December 2

Why Psychoterapies Never Get Better

Times reporter, Ben Carey, reported in all seriousness : " In a recent study using [Angelina] this virtual confidant, researchers at U.S.C. have found that  Angelina  elicits from people the crucial first element in any therapy: self-disclosure. People with social anxiety confessed more of their personal flaws, fears and fantasies to virtual figures than to live therapists conducting video interviews, the study found." 

Furthermore, " The researchers are incorporating the techniques learned from Angelina into a virtual agent being developed for the Army, called SimCoach."

According to the Times the U.S. Army is spending $4 million annually on research into cybertherapy to treat traumatized veterans. This, after spending who knows how many millions 

So what is the evidence that cybertherapy works? Well, the Times reports, it’s about as effective as conventional talk therapy. 

There are nearly 300,000 American psychotherapists who provide some 450 forms of talk therapy. However, as award winning science journalist, John Horgan, points out in an insightful article in Scientific American , there is absolutely no science to back up the effectiveness of psychotherapy–either Jungian, cognitive behaviorist, witch doctor, or cybertherapist who exists only in a computer.

 Horgan likens the claimed efficacy  to  "the so-called Dodo effect"– as in Alice’s Adventures in Wonderland, where everyone wins. What actually matters is whether one believes in the therapy–in other words, psychotherapy works the way the placebo effect "works. "  Both depend on trust in the "healer" and faith in the effectiveness of the therapy. 

"Over the last few decades, the psychologist Lester Luborsky of the University of Pennsylvania tested the Dodo effect by comparing different psychotherapies, including psychoanalysis, cognitive-behavioral therapy and interpersonal therapy. His research confirmed that all methods are equally helpful to patients. Claims that one therapy is more effective than others, Luborsky showed, can usually be explained by the "allegiance effect," the tendency of researchers to find evidence for the therapy that they practice or favor."

Another astute psychologist whom Horgan cites is Saul Rosenzweig who, in the 1930s speculated that all talking cures share certain common human factors which are usually helpful, depending upon whether a caring therapist establishes a bond with the patient.

And more recently, Dr. Jerome Frank, a psychiatrist at Johns Hopkins, noted that the Dodo effect undermined the validity of all psychotherapies. Patients responded equally to all modes of psychotherapy. This lead Dr. Frank to conclude that "relief of anxiety and depression in psychiatric outpatients by psychotherapy closely resembles the placebo response, suggesting that the same factors may be involved." The specific theoretical framework within which therapists work has little or nothing to do with their ability to "heal" patients.

Sad to say, there is NO scientific evidence to support any clinical practices in mental health–a psychotherapy’s success or failure depends on whether an individual human therapist establishes the caring relationship with an individual patient.

* John Horgan is an award winning, highly respected science journalist,  the author of  The End of Science and The Undiscovered Mind: How the Human Brain Defies Replication, Medication and Explanation, in which he examines in depth, the various efforts to explain, treat or replicate how the mind works–all resulting in failure.   

See also, review of Horgan’s book by Nathaniel Leherman, MD. 

  

Contact: Vera Hassner Sharav


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