Imagine if there were no FDA requiring medical treatments to demonstrate safety and efficacy before being marketed to the public. It would be like the days of “snake oil salesmen” when marketers could claim just about anything they wanted without providing a single shred of evidence that their claims were true. Fortunately, those days of totally unregulated, wild-wild-west like medical practice are mostly over.
But, amazingly, they are still common in the mental health marketplace. This is because there is no agency like the FDA that regulates psychotherapeutic practice or therapeutic procedures. Hence, as long as therapists don’t commit blatant crimes that Licensing Boards would frown on, just about anything goes in the still mostly untamed frontier of psychological therapy.
Thus, even when there is clear-cut scientific evidence that specific procedures work to solve particular problems or treat certain conditions, many therapists still won’t utilize them and insist on subjecting their clients to useless (and sometimes emotionally damaging) “psycho-archeological excavations” through psychoanalytic or psychodynamic therapy, instead of implementing the proven methods of cognitive behavior therapy (CBT).
Despite compelling evidence that insight alone will not help most phobias, OCD, bipolar disorders, panic attacks, and chronic pain (to name only a few), many therapists still choose to simply ignore the data and rely on methods that “feel” right, or make intuitive sense, despite the absence of supporting scientific findings. The result is that the science of psychology and methods of clinical practice often fail to connect and consumers are often not helped or even made to feel worse.
Of course, the practice of therapy is as much an art as a science and there is plenty of room for creativity and innovation. But, again, when clinicians rely almost exclusively on artistry or intuition, and ignore the scientific side of the equation, the best interests of consumers are rarely served.
Fortunately, some new developments are pushing mental health science and practice closer together. One such factor is an emphasis on accountability since more and more studies are pointing out empirically valid treatments for specific disorders. In addition, although it has many drawbacks, managed health care seems likely to promote science-based practice because managed care organizations are disinclined to reimburse practitioners who use unproven methods.
Perhaps an even greater force helping to narrow the gap between science and practice is the increasing knowledge of consumers and consumer-driven organizations like the OCD Foundation, the Anxiety Disorders Association of America, the National Mental Health Association, the National Alliance on Mental Illness, and others. It may be relatively easy for lazy or unsophisticated clinicians to neglect scientific findings and work around managed care, but when four out of five new clients specifically request evidence-based and empirically supported treatment like CBT, practitioners will have to face the facts and stop ignoring the data.
The bottom line?
Don’t hesitate to ask your therapist for solid, scientific evidence that a suggested procedure is appropriate in meeting your needs.
Remember: Think well, act well, feel well, be well!
Copyright by Clifford N. Lazarus, Ph.D.