Australasian Science: Australia's authority on science since 1938

Science and Pseudoscience in Mental Health

By Tim Hannan

A new book explores the range and popularity of unproven therapies for psychological disorders.

For those inclined to the view that contemporary healthcare should be founded on good scientific evidence, the past few months have provided some good news. The final report of the National Health and Medical Research Council affirmed that homeopathy lacks any quality evidence to support the claim for effectiveness in treating health conditions. The anti-vaccination movement has been challenged by health professional and parent campaigns, and the threatened loss of childcare rebates. Paleo diet publications have been pulped, detoxing deconstructed, and so-called wellness cures for cancer critiqued in the press.

It has almost been enough to lead one to imagine that reason may yet illuminate the dark places where pseudoscientific health practices lurk, but a new book landing on my desk quickly snuffed out that candle. In Science and Pseudoscience in Clinical Psychology, a team of psychologists reviewed the range of psychotherapeutic methods marketed in the USA that are either unsupported or inadequately evaluated. The number and popularity of these is both astonishing and disturbing.

Treatments promoted for emotional disorders include energy therapies such as Thought Field Therapy and Emotional Freedom Techniques, bodywork therapies including massage, yoga and craniosacral therapy, and a range of brain-based techniques that purport to derive from neuroscientific findings. For parents of children with developmental problems, treatments include sensory integration and sensory-motor techniques, whose popularity remains untouched by the lack of empirical support across several decades.

For this psychologist, the book elicited mixed emotions. On the one hand it is comforting that Australian psychology is not plagued with the variety of pseudoscientific treatments that proliferate in the USA. A Google search did not reveal any local practitioners of entity depossession therapy or Reichian vegetotherapy, although there is at least one Australian unregistered “therapist” available to assist anyone striving to recover memories of alien abductions.

It is likely that the requirements associated with obtaining and maintaining registration as a psychologist assist in eliminating or discouraging pseudoscientific practices, and eligibility to provide services through Medicare requires the delivery of evidence-based psychological strategies such as cognitive-behaviour therapy and interpersonal therapy.

On the other hand, there are areas of mental health that remain infested with pseudoscientific beliefs and practices. Like the USA, a range of unproven sensory-motor interventions are marketed to parents of children with developmental disorders, and proponents of chiropractic treatment for autism can still be found. One company offers dolphin-assisted therapy for autism, Down’s syndrome, global developmental delay, ADHD, muscular paralysis and depression, and offers the opportunity to combine this with a range of other modalities, including massage, Reiki and kinesiology – all with “professional therapists”.

The authors of the book also explore why health professionals and other practitioners employ pseudoscientific methods, and propose that some clinicians may not discover that the techniques they employ are ineffective due to difficulties in learning from experience. This failure to learn may arise, in part, from cognitive biases and heuristics that affect the interpretation of data. For example, a clinician who routinely assumes that anxiety arises from interpersonal problems will seek to confirm the hypothesis by seeking out evidence of family dysfunction rather than seeking disconfirming evidence. Studies have shown that the earlier in the clinical assessment process that such evidence is obtained, the more likely it is that an incorrect diagnosis will be made – and the more confident the clinician will be in the erroneous conclusion.

Another factor is the unavailability of accurate feedback on the outcome of the intervention. Clinical experience alone does not deliver the objective, longitudinal data that would demonstrate that a treatment was unsuccessful.

For clients and families, the decision to accept pseudo­scientific practices may be influenced by the nature or severity of the condition, and advice from clinicians regarding the likely outcomes from conventional treatments. The authors note that some opt to place unquestioning trust in the one practitioner to whom they have been referred; others seek out numerous therapists and strive to follow the advice of all, however conflicting this may be. Advice from family members or friends with similar experiences may lead caregivers to adopt a particular treatment, or the source of influence may be a media figure or an organisation with a seemingly informative website.

Of course, some deliberately reject “conventional” treatments, preferring those presented as alternative, new or unorthodox.

A/Prof Tim Hannan is Head of the School of Psychology at Charles Sturt University, and the Past President of the Australian Psychological Society.