Lancet Psychiatry: Regulatory requirements for psychological interventions (Purgato, 2021)

Pretty ironic seeing one of Lancet’s subjournals publishing an editorial calling out the unregulated nature of psychological interventions.

https://doi.org/10.1016/S2215-0366(20)30414-4

 

Quite simply, a lot of the current problems in medicine could be avoided if psychological treatments had to meet the same standards as physical ones. In cases where it is not possible to have objective outcomes it must be acknowledged that this means the evidence is of lower quality so use of those treatments requires a formal system where harms can be noted.

 

Completely agree. Also, psychotherapy trials should be at least single-blind. There is no excuse not to at least blind the rater who scores outcome measures such as observer-rated depression scales.

Also, better control groups are possible. Instead of waitlist control or treatment as usual (aka 7 minute appointment with the GP), CBT trials should have a control group matched for duration and intensity of clinical contact (say, control group gets the same number of sessions with a counsellor who just listens supportively but doesn’t administer the cognitive behavioural mumbo jumbo secret sauce of CBT).

I bet you the effect of CBT would be shown to be zero with just these modest improvements in methodology.