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Long but interesting and informative article about what is science

Discussion in 'General ME/CFS Discussion' started by Snowdrop, Nov 12, 2014.

  1. Snowdrop

    Snowdrop Rebel without a biscuit

    I was not able to read the whole thing in one go but I have read sections and scanned the rest.

    There is a section on CBT for anyone interested. I've quoted it below but the rest of the article looks well worth reading.

    Cognitive-Behavioral Therapy

    Cognitive-behavioral therapy (CBT) has a wide following, and there are many apparently bulletproof studies that seem to show its efficacy. But there are an equal number of studies that seem to validate other kinds of therapy, and a recent meta-analysis reveals that all recognized therapies produce similar results, to the degree that there is no basis for preferring any particular therapy.

    A Consumer Reports study summarized in this abstract concludes "... no specific modality of psychotherapy did better than any other for any disorder; psychologists, psychiatrists, and social workers did not differ in their effectiveness as treaters; and all did better than marriage counselors and long-term family doctoring." The summarizing article's author comes to this conclusion: "the Consumer Reports survey complements the efficacy method, and that the best features of these two methods can be combined into a more ideal method that will best provide empirical validation of psychotherapy."

    But the above abstract and its conclusion fails to take into account the Placebo Effect, the well-established, genuinely therapeutic effect of ineffective treatments if presented in a way that a subject believes they represent meaningful treatment, and the Hawthorne Effect, in which subjects improve no matter what treatment is being offered, solely because a treatment is offered and the subject is getting attention. These disregarded factors, plus the absence of any meaningful experimental controls or control group, suggest that there is no scientific basis for the oft-heard claim that psychotherapy works. Again, as before, this is not to suggest that therapy doesn't work, only that there's no scientific basis for the claim.

    A scientific approach to validating psychological therapy would need to have rigid scientific controls, meaning a double-blind, prospective experimental design, a control group, and a willingness to publish the results no matter what they revealed. But it's obvious that this suggestion is hopelessly unrealistic — there are ethical issues involved in offering placebo therapies to unsuspecting subjects, and the double-blind criterion appears to present an insurmountable obstacle, because, for the control group, both therapists and subjects would need to be unaware that the control therapy was a sham. This is obviously unrealistic.

    What this means is that, even if psychological science were to improve greatly, these systematic problems would represent an impenetrable glass ceiling (that I labeled the "Munchkin Country line" in Figure 3) that, stated bluntly,would prevent a rigorous science of the mind.
    ahmo likes this.

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