Regulatory requirements for psychological interventions, 2020, Purgato et al

[Sly Saint]

In health-care settings, psychological interventions are commonly used to treat a wide range of mental health conditions, ranging from mild reactions to stressors, to severe mental and physical health conditions. There are estimated to be more than 1000 different psychological approaches (some being minor variations of the others) based on a range of psychological concepts and theories of change.1

In most cases of developing a new psychological intervention,
a manual is generated and disseminated that reports information about the psychological techniques used, the number and duration of sessions, and the specific content of those sessions.2 Often studies are done to assess a new intervention’s beneficial and harmful effects, the cost-effectiveness of its uptake in different settings, and its core effective elements.3 However, for new psychological interventions, the pathway from development to assessment and dissemination for use in practice does not follow any commonly accepted criteria.

There are no specific standards about the type and quantity of evidence required before a new psychological intervention is made available for everyday use. For pharmacological interventions, market release of new medications is regulated by formal rules and methodological requirements developed by national and international regulatory agencies.4 Not only are there well defined criteria for establishing efficacy and assessing tolerability and side-effects of new medications, but also marketing authorisation is granted for restricted use, outlining that a positive benefit–harm balance has been established for a specific clinical condition only.5 An absence of regulatory requirements for new psychological interventions might have several negative consequences.

First, newly developed psychological interventions
might be disseminated in the absence of evidence about their efficacy and tolerability. Harmful consequences might include: worsening of symptomatology; negative
changes in family, occupation, or general adjustment in life; or adverse effects.6
Second, psychological interventions supported by evidence of efficacy for a specific clinical condition, context, or population group, might be used in other conditions and contexts, for which evidence of efficacy and tolerability has not been established. Third, treatment manuals might not be disseminated or accessible, and psychological
interventions might therefore not be properly implemented in practice.3
Scientific societies and international or national public health organisations should join efforts to develop specific standards about the type and quantity of evidence required before a new psychological intervention, its treatment manual, and related implementation tools, are made available for everyday use in clinical practice.

https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30414-4/fulltext

sci-hub.se/10.1016/S2215-0366(20)30414-4

("develop specific standards about the type and quantity of evidence required" imo quality needs to be in there; eg getting non-psych hps to review the evidence)

 

[Jonathan Edwards]

The mistake here is to think that somehow regulatory criteria tell you if evidence is adequate.

Regulatory criteria about the evidence required before a new psychological intervention is released for everyday use in practice would, if followed, have beneficial consequences for clinical practice, research, and policy. Clinicians would know which interventions had evidence-based efficacy for treating specific conditions, and have a valuable tool for differentiating between interventions with or without evidence.

Regulatory criteria are a t best a very blunt tool for assessing if evidence is adequate. A much easier method is to look at the evidence and see if it is adequate. Note that if you cannot do that without criteria you would not be able to generate any criteria because you would not know what to base them on.

Assessing evidence is a matter of establishing whether as a matter of fact the evidence is adequate. Reliability is an issue of fact, not opinion or arbitrary criteria. We can see that the evidence for psychological therapies is no good. Enough said.

 

[rvallee]

There are no specific standards about the type and quantity of evidence required before a new psychological intervention is made available for everyday use

Yes we are well aware of that and have been complaining about it for decades but are always told this is not the case so it's really weird to see this here. There are zero standards, no oversight, no accountability, no reliable way to assess anything. It's a complete free-for-all disaster, the whole system is FUBAR.

First, newly developed psychological interventions might be disseminated in the absence of evidence about their efficacy and tolerability

Not just the new, all the old ones as well. All of them. Literally all of it has been disseminated this way, with the build it and they will come approach. Except we never come, or walk away quickly, and they keep building it anyway.

And yet whenever people complain about specific examples the premise is rejected as absurd, dismissed with prejudice for being invalid, that this is not something that can be complained about. Get your affairs in order, people, they are in a state of complete disarray.

Oh, and ask your fellows in economics about opportunity cost, please and thank you. And about the law of diminishing returns. Hell, about anything related to economics frankly, economics may have issues but it is 100x more grounded in science than clinical psychology. Even a basic understanding of supply and demand would go a long way to explain why people reject the MUS/BPS/FND delusional fantasies and why you have to coerce and manipulate people in ways that mock the idea of informed consent, or even basic consent.

To do science you need to be able to measure. Work on the damn basics first, then you may do something useful for once. That mathemagics are a requirement is a big tell that you're not "measuring" what you think you are.