Why Ineffective Psychotherapies Appear to Work

  title={Why Ineffective Psychotherapies Appear to Work},
  author={Scott O. Lilienfeld and Lorie Ritschel and Steven Jay Lynn and Robin L. Cautin and Robert D. Latzman},
  journal={Perspectives on Psychological Science},
  pages={355 - 387}
The past 40 years have generated numerous insights regarding errors in human reasoning. Arguably, clinical practice is the domain of applied psychology in which acknowledging and mitigating these errors is most crucial. We address one such set of errors here, namely, the tendency of some psychologists and other mental health professionals to assume that they can rely on informal clinical observations to infer whether treatments are effective. We delineate four broad, underlying cognitive… 

Figures and Tables from this paper

Why Psychologists Should Reject Complementary and Alternative Medicine: A Science-Based Perspective

Professional psychology is in apparent conflict about its relationship to “complementary” and “alternative” medicine (CAM)—some scholars envision a harmonious partnership, whereas others perceive

Introduction to Special Section on Pseudoscience in Psychiatry

  • S. Lilienfeld
  • Psychology
    Canadian journal of psychiatry. Revue canadienne de psychiatrie
  • 2015
A careful consideration of errors in thinking is germane to psychiatry and related fields because of the continuing insinuation of pseudoscientific claims into myriad domains of mental health practice.

The sweet spot of clinical intuitions: Predictors of the effects of context on impressions of conduct disorder symptoms.

This paper explored what factors predict the extent to which clinicians and laypeople interpret mental disorder symptoms as a function of diagnosis-congruent versus incongruent contextual information and tested the impact of 2 statistical factors and 2 more intuitive factors on the degree to which a symptom is interpreted differently in different contexts.

Making the case for using personalised outcome measures to track progress in psychotherapy

Abstract The practice-based evidence movement has become increasingly influential in the practice of counselling. One element of this approach is the recommendation that therapists regularly

Treatment effectiveness, generalizability, and the explanatory/pragmatic-trial distinction

The explanatory/pragmatic-trial distinction enjoys a burgeoning philosophical and medical literature and a significant contingent of support among philosophers and healthcare stakeholders as an

The Health Benefits of Autobiographical Writing: An Interdisciplinary Perspective

It is argued that the narratological concept of conflict can be applied to resolve patterns of seemingly conflicting empirical findings in psychological studies and proposed that an interdisciplinary perspective can provide a broader theoretical basis for understanding the psychological processes underlying the health benefits of autobiographical writing.

Illusions of causality: how they bias our everyday thinking and how they could be reduced

How research on the illusion of causality can contribute to the teaching of scientific thinking and how scientific thinking can reduce illusion are discussed.

Development of a self-distancing task and initial validation of responses.

A behavioral task that requires mental manipulation of negative emotional material away from the self, as a means to assess the skills associated with mindfulness and decentering that likely underlie healthy emotional processing, suggests that the self-distancing task shows considerable promise for capturing skills associatedwith mindfulness and at least 1 element of decentering.



Science and pseudoscience in clinical psychology

  • W. Sanderson
  • Psychology
    Psychotherapy research : journal of the Society for Psychotherapy Research
  • 2004
It can be said of Daniel Siegel’s chapter that his work not only is an exposition of a valuable interdisciplinary model resting on a biological foundation but is also instructive for the less medically knowledgeable, as well as teach the reader more broadly.

Iatrogenic symptoms in psychotherapy. A theoretical exploration of the potential impact of labels, language, and belief systems.

The authors explore causal mechanisms for iatrogenic symptoms in therapy by discussing the processes by which clients may be socialized into therapy and the potential impact that psychiatric labels and language may have in influencing clients' self-perceptions.

How would we know if psychotherapy were harmful?

The ways in which treatment (or the inferences about treatment) can do harm are defined and factors that complicate efforts to detect harm are discussed, and methods to detect and understand harm when it occurs are recommended.

Psychotherapy works

Psychological therapies are effective in helping people: outcome studies (e.g. Shapiro & Shapiro, 1982; Hurlbert et al., 1993; Johnson et al., 1999) provide information on successful treatments and,

Placebo insight: the rationality of insight-oriented psychotherapy.

  • D. Jopling
  • Psychology
    Journal of clinical psychology
  • 2001
Because clients face significant epistemic pressures in the therapeutic encounter, the insight-oriented psychotherapies are highly susceptible to generating placebo insights, that is, illusions, deceptions, and adaptive self-misunderstandings that convincingly mimic veridical insight but have no genuine explanatory power.

A Conceptual and Methodological Analysis of the Nonspecifics Argument

In support of the inference that psychotherapies produce their benefit by nonspecific means, researchers cite two sets of empirical findings: (a) null results from comparative outcome studies of

The empirical status of empirically supported psychotherapies: assumptions, findings, and reporting in controlled clinical trials.

A critical review of the assumptions and findings of studies used to establish psychotherapies as empirically supported suggests a shift from validating treatment packages to testing intervention strategies and theories of change that clinicians can integrate into empirically informed therapies.

Expertise in psychotherapy: an elusive goal?

A model of outcome information usage and specific a priori hypothesis testing is proposed as a means of developing expertise for therapists' lack of access to quality outcome information regarding their interventions and an overreliance on fallible information-processing strategies even when such outcome information is available.

How psychiatrists think

Over the past decade, the study of error in medicine has expanded to incorporate new insights from cognitive psychology, generating increased research and clinical interest in cognitive errors and