Study on the effects of bad therapy

You know, BudFox, you are funny. First of all, I have NEVER, not once, made light of someone being abused by a therapist. Second, I said that people who aren't ready to do the work might not make any progress in therapy! I wasn't even saying that in relation to therapy causing harm, so once again you twist my words and make me sound like I'm some sort of insensitive twat. I really don't appreciate it. In fact, it upsets me.

You had a terrible experience with an unethical therapist, and I am truly sorry about that. The fact that this sort of thing happens really pains me. But I don't see how this experience makes you some sort of authority when it comes to the profession as a whole. You're angry, and I get it; you have every right to be! But attacking therapists in general? Not fair. Not okay. I'm sorry, but it really isn't. In fact, the definition of discrimination is: "the act, practice, or an instance of discriminating categorically rather than individually; prejudiced or prejudicial outlook, action, or treatment". I find discrimination of any kind to be unacceptable.

I don't see how you are being reasonable in any way with your responses. You twist my words and call me aggressive because I disagree with you. I have never seen you provide us with any credible sources to back up your statement that therapy is mostly harmful, and yet you mock me for not being able to prove that therapy is mostly helpful. That's pretty laughable, actually. I happen to have two really good therapists. You had a really terrible one. Unfortunately, that's just how life goes sometimes. It's not fair. It's not right. It just is.

I think you are confusing me with someone else. With my last main T, she insisted on termination and I reluctantly agreed. A bit later I tried to re-engage her in order to deal with very serious sht that had come up and to attempt some repair. She refused. Then threw me under the bus to save herself. As for her other clients, I can make some guesses, having seen her true colors. She seems to be a good person, but as a therapist she has no business tinkering with any serious wounds.

I'm not out to attack her or any particular T. I am interested in the system and in particular how it treats its casualties. The article/study linked by the OP showed me little or nothing of value as one who has been thru harmful therapy. However, i think the study has yet to be completed and so that's partly why there is no real data available. Did anyone else conclude that?

I do think it hasn't been completed. I couldn't find any other information on it or the questions or conclusions. The article in the OP says May of 2014. I guess it takes a long time to finish these things up.

I do think the system of therapy/psychotherapy/counseling is very flawed.

Maybe the people who believe they benefit from it would have naturally gotten better anyway? If people who got worse might have gotten worse anyway then it could go the other way I guess.

I used to be a big therapy supporter. I don't necessarily believe therapists are evil. I think many might mean well, but so many people report being harmed that I think those people need to be validated and not belittled and put down.

I never said therapy is mostly harmful. I just question the assumption that it is mostly helpful. It seems these two things are often conflated.

I think the biz is much too powerful and avoids scrutiny of its methods and outcomes, and I just don't accept any assumptions about it anymore, having been harmed by it. Burden of proof is on the biz and those who advocate for it.

BTW I didnt just have one terrible T. I've worked with a handful of others for at least a couple months, and consulted with or tried many more. In all 20+. Most were in the gray area of benign/inconsequential. None were helpful in any meaningful way, though most were nice enough people who wanted to help. I don't relish saying that. It just is.

I agree.

I agree with this also. This is, in my view, the number one reason why the system remains as flawed as it is.

I was glad to see that the study mentioned in the OP was at least starting to look at the question of adverse effects and safety in therapy. Again, to me, the question is not just whether I was doing more poorly after therapy than before. I think there needs to be a large survey of people who have been in therapy which asks the specific question: "Do you feel you have been harmed by the therapy? If so, please tell us, from your perspective, what happened and how it hurt you?"

Most clients may very well say no, they were not harmed. But for those of us who have been -- seems to me that we are a potential gold mine of good information, if anybody was interested.

This is, to me, just so obvious I can't believe that the profession remains so blind. Maybe, of course, here in the U.S. there is just no person or institution whose "job" it is to do it. Eventually, though . . . it is just too obvious, somebody will wake up or get the energy or something. . .

I hope.

The reason, I believe, that the industry is not doing much if anything about it is that they have set it up to blame the client no matter what save for sexual exploitation. And even there they blame the client some in a lot of the literature.

Yes, maybe. But did they deliberately set out to set it up that way or was it just the unexamined self-protective, authoritarian way it developed in the absence of planning and openness to feedback?

Thank you Little Cat, I'm very interested in reading and understanding the study. I hope to read all of soon. It looks like they combed and studied the academic literature globally,that was already out there:

"The second aspect of the work package is looking at psychotherapy service users' self-reported experiences of the adverse effects of psychotherapy, outside of qualitative research studies. Here we are looking at discussion boards, blogs, articles, reports, and book chapters for the data. As for the first part of the work package the data is being synthesised and a model developed using Task Analysis."

I do believe we are being heard those that have been affected by less than adequate therapy/therapist, maybe even us as we use these different forums:

"Once the work package is complete we will have a better understanding of the therapy events that lead up to adverse effects, the types of adverse effects that occur and how they are experienced and expressed by psychotherapy service users."

If you would like more information about the study or to discuss anything further, please contact The Research Team in the first instance:

adept@sheffield.ac.uk

Maybe they would be interested in hearing from us.

I looked at the material thoroughly and those quotes were from a description of the study as it was being done. The finished product was the report linked in the OP. And it appears to me that we are NOT being heard. Maybe the kinds of harm that we experience in the U.S. are not happening in the U.K. I don't know.

The fact is that people in weakened psychological condition going into therapy simply do not have the perception and decision making abilities that are expected of normal citizens. That's why some of us are there. And I, for one, put myself in a position to be shamed and blamed in therapy that I NEVER did in real life. The study defines harm as "Therapy is the main cause of significant personal distress, suffering, or injury; where a significant deterioration in someone’s psychological condition is directly caused by the therapy."

The complete study linked in the OP says:

“Harm from psychological therapies is fortunately rare compared with the benefit, but we need to reduce the risk of harm. It is important to remember that just because someone has become worse over the course of the treatment it does not mean that the treatment harmed them.”

Looks like stopdog is correct, they are continuing, even after going through the motions of doing a study, to . . . I just don't really know how to describe it.

Here is something:
William Doherty: How Therapy Can be Hazardous to Your Marital Health

http://www.apa.org/monitor/2013/02/therapist.aspx

https://feelinggood.com/2013/10/03/t...re-to-measure/

http://www.amazon.com/What-Therapist...sts+talk+about

http://www.amazon.com/Bad-Therapy-Ma...apists+failure (I have read this book and much of it is spent congratulating each other for admitting they failed a client)

And for the true believers:
http://horan.asu.edu/cpy702readings/.../seligman.html

The original study is complete but publishing in peer reviewed journals takes time, so I suppose that could be why there's not much out there yet. There is this though BPS Research Digest: How often does psychotherapy make people feel worse?.
I think another reason for some of the differences between the US and UK is that fewer people here can either access or use therapy as a form of treatment. We don't pay for our healthcare, so provision tends to vary based on where you live or the acuity of your problems. Thanks for the links SD, very interesting reading.

Apologies for posting twice in a row, but I thought you might also like to know how we appraise evidence in the UK. It's using this hierarchy The hierarchy of research evidence - from well conducted meta-analysis down to small case series, publication bias | Health Knowledge. Helps me judge how much credence to give something I read.

I specifically want to look at scholarly publications they might have done or will done.

ETA: At some point I plan to contact them.

Many thanks, Little Cat. From the article you linked to, it looks like there's a lot more to the study, and I looked more closely at the website they developed for clients, too. Very interesting.

I dunno, measuring therapy outcomes seems like such a sketchy proposition. What questions do you ask and how precisely are they framed? What exactly is being measured and how do you factor in all the confounding variables that impact a person's life and mental-emotional state?

And if you add in publication bias, it gets sketchier still. In mainstream medicine suppression of negative outcomes seems to have become endemic, to the point where nothing can be trusted.

For me previously, I was unconsciously compliant in the presence of authority and would likely have resisted criticism of my therapists. I would have played along if encouraged in any way to report that therapy was helpful. And if currently in therapy, with the financial and emotional investment required, one is likely going to want to believe it is helping, and to say otherwise might be a cognitive dissonance thing. So there is a timing variable too -- do you ask during therapy, at the completion of therapy, some time later, multiple times?

Yes -- and for people who have not been harmed in therapy it may be hard for them to understand. I do understand and very much appreciate your eloquence. Your example in speaking out helps me and may help others. It's very hard for me, and perhaps others, to articulate the ways therapy hurt me. I say "therapy" even though it was individual therapists who hurt me because I believe that the therapists' ignorance, including ignorance of the types of harm they could cause, has been a systemic flaw not necessarily personal ones on the part of the therapists. Eventually, people of good will may be able to understand. That continues to be my hope.

I'm not confusing you with someone else. The "you" in this case was a general one, not aimed at you specifically. I was just giving a general example to show that we can't really know what work a therapist we didn't personally gel with is doing with other clients. I know your criticisms are of the system as a whole, and that is what I am objecting to because it just sounds unreasonable to me. Some people have bad experiences, but that doesn't mean that the profession itself is fundamentally harmful.

CBT is supposed to help with dichotomous thinking.

I understand the need for the informed consent on what they specifically do and how harmful it could be, and that there's a fact that they may not gel with the client before the start of the first session. The profession try to sell YOU that they could treat YOU for the better, and that could leave a lasting harm. Bad therapy could fundamentally potentially harmful, therefore there's a need for something like medical warnings, but who checks that?

It won't harm anyone to just check and study the system's potential flaws.

Thanks for this great thread.

You can't know whether or not you'll gel with someone until you've interacted with them. That is one of the problems of therapy; you have to actually see a therapist in order to decide if they are someone you can get along with and benefit from. The outcome of therapy cannot be predicted, I think we all agree on that. However, if you don't personally gel with a therapist there is a fairly easy solution to that: stop seeing that therapist, and look for someone else. Both of my therapists said in the very first session that it was important to determine whether we were a good match or not, but I suppose I can't know if that is something all therapists point out during the first session. I would like to think that they do, but I am sure many of them don't, which is unfortunate.

Informed consent is a different matter. I am inclined to agree that therapists should point out the aims of therapy and how they will work with the client in order to achieve them. The client should understand what they are entering into before they decide to move forward with it. This was certainly made clear to me by both of the therapists I am currently working with, but again, it is obvious from the stories I have read on this forum that this is not something all therapists do. And that is regrettable.

None of the many therapists I interviewed (over 30 appointments) before sticking with the two least awful, brought up gelling with them or warned about harm or explained how therapy was supposed to be useful and how to know if it was not. In my experience, it is not usual.

I'm the result of bad therapy. There ya go......see what it's done to me?

Strange thing is, people are still worshipping my bad T. Go figure..

That is unfortunate, SD. Maybe there is a difference between therapist training/practice in the US and in the UK? I don't know, but I have wondered on occasion.

I am not in peril. I did not go in blindly or unarmed.

I know. I am just saying that, in general, it is unfortunate that these therapists don't inform their clients before starting such an intense process with them. That is a problem.

This to me is the crux of the issue. What exactly is being measured? How do they define "harm" or "benefit"? How big was the research sample? Who was in it (demographics)? Who was in the control group? What were the original problems people brought to therapy? What therapy methods were used? How long was the course of therapy?..The list goes on and on..

I know that these specifics are supposed to be published in the peer-reviewed publication, so I'd like to wait for it to come because I'd like to see the actual findings presented in the concrete context of data. Before that happens, this general information doesn't mean anything to me because no basis for it is shown. But I still appreciate that something is being done in that area.

Now here is a short video about how much fraud there is in psychological studies and why