Why Ineffective Psychotherapies Appear to Work, 2014, Lilienfeld et al.

[Chandelier]

Why Ineffective Psychotherapies Appear to Work

Spoiler: Authors

Lilienfeld, Scott O.; Ritschel, Lorie A.; Lynn, Steven Jay; Cautin, Robin L.; Latzman, Robert D.

Abstract
The past 40 years have generated numerous insights regarding errors in human reasoning.
Arguably, clinical practice is the domain of applied psychology in which acknowledging and mitigating these errors is most crucial.
We address one such set of errors here, namely, the tendency of some psychologists and other mental health professionals to assume that they can rely on informal clinical observations to infer whether treatments are effective.
We delineate four broad, underlying cognitive impediments to accurately evaluating improvement in psychotherapy—naive realism, confirmation bias, illusory causation, and the illusion of control.
We then describe 26 causes of spurious therapeutic effectiveness (CSTEs), organized into a taxonomy of three overarching categories: (a) the perception of client change in its actual absence, (b) misinterpretations of actual client change stemming from extratherapeutic factors, and (c) misinterpretations of actual client change stemming from nonspecific treatment factors.
These inferential errors can lead clinicians, clients, and researchers to misperceive useless or even harmful psychotherapies as effective.
We (a) examine how methodological safeguards help to control for different CSTEs, (b) delineate fruitful directions for research on CSTEs, and (c) consider the implications of CSTEs for everyday clinical practice.
An enhanced appreciation of the inferential problems posed by CSTEs may narrow the science–practice gap and foster a heightened appreciation of the need for the methodological safeguards afforded by evidence-based practice.

Web (Paywall) | DOI | PDF | Perspectives on Psychological Science

 

[Chandelier]

Also mentioned in the current WIRED thread and in this old gem:

Thread 'Reasons to be sceptical of that shiny new study: A bibliography'

Oct 23, 2017

Articles that highlight the problems/limitations of clinical trials in general (**=key article)

Placebo effects are weak: regression to the mean is the main reason ineffective treatments appear to work.
Colquhoun, D. (blog) 2015
link to blog

Placebo Myths debunked.
Novella, S. (blog) 2017
In this article, Novella explains that the placebo effect isn’t one thing, but rather a collection of spurious effects than can affect trial outcomes. These include: a) regression to the mean (people often enrol in studies at their worst, so there is...

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[rvallee]

Arguably, clinical practice is the domain of applied psychology in which acknowledging and mitigating these errors is most crucial.

Uh. Wow, that's really embarrassing, then. Because in reality it's almost a system designed to over-commit on all the mistakes it makes, categorically refusing to even admit to mistakes. It's even worse than in most business standards, it's at grand-failson of a failson owner of the company who will be CEO regardless of whether it drives the company into the ground. Oh, there's a lot of false self-deprecation that feigns to acknowledge those, but nothing ever actually changes. Which is so much worse, since everyone kind of understands that most of this is fake, but play along anyway.

But the simple answer requires a different question, because they don't actually appear to work, it's that it ultimately makes no difference whether something works or not here, no one can even tell the difference, and there is pervasive, systemic bias towards pretending that it all works out in the end. It "appears to work" because experts claim that it does. Because they want the thing they developed and wrote down to be real and effective, and the tools simply don't exist to reliably do that. Those tools are so easy to manipulate, and simply get ignored whenever they give out an answer they don't want.

Those therapies don't "appear to work" any more than supplements stacks did in the treatment of Long Covid, when it was a huge thing for over a year. Not any more than there used to be credible, scientific evidence of the Moon being made of cheese. Just because it's an entire expert profession doesn't change that you can't actually fake it until you make it. All that happens when you fake it is that you end up producing a lot of fake stuff. And people love buying fake stuff in some situations, very few more than in this one.

The emperor? Butt naked. Always has been. Always will be, as long as there is an emperor. The king is dead. Love live the emperor.