-plus-hand observations. In particular, professional "caring" is seen as clinical curiosity (at best) and less authentic, whereas ordinary-person empathy is more meaningful even in small doses.
Relatedly, addicts who seek traditional addiction therapy (anecdotally and second-plus-hand observationally) become lifetime (so far) addicts in how they perceive themselves, even if they quit the substance/behaviour. This tends to have a depressive effect. Addicts who make other changes in their lives which break the addictions have a more reflective view of the different times of their lives (non-addicted, addicted, then non-addicted again), and appear happier.
Addiction and depression are complicated things which I do not have any special knowledge of personally! However, I have varying adjacencies to many people with more complicated lives than my own. I share these anecdotes only because the observations are stark and seem important.
I hadn't heard of this study. I had heard that the case count for psychoanalytic psychotherapy was insufficient to fairly cluster by symptoms as (e.g. hierarchical) features, even. And then Milgram's selection bias.
Is all "Talk Therapy" bad then, and what's a good way to actually help;
Clean language > Clean language in detail: https://en.wikipedia.org/wiki/Clean_language#Clean_language_... :
> Clean language offers a template for questions that are as free as possible of the facilitator's suggestions, presuppositions, mind-reading, second guessing, references and metaphors. Clean questions incorporate all or some of the client's specific phrasing and might also include other auditory components of the client's communication such as speed, pitch, tonality. Besides the words of the client, oral sounds (sighs, oo's and ah's) and other nonverbals (e.g. a fist being raised or a line-of-sight) can be replicated or referenced in a question when the facilitator considers they might be of symbolic significance to the client.
> [...] "What would you like to have happen?
Clean Language Questions : https://cleanlearning.co.uk/blog/discuss/clean-language-ques... :
> The questions containing the verb ‘to be’ help to keep time still and are mostly used for developing individual perceptions:
> Questions containing the verb ‘to happen’ generally encourage the client to move time forwards or backwards:
> Questions which utilise other verbs are:
A prompt: Leadership and Public Speaking: which can utilize Clean Language; and which are necessarily suggestive of direction, course, or sequalae of events?
Its weird that we are arguing this. The shift is well covered over the last half a decade. Also whats the point of lots of psychoanalytic papers being published? There exists a ton of string theory papers. Theology is a huge field, once the biggest academic discipline. Bullshit exist, so what.
Psychology has its successes, empirically proven by getting results in clinical settings, we don't have deep answers on why some of it works or not but working known pharmaceutical compounds also suffer from that, we know they work but we don't know how (some NSAIDs come to mind, psychiatric meds, anesthesia as well).
Or maybe it's just a classic example of a pseudo-field?
>There actually is a mountain of quantitative outcome research across therapy approaches
"Quantitative outcomes" for non-quantifiable conditions means "numerical statistics on answers in questionaires" and such.
>It's readily readable in metastudy form on Google Scholar and elsewhere.
Ah, metastudies, that pinnacle of rigour. "We hastily surveyed 200 varying quality, full of methodological errors, non replicating for the most part, primary studies, and the field is totally a success".
Uh, I have bad news for you about the reproducibility crisis that's also in medicine/biology.
It's just like psychology but 100x worse because there's real money at stake.
Note how tye very same accusation as yours could be (and was made) for Freudian psychanalysis, homeopathy, and any other bs field.
Edit: to illustrate. Your phone rings. You hear the words. You know which words, the unthinkable ones.
The phone rings, your family just got crushed by a runaway truck.
The phone rings, the company you founded and spend every waking hour of the last four years has a hostile take-over. They are firing you and you find out that the structure of the shares is in such a way that you walk away with peanuts.
The phone rings, your mother is in de hospital, she will probably die before next dawn. You are six thousand miles away.
You know, the gnarly stuff of life.
Bad things happen to almost everyone some of the time. Do you see nearly all of the people on the planet broken down, pshychotic? If you do, I think the problem is with the observer.
Most people are sane despite dealing with bad stuff, which proves the assertion wrong.
I mean, you are probably a very stable genius at the moment, but not everybody is and you might not be that for ever. Things can change. If your endocrine system gets a hit somewhere and you get hit by this kind of news. You probably will go into a bad place. I know someone who was severely dehydrated from a viral infection, got into a delirium, then had to recover for 6 years, and still is not the same now.