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

[Sly Saint]

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)
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Article: Some Psychological Interventions Are More Harmful Than Helpful

We collected data from every randomized controlled trial (the sort of studies used in medicine to determine if a drug or vaccine works) for a PHT that we could find (more than 70); in total, we reviewed more than 500 statistical tests of PHTs. We then extracted and analyzed warning signs of low credibility from each study; you can therefore think of our paper as containing “credibility report cards” for each PHT.

What did we find? First, the good news: statistical typos were very rare in published research on PHTs. Moreover, the literature underpinning grief counseling—a specific PHT intended to help clients cope with the death of a loved one—looked supportive of its effectiveness and reasonably credible.

Our research suggests that being a provider or consumer of psychological interventions is tricky. Unlike the FDA for medications, medical devices and vaccines, there is no government body that judges psychological treatments as safe. Therefore, those involved need to not only consider the potential for a psychotherapy to help, but also to harm. Making these considerations even more difficult, providers and consumers need to be aware that published research on the helpfulness and harmfulness of psychological interventions is not always credible. We think that, moving forward, more consumers of psychological interventions need to feel comfortable asking providers what scientific evidence there is for a given intervention’s helpfulness and against its harmfulness.

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

 

[cassava7]

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.​

 

[ME/CFS Skeptic]

These are the six interventions they looked at:


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

 

[Caroline Struthers]

It is promising to see some research into the harms of psychological therapies

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)

 

[Invisible Woman]

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.

 

[Ash]

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.