PSYCHOLOGICAL TREATMENTS THAT CAUSE HARM
It is clear that psychotherapy is very effective. Meta-analysis studies have shown consistently that the positive effects of treatment exceed those of no treatment or placebo treatments for a wide range of disorders. Yet, there has been a recent noticeable interest in both the scientific community and in the media with psychological treatments that could potentially cause harm. Psychology lacks a medicinal equivalent to the Food and Drug Administration. This leaves the physiological profession vulnerable to detrimental effects to mental health consumers.
The psychological field has moved toward empirically supported therapies (ESTs) in an effort to address treatments that could potentially cause harm. ESTs are lists of treatments that have been found in controlled trials or systematic single-case designs to be effective for specific psychological disorders. It appears that these ESTs help steer psychology in a more scientifically established direction. Yet a problem with ESTs exist. They may be based on inadequate research and they unjustifiably restrict clinicians from administering interventions with promising positive outcomes due to lack of sufficient research. Emerging findings from psychotherapy outcome literature demonstrates that not all therapies are created equal,
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and in fact some can cause harm. Dr.
Lilienfeld gives two reasons why potentially harmful treatments (PHTs) are important. First, knowledge of PHTs can help prevent therapists from harming their clients inadvertently through well-intended yet detrimental interventions. With increased knowledge of PHTs, clinicians can help their clients make better informed decisions about their treatments and highlight which treatments should be approached with caution or just avoided altogether. Secondly, investigation of PHTs can provided knowledge of mechanisms underlying client harm and decline in psychotherapy. This will provide insight to sources of complications and barriers to treatment
outcomes. One of the PHTs that Dr. Lilienfeld discovered and outlined in his research and analysis is “scared straight” programs. This type of therapy aims to avert at-risk adolescents away from lives of crime by exposing them to the dangerous realities and conditions of prison. These programs began in New Jersey in the early 1970s and gained in popularity after a successful documentary aired in 1979. In 1982, an RCT examining the initial program revealed that the “scared straight” treatment actually resulted in a significant increase in arrests when compared with a non-treatment condition, thus achieving the opposite intended effect. Similar results with “kids spend the day in prison” programs have been reported. A recent meta-analysis of seven studies of “scared straight” programs showed that this type of treatment intervention increased the odds of offending by a ratio of between 1.6 and 1.7 to 1. With this evidence it becomes clear that this type of treatment is extremely ineffective and harmful as it essentially doubles the risk of the behavior it is trying to prevent.
9). Based on the afore initiatives, the mental health professional must decide which therapy would be beneficial in treatment for the clients’ problems. Evaluations and reevaluations may be needed to be successful in treatment (Nurcombe, 2014,
Heitler, Susan. Ph.D. “8 Reasons to Cheer for Psychotherapy and to Broaden Its Availability.” Psychology Today. N.p. 10 Aug. 2012. Web. 11 Nov. 2013
Leichsenring, F., & Leibing, E. (2003). The effectiveness of psychodynamic therapy and cognitive behavior therapy in the treatment of personality disorders: a meta-analysis. American Journal Of Psychiatry, 160(7), 1223--1232.
As science has evolved, so have treatments for mental illnesses have over time. The medical model is described as the view that psychological disorders are medical diseases with a biological origin (King, 2010, pg. 413). Abnormal behavior that categorizes some disorders can be impacted by biological factors such as genes, psychological factors such as childhood experiences, and even sociocultural factors such as gender and race (King, 2010). Treatments such as psychosurgery (lobotomy) , drug therapy (pharmaceuticals), electroconclusive therapy, and psychoanalysis are used to treat a wide range of psychological disorders. Back then, the public’s negative views on mental illnesses also went as far to associate with the people who treated it; psychiatrists. “Nunnally (1961) found that the public evaluated professionals who treated mental disorders significantly more negatively than those who treat physical disorders,” (Phelan, Link, Stueve, & Pescosolido, 2000, pg. 189). People back then didn’t see the point in “paying to be told that they were crazy”. However, in today’s society, it is now acceptable to seek help from psychiatric professionals; we are seeing more and more people seek mental health treatment. “In terms of facility-based records of utilization (Manderscheid and Henderson 1998), the data suggest that the rate of utilization of professional mental health services has at least doubled and maybe tripled, between the 1950’s and today,” (Phelan, Link, Stueve, & Pescosolido, 2000, pg. 189). In the 1950’s, neuroleptic drugs like Thorazine were introduced to treat the symptoms of schizophrenia. These drugs block a neurotransmitter called dopamine from getting to the brain, which in turn reduce schizophrenic symptoms, however there are some side effects such as substantial twitching of the neck, arms, and legs, and even dysphoria or lack of pleasure. (King, 2010, pg.
The overall history of psychology is a short one in comparison to the other fields of medicine and this is because things considered to fit into psychology today were put in other categories throughout history. They were passed off as other ailments or labeled as nerves or stress (Tracy, 2013). Anxiety disorders were seen as a woman’s problem and unimportant. This is a misconception though, because both men and women suffer from anxiety disorders (Tracy, 2013). As time progressed many things were tried and most failed due to the little to no understanding of the cause. Many early treatments involved bloodletting, hydropathy, herbs and balms, bathing in very cold rivers or streams, and health spas (Tracy, 2013). The a...
Our text book, Systems of Psychotherapy, describes psychotherapy as “…the informed and intentional application of clinical methods and interpersonal stances derived from established psychological principles for the purpose of assisting people to modify their behaviors, cognitions, emotions, and/or other personal characteristics in directions that the participants deem desirable.”
Torture, for weeks, for months, for years, but it is somehow plausible to consider it help. The sane being shoved into a psych ward, drugged, and forced with erroneous treatments, yet this is regarded as the panacea? Mental institutes do not solve everyone’s problems. Forced treatment on the resistive or illegitimate mentally ill exemplifies the need to regain civil rights for patients. The current laws applied to the topic remain not enough to withhold these patients’ civil rights. Also, patients bias court cases while influenced by prescribed drugs. The stories and results of these foul acts are tremendously horrifying. As Americans we are born with our civil rights therefore these persons deserve justice.
...ential impediment to postmodern and CBT interventions is practitioner incompetence. Psychological harm to clients is a potential danger of interventions implemented by untrained or inexperienced therapists. Likewise, the attitude and professional maturity of the practitioner are crucial to the value of the therapeutic process. In both approaches, whether taking on the role of teacher or collaborator, the therapist’s stance is one of positive regard, caring, and being with the client. While techniques and therapeutic styles may vary between and within the postmodern and CBT counseling approaches, they both enlist the client’s diligent participation and collaboration throughout the stages of therapy to accomplish positive therapeutic outcomes.
Roth, A., Fonagy, P. (2005). What works for Whom? A Critical Review of Psychotherapy Research. US: Guilford Press.
The disorder which is being treated is actually strengthened to the point of a serious mental illness. Similarly, in today’s society, medical and psychological advice may have the same effect. Medical technology and practice have progressed considerably since the time of the “Yellow Wallpaper.” This is not to say that today’s physicians are infallible. Perhaps some of today’s treatments are the “Yellow Wallpaper” of the future.
Doward, J. (2013), Medicine's big new battleground: does mental illness really exist? The Observer 12 May.
King, J. H., & Anderson, S. M. (2004). Therapeutic implications of pharmacotherapy: Current trends and ethical issues. Journal of Counseling and Development, 82(3), 329–336.
Cognitive Behavioral Therapy appears to be a new treatment, although its roots can be traced to Albert Ellis’s Reason and Emotion in Psychotherapy, published in 1962. Cognitive therapy assumes that thoughts precede actions and false self-beliefs cause negative emotions. It is now known that most depression treatments have cognitive components to them, whether they are recognized or not. In the 1970’s many psychologists began using cognitive components to describe depression. From there, they developed cognitive forms to treat depression with impressive results (Franklin, 2003).
There are some key distinctions between Randomized Controlled Trials (RCT) in a psychotherapeutic context and a medical context. There are key differences between the design of an RCT to evaluate a new drug and an RCT to evaluate a new form of couples’ therapy. However, it is important to begin by defining and understanding the importance of RCT in research (O'Brien, 2013).
This tension between an emphasis on a positivist science base and an emphasis on therapy and professional issues runs through many debates in clinical psy...