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    It’s Smart to Be a Skeptic. Beware of Therapists Who Overpromise.

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    If you are contemplating starting therapy, beware of therapists who overpromise. It’s smart to be a skeptic.

    Skeptic: a person who questions the validity or authenticity of something purporting to be factual*.

    I’m sure I’m not alone in thinking that if I’m going to invest my time, energy or other resources into something, I want to know it’s the real deal. I think it’s smart to be a skeptic.

    Psychotherapy is an interesting field. Like everyone else, therapists have to make a living. Unlike many other professions though, what we have to offer is largely subjective and intangible. Members of my profession routinely talk about things like self-esteem, happiness, harmony, resolution, satisfaction, etc. We have to promote ourselves and our skills. And we have to be able to tell people what they can expect if they give us their valuable time and money. There are many therapists in practice in big cities like San Diego and it’s a challenge to stand out from the crowd.

    It is tempting for the therapist to overpromise.

    Most of us in the therapeutic community work hard to uphold the highest possible ethical standards. Reading through some local therapy websites it was clear most of my colleagues have done their best to accurately portray what they can provide to prospective clients. For every realistic and honest statement, however, there were as many skeptical claims:

    *Realize dreams in the future
    *Create a relationship that serves as a safe haven
    *Produces positive results for 86% of those who attend
    *Top Rated Marriage Counselors in San Diego, CA
    *Providing simple things…to improve the relationship
    *Overcome negative thinking
    *Highest level of self-fulfillment
    *We replace negative feelings and self-limiting behaviors with a positive self-image, healthy coping skills, and a high level of personal satisfaction

    I have spent many years studying the science of human behavior and methods for creating change in feeling and behavior and I am convinced that all of the above claims are unrealistic and unsupportable.

    Sometimes the therapist is not deliberately trying to overpromise his or her clients. The problem is that he or she has been trained in a method of therapy that has been over-sold by its creators. As an example, the above quote about an 86% positive result was based on an exit survey given to attendees of a workshop conducted by a famous marriage researcher and therapist. An enjoyable experience at a workshop is unlikely to translate into long term change. When therapists invest hours and hours and hundreds or thousands of dollars into learning the methods developed by such a prominent person they too may forget to maintain a healthy level of skepticism.

    A common and reasonable question I am often asked is: What is your success rate? There are practitioners who will provide the answer to that question based on figures provided by the proponents of the therapy they practice. The reality is that those figures-very impressive-are determined after research subjects have been carefully culled to provide the ideal client for the research. What is termed “success” is also based on a very narrow definition that may or may not apply to the needs of the inquiring client.

    Some questions that may be useful for the skeptical consumer include:

    *What is the rationale for the way the therapist conducts therapy? Can the therapist explain the thinking behind his/her methods? Does that make sense to you?
    *Does what is being promised sound too good to be true? Most of us have at some point been lured by false promises of easy and dramatic results. Is this likely to be more exaggerated claims and false promises?
    *Is the therapist overly confident that his or her method will solve your problem? Research just doesn’t support claims that one approach is head and shoulders above all others.
    *How much effort do you want to put into therapy? If you are hoping the therapist will work some magic on you, lower your expectations!
    *Are you willing to experience some discomfort for positive change? Most therapists will tell you that change can be uncomfortable.
    *Are you willing to take responsibility for your situation? If not, go with the guru! Otherwise, put on your skeptic’s hat, roll up your sleeves, and get ready to work and learn. It’s very possible that with some realistic time and effort on your part you can experience some substantial benefits in your life and the lives of your loved ones.
    References:

    http://dictionary.reference.com/browse/skeptic
    Abraham, L. (2010) Can you Really Predict the Success of a Marriage in 15 Minutes? http://www.slate.com/articles/double_x/doublex/2010/03/can_you_really_predict_the_success_of_a_marriage_in_15_minutes.2.html
    Coyne, J. (2014). Salvaging Psychotherapy Research: A Manifesto
    Coyne, J. (2014). Deconstructing misleading media coverage of neuroscience of couples therapy http://jcoynester.wordpress.com/2014/07/09/deconstructing-misleading-media-coverage-of-neuroscience-of-couples-therapy/
    Coyne, J. (2014) Neurobalm: the pseudo-neuroscience of couples therapy http://blogs.plos.org/mindthebrain/2014/07/08/neurobalm-pseudo-neuroscience-couples-therapy/
    Messer, S. (2002) Empirically Supported Treatments: Cautionary Notes. Medscape General Medicine, 2002;4(4) www.Medscape.com
    Mullen, E.J., Streiner, D.L. (2004) The Evidence For and Against Evidence-Based Practice. Brief Treatment and Crisis Intervention Vol. 4, No 2. DOI: 10.1093/brief-treatment/mhh009
    Parker, G., Fletcher, K. (2007). Treating Depression With the Evidence-Based Psychotherapies: A Critique of the Evidence. Acta Psychiatrica Scandinavica, 115: 352-359. DOI: 10.1111/j.1600-0447.2007.01007.x
    Runkel, P. (2011) Understanding Overfit in Statistics: Those Skintight Jeans Fit Perfect When You Bought Them, But…http://blog.minitab.com/blog/statistics-and-quality-data-analysis/overfit-those-skintight-jeans-fit-perfect-when-you-bought-them-but
    Shedler, J. (2013). Bamboozled by Bad Science. Psychologically Minded, 49
    Shedler, J. (2006). Why the Scientist-Practitioner Schism Won’t Go Away. The General Psychologist, 41, No. 2

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