Potentially harmful therapies: A meta-scientific review of evidential value, 2021, Williams et al.

Discussion in 'Other research methodology topics' started by Sly Saint, Sep 18, 2021.

  1. Sly Saint

    Sly Saint Senior Member (Voting Rights)

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    paper here:
    https://psycnet.apa.org/record/2021-45656-003
    Potentially harmful therapies: A meta-scientific review of evidential value.

    Abstract

    Lilienfeld (2007, Psychological treatments that cause harm. Perspectives on Psychological Science, 2, 53) identified a list of potentially harmful therapies (PHTs).

    Given concerns regarding the replicability of scientific findings, we conducted a meta-scientific review of Lilienfeld's PHTs to determine the evidential strength for harm. We evaluated the extent to which effects used as evidence of harm were as follows: (a) (in)correctly reported; (b) well-powered; (c) statistically significant at an inflated rate given their power; and (d) stronger compared with null effects of ineffectiveness or evidence of benefit, based on a Bayesian index of evidence.

    We found evidence of harm from some PHTs, though most metrics were ambiguous. To enhance provision of ethical and science-based care, a comprehensive reexamination of what constitutes evidence for claims of harm is necessary. (PsycInfo Database Record (c) 2022 APA, all rights reserved)
    ____________

    Article: Some Psychological Interventions Are More Harmful Than Helpful

    https://www.scientificamerican.com/...e-harmful-than-helpful/?WT.mc_id=SA_syn_RDFRS
     
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  2. cassava7

    cassava7 Senior Member (Voting Rights)

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    It is promising to see some research into the harms of psychological therapies. Hopefully this lead can be followed by other research groups, although for interested researchers in the field of clinical psychology, there may be reticence to do so stemming from a fear of retaliation.

    An evident limitation of any systematic review of harms, including this one, is that it is bound to suffer from the poor reporting of harms in randomized controlled trials. The true and full extent of the problem is likely underestimated, as harms that have been reported in the literature may have been downplayed, while no or too little evidence is available for some treatments. Of course, beyond psychological therapies, this is also true of drugs and medical devices.

    The following paragraph of the Scientific American article translates directly to ME/CFS. Only the therapy DARE needs to be replaced with GET/CBT, and "student learning" with "patients' health":

    Unfortunately, both of these treatments are often touted by their developers, podcasts and TV shows. Drug abuse resistance education (DARE) is similarly well-promoted. A program that most millennials and Gen Zers were or have been exposed to, DARE involves a uniformed police officer teaching students about the perils of drug use and drinking. We found the credibility of the DARE literature to be so-so, and its effects suggest it doesn’t do much of anything at all. DARE has had an operating budget in the millions and been deployed across the world. Resources devoted to it could have been spent on programs that actually benefited student learning and well-being. ​
     
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  3. ME/CFS Skeptic

    ME/CFS Skeptic Senior Member (Voting Rights)

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    These are the six interventions they looked at:
    upload_2021-9-19_11-41-41.png

    They mostly looked at evidence from RCT's to see if outcomes favored the control instead of the intervention group.
    @Caroline Struthers
     
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  4. Caroline Struthers

    Caroline Struthers Senior Member (Voting Rights)

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    Yes it is. But I think there should be more research into whether the therapies work or not. If they don't work (or make a transient and non-significant positive difference), this is also harmful. A waste of time and resources, even if the individual patients are not significantly physically or mentally worse off (apart from disappointment in the treatment not working)
     
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  5. Invisible Woman

    Invisible Woman Senior Member (Voting Rights)

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    One of the biggest bugbears forme about some therapies is that there is an assumption that the individual may not be coping in the best way possible for them. This may be true sometimes but not always.

    If there is an intrinsic part of the therapy that undermines the person's faith in their own judgement and coping strategies and the therapy doesn't replace those strategies with something better then the patient may be left without an effective coping strategy at all. Their faith in themselves and in therapy undermined, leaving them nowhere to turn.

    Though it might seem subtle this can have a very powerful effect. I think most of us have experienced a period of minor remission amd started to think well maybe I could do....was I really that sick? Only to find, no you can't do that and get away with it and if you try you will be that ill & worse for a prolonged period of time.

    Even those of us just exposed second hand to the ideas espoused in treatment for ME, let alone those who have been through it.
     
  6. Ash

    Ash Senior Member (Voting Rights)

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