5 ms·
The problem with mainstream therapy is that, unless you're being treated by a psychiatrist, there's very little in the way of objective evidence of therapy work
by lelanthran 2y ago
The problem with mainstream therapy is that, unless you're being treated by a psychiatrist, there's very little in the way of objective evidence of therapy working.
Sure, lots of self-reported successes by patients with no control to compare against, but at this point there is just as much self-reported evidence that prayer works.
For medical treatments, the bar should be higher than "patient believes it worked".
- 0xDEADFED5 2y agoif you learn things from therapy that improve your life then i guess it has worked. i imagine success stories tend to self-select as well. if you go to therapy in the first place it means you're admitting a need and willingness to change. if a person thinks they know everything and can't benefit from therapy then they're probably unlikely to gain anything from the experience.
- lelanthran 2y ago> if you learn things from therapy that improve your life then i guess it has worked. But this is true of things that we already know don't work - aromatherapy, homeopathy, acupuncture. The evidence for therapy is neither more nor less than the "evidence" for things we already know fails double-blind studies.
- mikebonnell 2y agoFor CBT therapy, the evidence strongly suggests that it does help in the vast majority (but not all cases). More research is still needed to your point, and we can acknowledge the research done so far has provided evidence in favor. "The effect's associated prediction interval −0.05 to 0.50 suggested CBT will remain effective in conditions for which we do not currently have available evidence. While there remain some gaps in the completeness of the evidence base, we need to recognise the consistent evidence for the general benefit which CBT offers." https://pmc.ncbi.nlm.nih.gov/articles/PMC7856415/ https://pmc.ncbi.nlm.nih.gov/articles/PMC7856415/ "Eleven studies compared response rates between CBT and other treatments or control conditions. CBT showed higher response rates than the comparison conditions in 7 of these reviews and only one review reported that CBT had lower response rates than comparison treatments. In general, the evidence-base of CBT is very strong. However, additional research is needed to examine the efficacy of CBT for randomized-controlled studies." https://pmc.ncbi.nlm.nih.gov/articles/PMC3584580/ https://pmc.ncbi.nlm.nih.gov/articles/PMC3584580/
- disgruntledphd2 2y agoHow would one double blind a traial of one or more therapeutic methods?
- mikebonnell 2y agoHonestly, I don't think it's possible.
- disgruntledphd2 2y agoCorrect! And even if it was, what's the active ingredient of therapy?
- nick__m 2y agoWe know how aromatherapy, homeopathy and acupuncture works, it's called the placebo effect. Now maybe you meant to say: we don't know how the placebo effect works.
- aleph_minus_one 2y ago> if you learn things from therapy that improve your life then i guess it has worked. To give a very "Hacker-Newish" snappy remark: So, if the therapy teaches you programming, and you thus get a much better job improving your life, you'd claim that "learn to program" is a suitable therapy? ;-)
- bawolff 2y agoI'd add the caveat that therapy is supposed to be meta (teach you about yourself). Learning to program isn't therapy. Learning how to learn to program might be.
- aleph_minus_one 2y ago> I'd add the caveat that therapy is supposed to be meta (teach you about yourself). Then learning to program is therapy. :-D I am serious: Learning (very abstract) mathematics, and programming, taught me an insane amount about myself: - how I attempt to model and structure the world - how better models of very diverse phenomena look like - what such insights mean for my life - ...
- drewcoo 2y ago>> I'd add the caveat that therapy is supposed to be meta (teach you about yourself). > Then learning to program is therapy. Are you trying to say that learning to program is not learning logic?
- theGnuMe 2y agoIn the sense that you learned to reprogram your mind.
- yladiz 2y agoHow would you even measure the improvement of mental health objectively? You can’t just measure some levels of neurotransmitters and say “okay this is better, dopamine went from X to Y” because the patient may not feel any better. It’s not like with a broken bone where you can look at an image of the bone and see that it has healed, you have to rely on what a person tells you, which is inherently subjective, and since a person can’t be cloned, you can’t have a “control” either.
- Hasnep 2y agoJust because you can't think of a way to measure mental health doesn't mean a way doesn't exist. Scientists have ways of measuring subjective things in objective ways, they're not perfect but you can read the papers where they define them and then find other papers where they're useful.
- Towaway69 2y agoOnce it becomes measurable, then you can implant emotions into AI agents. Once you an AI identity that is emotionally indistinguishable from us non-AI identities and which is infinitely smarter than us, what purpose would we have left to fulfil?
- NicholasGurr 2y agoMy purpose would remain unchanged. What you’re asking is almost the same as asking, “If a person exists who is better (smarter, stronger, more attractive) than you, what point is there in existing?” Because I experience life subjectively and would prefer to continue doing that.
- Towaway69 2y agoYou make a good point - purpose is very subjective and personal. Maintaining that purpose regardless of outside influence becomes the hard bit! OTOH what happens if there is a whole species of beings who are smarter, stronger, … than our species? Would our collective purpose become to accept them as our betterment? Our personal purpose would vary greatly from fear to wonderment.
- rmbyrro 2y agohave you ever done therapy for a deep emotional issue? your comment sounds like you've never
- lelanthran 2y ago> have you ever done therapy for a deep emotional issue? your comment sounds like you've never Yes. With two different therapists. Also people close to me have been. I see no difference between the results from therapy and the results from prayer and a belief that aliens with UFOs made things better.
- wruza 2y agoPeople report that you may skip over dozen of therapists until you find the one. They just suck, cause it's an area filled with uh-huh listener scam for your $$$.
- BizarreByte 2y ago“Therapy doesn’t work” is always refuted by this claim that you just haven’t found the right one yet. It’s tiring honestly, you are not allowed to criticize therapy in the current year.
- wruza 2y agoNot the right one, but the one who actually practices it instead of giving vague mom/dad’s advices. always That should mean something. But I agree that people may omit important details about the structure of their therapy work, so it may not feel convincing. To make sense of what I mean by therapy, look at my recent comment history. It does not boil down to the “emotionally right” one. I’m quite different from and not really emotionally connected to mine, for example, although I respect his professional skills very much.
- fabioz 2y agoI believe this view is actually outdated -- it was actually true in the past, but I know that currently "Cognitive Behavioral Therapy" does define things much more objectively than previous approaches... It's a bit unfortunate that people out of the psychology area don't even really know that there are multiple different Psychotherapies approaches and that they vary wildly in how problems are tackled/studied (source: my wife works in the area).
- megous 2y agoNo. CBT is still a mumbo jumbo of concepts and approaches that have no relation to reality (like any other therapeutic school), other than "if you follow these practices, you will maybe get better". You'll not be able to prove validity of the concepts behind this school of therapy themselves in any other sense, even if you would be able to identify some coherent set of concepts from all the various techniques and approaches that CBT subsumed over the years. And certainly just because "if you follow these practices, you will maybe get better" metric does not say anything about validity of the concepts of a particular school of therapy in any case, no matter what school you're talking about. I mean yeah, many people usually care about whether some therapy works and how well, and not whether the concepts that you're told in therapy to justify what the therapy is doing make coherent sense or can be scientifically validated, so this is usually not a problem for people in need of care. But idea that CBT's concepts are more objective than other mumbo jumbo therapies out there is just plain wrong.
- m90 2y ago> unless you're being treated by a psychiatrist What tools for "measurement of success" does a psychiatrist have that aren't available to a therapist?
- codingdave 2y agoTherapy is skills training, not medical treatments. Which is also why the reliability is varied - not everyone wants to learn mental health skills. Not everyone who learns them wants to do them. Not everyone who wants to do them is able to make themselves do so. When you go to a psychiatrist, now we are talking medical treatments. That is where you get a specific diagnosis and possibly medicine to change how your body and mind work. That is where to expect objective results. Both explore what is needed by talking to patients, often with some testing... but they are not the same thing. And neither are going to solve all problems for all people. But it helps to evaluate them properly if you understand what they are, and what they are not.
- kragen 2y agoSome skills training is well supported by empirical evidence. People who take piano lessons observably improve their ability to play piano, on average, even though some don't, even though they often regress after they stop, and even though some people improve without taking lessons. Similar remarks apply to golf lessons, JavaScript bootcamps, calculus courses, and plumbing apprenticeships. Most kinds of therapy, by contrast, are closer in their empirically measured effectiveness to studying geography through astral travel or studying history through past-life regressions. CBT and exposure therapy are among the few exceptions.
- bengale 2y ago> but at this point there is just as much self-reported evidence that prayer works. If you remove the assumption that a deity answers the prayer; what they're doing is focusing on gratitude and if asking for things they are identifying goals. This is a healthy mindset so unsurprising that they report it "working".
- bawolff 2y agoIf you exclude people with diagnosiable mental illness, it seems like it would be hard to come up with an objective definition of therapy "working" beyond patient self-report. Its not like its a broken leg where you can test how well they walk. If the patient is happier, does it matter if there isn't an objective measure.
- bowsamic 2y agoWho cares, though? If I feel better it worked. And yes if I was in a mental health crisis and I thought prayer would help I’d definitely try it
- BizarreByte 2y agoAll kinds of pseudoscience makes people believe they feel better. Without proof therapy works it’s no better than homeopathy.
- deleted 2y ago[deleted]
- freen 2y agoThere are standardized diagnostics and measurements of severity for many, if not most, psychological disorders. There is an extremely large body of evidence that therapy substantially improves psychological disorders as measured by these diagnostics and measurements. What are you talking about?
- beardedwizard 2y agoThe comments claiming no evidence are totally baffling, there are mountains of studies with data. This thread scares me with the amount of misinformation being aggressively pedaled.
- deleted 2y ago[deleted]
- BjoernKW 2y ago> unless you're being treated by a psychiatrist Quite to the contrary, while there is plenty of evidence of specific types of therapy yielding actual results, there's often very little evidence of the methods commonly applied by psychiatrists (i.e. medication) to be actually beneficial. In fact, some types of psychiatric drugs (with SSRIs probably being the worst offender) are actively harmful, while evidence of their presumed positive effects is vague and ambiguous at best.