“When people are sick, the promise of any cure becomes alluring. Common sense and demands of evidence are easily replaced by false hope. In this fragile state, the need for critical evaluation of treatment options becomes more important — more vital.” – Dr. Barry Beyerstein
You shouldn’t have to buy mental health care like you buy a household appliance, but here’s the terrible reality: your mental health is for sale.
In other words, if you or a loved one is looking for mental health care, you need to be prepared to navigate a marketplace with at least 600 different “brands” of psychotherapy—and that number continues to grow. Many of these therapies have not undergone rigorous scientific scrutiny, so it’s impossible to know for sure which ones are effective, which ones aren’t, and which ones may be harmful.
The $5.6 trillion wellness industry and alternative medicine community is home to countless unregulated mental health service providers, many of whom are out to exploit people’s financial and emotional vulnerabilities. They may market themselves under a variety of legally unprotected titles, such as “life coach” or “wellness consultant” or, in some countries or regions, “counselor” or “practitioner.” The world of mental health care is very much a “buyer beware” world.
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I’ve worked full time as a clinical psychologist for over 10 years. During that time, I’ve seen so many patients harmed by the pseudoscience propagated by the health industry. I’ve seen the explosion of misinformation about mental health on social media and in popular culture. I’m tired of it all. Looking at the science: Protecting your mental health from the wellness industryWe aim to expose and debunk exploitative pseudoscience, scams and misinformation, with the goal of providing real information to those affected by mental illness, misled by false marketing, or simply curious about the connection between science and mental health.
From the perspective of any legitimate mental health professional, it is an ethical imperative to provide evidence-based treatment for mental health problems. The concept of evidence-based practice owes its history to a movement called evidence-based medicine (EBM), which was fully articulated in 1992. This means that clinicians must strike a delicate balance between three pillars:
- Best available scientific evidence
- Their own clinical judgment and experience
- Patient-generated preferences and values
The idea of evidence-based practice is philosophically embedded in the codes of ethics and legal standards of practice of genuine mental health professions such as psychology, psychiatry, social work, and nursing.
The troubling reality is that non-evidence-based, pseudoscientific treatments for mental health concerns are widely promoted and used within and outside of various health care systems. It is not uncommon for mental health professionals to regularly encounter patients who have undergone such treatments. Such treatments include overtly pseudoscientific treatments (e.g., naturopathy, energy medicine, neuro-linguistic programming, past-life therapy) as well as controversial treatments that, in some cases, have more scientific plausibility but have lower or mixed quality evidence supporting their use (e.g., cannabis, psychedelics, mindfulness, 12-step programs, animal-assisted therapy).
While the line between science and pseudoscience will always remain blurry, critically evaluating and identifying potential pseudoscientific treatments for mental health concerns contributes to safe, ethical, and appropriate patient care. There’s a reason evidence-based practice is the foundation of our care models: adopting a care approach that emphasizes pseudoscience can be harmful in at least three ways:
- It may directly cause harm.
- Indirectly, this can take time and financial resources away from evidence-based services.
- It could further undermine the scientific basis and credibility of our profession.
The idea of using science to guide psychological practice is not new. Clinical psychology embraced science as an explicit value as early as 1947, when the idea that psychologists should be trained as both scientists and practitioners became the policy of the American Psychological Association (APA). In 1949, the “scientist-practitioner model” (sometimes called the “Boulder model”) was born at the Conference on Graduate Education in Psychology in Boulder, Colorado. This reflected the recognition 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 must be skilled consumers of the scientific literature and both able and willing to incorporate that knowledge into their practice. It also supports the idea that psychologists have an ethical responsibility to promote and practice evidence-based patient care that excludes pseudoscience and is wary of its ambiguities.
Unfortunately, a notorious gap exists between science and practice in clinical psychology, with the scientific literature notoriously underutilized by practitioners for a variety of reasons, including differing attitudes towards 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 grows to epic proportions when it extends to mental health professions outside of psychology, as well as unregulated providers in the alternative medicine community and wellness industry. Providers who advertise their services to address mental health issues, but do not value, respect, or understand the role of science in mental health care, risk compromising patient safety and the effectiveness of treatment.
Unfortunately for patients, a buyer-beware approach needs to be adopted when it comes to mental health, both within the health care system and in the unregulated spaces where mental health care is sold. Improving the science and mental health literacy skills of both the public and health care professionals can help alleviate this alarming problem.
After all, your mental health is at risk when you seek treatment. It’s important to make informed decisions about your mental health by understanding how to arm yourself with science and mental health knowledge, how to identify mental health misinformation and have a keen eye for the propaganda tactics and metaphors used to sell pseudoscientific treatments, and how to know what to look for when seeking real professional help.
In the face of an onslaught of fake mental health treatments and products that increasingly inundate our culture, it is even more important to learn how to avoid false and predatory practices and understand what mental health really means.
References
Dozois, D. (2013). Psychotherapy: bringing evidence to practice and practice to evidence. Canadian Journal of Psychology, 54, 1-11.
Lilienfeld, S. O., Lin, S. J., & Lohr, J. M. (2014). Science and pseudoscience in clinical psychology. Guilford Press.
Stea, J. N. (2024). Looking at the science: Protecting your mental health from the wellness industryRandom House Canada.
Stea, J. N., and Hupp, S. (2023). Research in clinical psychology: Pseudoscience, heresy, and controversy. Routledge.
Stea, JN, Yakovenko, I., Kim, HS, & Hodgins, DC (2023). Substance use and addictive disorders (pp. 179-202). Hupp, S., & Santa Maria, CL Pseudoscience and Psychotherapy: A Skeptical Field GuideCambridge University Press.