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|Clinicians Digest Jan/Feb 2007 - Page 2|
The Most Discredited Therapies
With the increasing focus on evidence-based therapies, psychologist John Norcross decided it would be worthwhile to identify some of the most discredited therapies. Along with current American Psychological Association President Gerald Koocher and doctoral student Ariele Garofalo, he combed the literature and asked hundreds of mental health professionals to nominate what they considered "discredited treatments and tests that have been used professionally within the last 100 years for mental health purposes."
After the list was compiled, a panel of 101 researchers, journal editors, and therapists were asked to rate each method on a 5-point scale from "not at all discredited" to "certainly discredited" (raters could also choose "not familiar with"). Using the Delphi survey method, which Norcross believes yields results with a strong consensus, his team then sent the panel members the results of the survey, minus those techniques that less than 25 percent of the members had rated, and asked them to rate them again. In the end, the expert panel rated 89 treatment and assessment methods.
Part of the list of discredited methods, presented in the October Professional Psychology: Research and Practice, reads like an amalgamation of medical horrors and New Age ideas: prefrontal lobotomies, crystals, and pyramids. Other treatments listed comprise an historical tour of psychotherapy: Freudian dream analysis, Jungian sand trays, past lives, future lives, primal scream, Erhard Seminar Training, Bettleheim's model for treating childhood autism, family therapy for schizophrenia based on the double-bind theory, marathon encounter groups, and holding therapy for attachment disorders.
More recent controversial treatments on the list that garnered highly discredited ratings were reparative therapy for homosexuality, rebirthing, and Thought Field Therapy. Other recent therapies, like EMDR for trauma, psychosocial therapies for AD/HD, thought-stopping for excessive rumination or worry, and laughter or humor therapy for depression, were deemed credible. Several older methods, including J.L. Moreno's psychodrama and Wilfred Bion's psychoanalytically oriented group analysis, also garnered respectable ratings.
Norcross stresses that a discredited ranking of any treatment should primarily be construed as a call for more research on it, not as a condemnation, that experts "can and have been wrong," and that therapists shouldn't be afraid to be innovative and trust their intuition. Nevertheless, he says, the study has generated considerable controversy, including protests from many psychotherapists who pointed out that they themselves have successfully used some of the most "discredited" treatments like the Luscher Color Test for personality assessment. "I don't know how to answer them," he says. "If something's helped them, I want to be respectful of their experience. At the same time, we know from research that placebos work about a third of the time."