Esther12
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Open access: http://users.ipfw.edu/young/350-Abnormal/assignments/Psych-treatments-that-cause-harm.pdf
I only had a browse of this, and decided it was one of the many interesting papers I was going to have to put to one side, but thought that it could be of interest to someone else here (feel free to summarise for us!) so am posting it up.
Psychological Treatments That
Cause Harm
Scott O. Lilienfeld
Emory University
ABSTRACT—
The phrase primum non nocere (‘‘first, do no
harm’’) is a well-accepted credo of the medical and mental
health professions. Although emerging data indicate that
several psychological treatments may produce harm in
significant numbers of individuals, psychologists have
until recently paid little attention to the problem of haz-
ardous treatments. I critically evaluate and update earlier
conclusions regarding deterioration effects in psycho-
therapy, outline methodological obstacles standing in the
way of identifying potentially harmful therapies (PHTs),
provide a provisional list of PHTs, discuss the implications
of PHTs for clinical science and practice, and delineate
fruitful areas for further research on PHTs. A heightened
emphasis on PHTs should narrow the scientist–practi-
tioner gap and safeguard mental health consumers against
harm. Moreover, the literature on PHTs may provide in-
sight into underlying mechanisms of change that cut across
many domains of psychotherapy. The field of psychology
should prioritize its efforts toward identifying PHTs and
place greater emphasis on potentially dangerous than on
empirically supported therapies.
Some bits remind me of Dolphin 's comments comparing safety procedures for drugs and psychological treatments:
This state of relative neglect concerning harmful psycholog-
ical treatments contrasts sharply with the marked recent sci-
entific and media interest in the potential negative effects (e.g.,
suicidality) of psychotropic medications, particularly fluoxetine
(Prozac) and other selective serotonin reuptake inhibitors
(Sharp & Chapman, 2004). Psychology, of course, has no formal
equivalent of medicine’s Food and Drug Administration (FDA)
to conduct Phase I or Phase II trials, both of which help to
identify safety problems with novel treatments before they are
disseminated to the public. As a consequence, the systematic
monitoring of unsafe psychological interventions devolves
largely or entirely to the profession of psychology itself. I will
argue that because the field of psychology has been reluctant to
police itself (Meehl, 1993), the consequences for mental health
consumers and the profession at large have been problematic.
Because psychology lacks an FDA to ensure safety monitoring
and quality control of treatments, the profession at large must be
considerably more aggressive in self-policing and in confronting
the hazards posed by PHTs. In the recent past, the principal
impetus for constraining the use of some PHTs, particularly
recovered-memory techniques and DID-oriented therapy, has
come not from within the psychological profession but rather
from outside of it, in the form of widely publicized lawsuits
against practitioners (Lynn et al., 2003). Therefore, major pro-
fessional organizations in psychology should play a more active
role in educating clinicians regarding the hazards posed by
PHTs. Regrettably, training in some PHTs, including CISD and
rebirthing, has been eligible for continuing-education credit
from APA (Wood, Garb, Lilienfeld, & Nezworski, 2002).
It didn't look killer interesting, or to be making really startling new points with references to data that was important, but I may have missed stuff, and I didn't work to understand anything with unfamiliar terminology. Overall, it seemed pretty complacent, considering the topic, and the recognition of the importance of 'do no harm' in medicine.