“When people become sick, any promise of a cure is beguiling. Common sense and the demand for evidence are easily supplanted by false hope. In this vulnerable state, the need for critical appraisal of treatment options is more—rather than less—necessary.” —Dr. Barry Beyerstein
You shouldn’t need to shop for mental health care as if you’re purchasing an appliance, but that’s the dismal reality: Your mental health is for sale.
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In other words, if you or your loved ones are looking for care with respect to mental health, then you need to be prepared to navigate a market with at least 600 “brands” of psychotherapy—and counting. Many of these psychotherapies have not been subjected to rigorous scientific scrutiny, which means we don’t know for sure which ones are effective, ineffective, or harmful.
There also exist countless unregulated providers of mental health services in the $5.6 trillion USD wellness industry and alternative medicine community, many of whom are only looking to exploit people’s financial and emotional vulnerabilities. They may market themselves as “life coaches,” or “wellness consultants,” or—depending on particular countries and jurisdictions—other various non-legally protected titles, such as “counselors” or “practitioners.” The world of mental health care is very much caveat emptor: buyer beware.
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I’ve been a full-time practicing clinical psychologist for over a decade. During that time, I’ve seen so many patients hurt by pseudoscience circulating in the wellness industry. I’ve seen an explosion of mental health misinformation on social media and in popular culture. I’ve had enough of the harm. I even wrote a book, entitled Mind the Science: Saving Your Mental Health from the Wellness Industry, to expose and debunk that predatory pseudoscience, grift, and misinformation with a view toward providing real information to those who have been touched by mental illness, have been misled by false marketing, or are simply curious about the relationship between science and mental health.
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From the perspective of legitimate mental health professionals, providing evidence-based treatment for mental health concerns is an ethical imperative. The notion of evidence-based practice owes its history to a movement called evidence-based medicine (EBM), which became fully articulated in 1992. It means that clinicians need to engage in a delicate dance between three pillars:
The best available scientific evidence.
Their own clinical judgement and experience.
The preferences and values that patients bring.
The idea of evidence-based practice is now philosophically baked into the codes of ethics and legal standards of practice of bonafide mental health professions, such as psychology, psychiatry, social work, and nursing.
The irksome reality is that non-evidence-based and pseudoscientific treatments for mental health concerns are promoted widely and used within various healthcare systems and outside of them. It’s not uncommon for mental health professionals to regularly encounter patients who have received such treatments, which can include unequivocal pseudoscientific practices (e.g., naturopathy, energy medicine, neuro-linguistic programming, past life regression therapy, etc.) and controversial ones that are in some cases much more scientifically plausible but still plagued by low-quality or mixed evidence to support their use (e.g., cannabis, psychedelics, mindfulness, 12-step programs, animal-assisted therapies, etc.).
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While the demarcation between science and pseudoscience has always remained fuzzy, it’s in the service of safe, ethical, and competent patient care to critically appraise and identify potential pseudoscientific therapies for mental health concerns. There’s a reason that evidence-based practice is the foundation of our care models—and that’s because adopting an approach to care that elevates pseudoscience can be harmful in at least three ways:
It can directly produce harm.
It can indirectly take time and financial resources away from evidence-based services.
It can further erode the scientific foundations and trust of our profession.
The idea behind using science to guide psychological practice is not new. Clinical psychology adopted science as an explicit value as early as 1947 when the idea that psychologists should be trained as both scientists and practitioners became American Psychological Association (APA) policy. In 1949, the “scientist-practitioner model” (sometimes referred to as the “Boulder model”) was born at the Conference on Graduate Education in Psychology in Boulder, Colorado to reflect the realization that psychologists should be trained in both research and clinical practice—and that these elements of our profession should inform each other.
Today, the term “scientist-practitioner” refers to both a model of training and a model of practice. It means that clinical psychologists should be skilled consumers of the scientific literature and possess both the ability and willingness to incorporate that knowledge into their practice. It also champions the idea that psychologists have an ethical responsibility to promote and practice evidence-based patient care that is devoid of unequivocal pseudoscience and leery of its shades of gray.
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Unfortunately, there exists a notorious gap between science and practice in clinical psychology insofar as we know that the scientific literature is often not utilized by practitioners for a variety of reasons, which can include variable attitudes in relation to evidence-based practice; concerns about the generalizability of research findings; and concerns about the importance of randomized controlled trials.
This gap between science and practice stretches to epic proportions outside of psychology when it is extended to other mental health professions and beyond to unregulated health providers in the alternative medicine community and the wellness industry. Providers who advertise their services to address mental health concerns but do not value, respect, or understand the role of science in mental health care risk compromising the safety of patients and treatment effectiveness.
Unfortunately for patients, a buyer beware approach to their mental health must be adopted both within healthcare systems and in the unregulated space where mental health care is marketed and sold. Improving the science and mental health literacy skills of both the general public and healthcare professionals can help mitigate this alarming problem.
At the end of the day, your mental health is on the line when you’re seeking care. It’s important to make informed decisions about your mental health by understanding how to become science and mental health literate; how to spot mental health misinformation and develop a keen eye for the propaganda tactics and tropes that are used to market pseudoscientific practices; and how to know what to look for when seeking real professional help.
In a landscape where we’re up against an onslaught of bogus mental health treatments and products that have increasingly flooded our culture, it’s all the more important to learn how to steer clear of misguided and predatory practices, and to understand what mental health really means.
References
Dozois, D. (2013). Psychological treatments: Putting evidence into practice and practice into evidence. Canadian Psychology, 54, 1-11.
Lilienfeld, S. O., Lynn, S. J., & Lohr, J. M. (2014). Science and Pseudoscience in Clinical Psychology. The Guilford Press.
Stea, J. N. (2024). Mind the Science: Saving Your Mental Health from the Wellness Industry. Random House Canada.
Stea, J. N., & Hupp, S. (2023). Investigating Clinical Psychology: Pseudoscience, Fringe Science, and Controversies. Routledge.
Stea, J. N., Yakovenko, I., Kim, H. S., & Hodgins, D. C. (2023). Substance use and addictive disorders (p.179-202). In Hupp, S., & Santa Maria, C. L. Pseudoscience and Psychotherapy: A Skeptical Field Guide. Cambridge University Press.
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Publish date : 2024-06-25 15:37:27
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