Thread by @paytonjjones

The field of clinical psychology naturally provides a perfect little petri dish for pseudoscience. Why?

1) Common factors do the heavy lifting in psychotherapy, meaning almost any type of therapy will work at least decently well

2) Client expectancy matters a lot. So if you can convince clients you know what you're doing, you'll boost your effect! This rewards scientists & therapists who are overconfident and overstate their knowledge of how their psychotherapy model works

3) Therapist expectancy also boosts psychotherapy effects. Again, this rewards "true believers" & overconfidence in knowledge of how therapy works

4) Both client & therapist expectancy are boosted by the *novelty* of a therapy. This means that if an "old" therapy and a "new" therapy are equal in their mechanistic effectiveness, the "new" therapy will always appear to have a slightly bigger effect size when tested.

5) Lying, being overconfident, or getting false positive results about the effectiveness of a therapy model is rewarded in the scientific literature. "Allegiance effects" also boost the apparent effectiveness of therapies.

s3.amazonaws.com/academia.edu.d…

6) This entire process is easily monetized and can be extremely profitable. MLM-style marketing schemes are extremely common in the psychotherapy world, even for therapies that like to court the "evidence-based" crowd (e.g., behavioraltech.org/training/train…)

7) High-quality RCTs are very expensive, and there is no career or monetary benefit to doing an RCT that shows null results. There is also little incentive to examine long-term, longitudinal effects.

All this combined has resulted in the wide success of some truly absurd theories over the years:

-Animal magnetism en.wikipedia.org/wiki/Animal_ma…
-Rebirthing therapy en.wikipedia.org/wiki/Candace_N…
-Primal scream therapy en.wikipedia.org/wiki/Primal_th…

Not to mention that even the "better" therapy models are often chock-full of unsupported claims about mechanisms, arbitrary untested techniques and procedural implementation, rigid dogmas, and hero worship of the psychotherapy "founder".

Unfortunately, this pattern seems almost inevitable. I would be very (pleasantly) shocked if we don't see the same pattern of overhyped therapy models repeat itself dozens of times in the next 50 years.