Losing confidence in therapist who subscribes to alternative remedy
May 2, 2010 4:41 PM   Subscribe

My therapist plans to use thought field therapy (TFT) on me. I've been researching it online, and I don't think it's legitimate.

As some quick background, I've seen her for two sessions. I don't think I'm clinically depressed, but I've been having mood swings with bouts of depression, anxiety, and despair, mostly connected to my job search. I've been very concerned about my ability to competently find a job since my thoughts about it are so negative.

In our last session she said she was going to use TFT to treat my pattern of negative thoughts. She mentioned this very briefly and didn't go into any detail, but she seem very enthusiastic about it.

Here's why I don't believe TFT is a legitimate technique (if you're not interested in these details, feel free to skip the next 3 paragraphs):

As I said, I've been researching TFT online. Wikipedia has lots of skeptical info about it. NPR did a segment about it where they interviewed a skeptic who conducted an experiment that showed it didn't work any better than the control (tapping random parts of the body instead of the parts you're supposed to tap when you use TFT). More, more, more, more, more.

Every skeptical source says the technique hasn't been shown to be effective in any scientific study. Its proponents seem to have been confronted with this point, and their response is to give anecdotal accounts of therapists and patients personally experiencing it as effective. The proper response would be to actually test the technique with studies, but the proponents seem to want to dismiss skeptics by saying no one should criticize it unless they've experienced it firsthand. Saying you can't criticize a technique unless you've tried it yourself is a rhetorical gambit, not valid scientific reasoning.

I also find the claims intuitively implausible. The descriptions of how it's supposed to work -- "tapping" certain areas of the body to access "fields" or "perturbations" and "unblock" "energy" -- have the air of pseudoscience. I see claims that it has an 80% or 85% or 90% or even 97% or 98% success rate, but this isn't convincing if it's never actually been tested. The inventor of the technique apparently claims that it cures depression (among many other things) -- in 15 minutes! Wouldn't anyone who discovered a 90% successful 15-minute cure for depression be eager to have this empirically demonstrated, rather than making excuses for the lack of empirical proof?

Some of the more cautiously skeptical commentators say that TFT might work only through a placebo effect. Well, even if that's true, it wouldn't work on me since a placebo works on people who are inclined to believe in its effectiveness, and I'm not.

I was referred to this therapist through a company that provides a free referral service through my employer. I'm supposed to talk to the referral company on the phone tomorrow to let them know about the next scheduled appointment, and I'm sure I'll have the opportunity to mention any thoughts or concerns I have about how the therapy has been going. Should I just be honest with them and say I've lost confidence in my therapist and would like to be referred to a new one, then call my therapist and tell her I'm no longer interested in her services?

It would seem obvious that I shouldn't keep seeing a therapist I've lost faith in. But I find it hard to bring myself to cut things off and admit that the first two sessions were a waste. Should I just say that's a sunk cost and I have to move on?

(Of course, if anyone here has any experience with TFT, positive or negative, I'd be interested in hearing about that. It's never been mentioned on AskMe or MeFi.)
posted by jejune to Human Relations (32 answers total) 1 user marked this as a favorite
You need a real therapist not someone engaging in pseudoscientific mumb-jumbo. Your "therapist" is slinging bullshit. Run.
posted by dfriedman at 4:43 PM on May 2, 2010 [15 favorites]

It sounds like the most important consideration is that if you don't trust the person you're seeing, you're unlikely to find it helpful.

That said there's very little that is scientific or empirical about 'therapy.' If you want to see someone who will use only treatment methods that are believed by the scientific community to be effective, you should ask the referral service for a psychiatrist, not a psychologist, therapist or social worker.
posted by jardinier at 4:52 PM on May 2, 2010 [2 favorites]

Best answer: You did not waste the first two sessions. Therapist/Client matching can be hit or miss.

This one happens to be a miss because she engages in quackery, but there are other legitimate reasons to leave one clinician in search of one more suited to you.

Don't feel guilty for continuing your search. You'll find a therapist that meets your needs.
posted by bilabial at 4:53 PM on May 2, 2010 [1 favorite]

I'm in a similar situation... except for the TFT part. From what I understand, it's not uncommon to just not dig a particular therapist so I wouldn't feel weird/bad about bailing out. What's more, I would probably be inclined to inform the referral service about a therapist engaging straight-up fringe psychology.
posted by Ultra Laser at 4:54 PM on May 2, 2010

Best answer: You are perfectly within your rights to tell the referral company that you don't want to see this therapist any more, and if they ask why, be honest. Your concerns are legit. Ask them to refer you to someone else.
posted by That's Numberwang! at 4:56 PM on May 2, 2010 [1 favorite]

Seconding dfriedman, and the comments that it's the way it works (seeing a few before finding one that fits).

But seeing the word qi on the wikipedia pages persuades me it's bullshit.
posted by opsin at 5:09 PM on May 2, 2010

I would consider asking the referral company for reimbursement, they are supposed to be vetting the therapists they recommend, in this case they did a very, very, poor job.
posted by HuronBob at 5:19 PM on May 2, 2010 [8 favorites]

The easiest way to drop your therapist is just not making another appointment, or canceling an already-made appointment by voicemail and explaining you didn't feel it was a match, or that you will contact them when you are ready to make another appointment with them. Some therapists will try to persuade you to continue therapy.
posted by beingresourceful at 5:30 PM on May 2, 2010

This probably "works" for people via the placebo effect, and if you're going in feeling like it's bullshit, it's going to be a waste of your time.
posted by availablelight at 5:33 PM on May 2, 2010

If you want to see someone who will use only treatment methods that are believed by the scientific community to be effective, you should ask the referral service for a psychiatrist, not a psychologist, therapist or social worker.

I respectfully disagree, unless you mean the only things that work are psychopharmacological treatments, in which case yes, you'll have to go to a psychiatrist for that. On the other hand, there are plenty of psychiatrists who practice talking therapies of the Freudian ilk, all of which are blissfully free of empirical support, and plenty of psychologists and social workers who use things like CBT which have something of an evidence base. For pretty much everything other than psychopharmacological treatments, what the particular therapist's educational background is doesn't tell you a lot of useful information about their approach to therapy.

To the OP, yes, that does sound like quackery to me, but more importantly it sounds like quackery to you. So you're not going to trust your therapist and hence you're likely to lose any benefit you'll get just from your relationship with your therapist.

That said, a lot of what happens in most approaches to therapy is not particularly well researched and supported by evidence. What works with what particular client can be hit and miss (many psychologists used to use what they called the "scientist practitioner model", which basically meant they'd try something, and if didn't work, try something else – I'm not sure if they still use that terminology, however), and it's possible your therapist would have tried something you're more comfortable with if it didn't work.

Still, it sounds like you don't trust her clinical judgement, which is as good a reason as any to find a new therapist.
posted by damonism at 5:39 PM on May 2, 2010 [3 favorites]

Best answer: Just politely tell the company that you would prefer a therapist who is experienced in cognitive-behavioral therapy or another evidence-supported modality, and that this therapist doesn't meet that qualification.
posted by fairytale of los angeles at 5:47 PM on May 2, 2010

Best answer: Both cognitive-behavioral therapy and contemporary variants of psychodynamic psychotherapy (among others) have fairly extensive empirical support as effective therapies for various types of psychiatric/psychological problems. Thus, it isn't precisely clear that you need to see a psychiatrist for the only "empirical" mental health help you're going to find, as jardinier suggests, unless you would like to consider pharmacological treatments for your depression and anxiety (which very well may be the case). A competent therapist (whether Ph.D. psychologist, social worker, etc.) practicing with good technique could still help you help yourself.

Don't waste this valuable time you're dedicating to healing yourself on "treatments" that neither have evidentiary support nor feel right. Finding a therapist who works well with you can be hard. Give yourself a pat on the back for trying in the first place, get some new referrals, and move on from this woman who obviously doesn't resonate with you at all.
posted by Keter at 5:50 PM on May 2, 2010 [2 favorites]

It is inaccurate to say that only a psychiatrist uses "treatment methods that are believed by the scientific community to be effective." LCSW, Psychologists, MFTs (Marriage and Family Therapists) and others all use well proven methods to help their patients. Cognitive therapy, behavioral therapy, psychotherapy, etc are all valid proven treatment modalities that most psychiatrist do not use. Find out what kind of 'therapist' you are working with, what her training is, and whether she is legit or not. I can't imagine a legitimate therapist using something so unproven.
posted by SLC Mom at 5:50 PM on May 2, 2010 [2 favorites]

Response by poster: LCSW, Psychologists, MFTs (Marriage and Family Therapists) and others all use well proven methods to help their patients. Cognitive therapy, behavioral therapy, psychotherapy, etc are all valid proven treatment modalities that most psychiatrist do not use. Find out what kind of 'therapist' you are working with, what her training is, and whether she is legit or not.

She's an LCSW with a master's degree in social work.
posted by jejune at 6:05 PM on May 2, 2010

damonism: unless you mean the only things that work are psychopharmacological treatments, in which case yes, you'll have to go to a psychiatrist for that.

Sorry, I didn't mean that at all. I meant the opposite, I think the medicalization of mental health issues is a flawed approach.

As SLC Mom notes, psychiatrists don't necessarily use the most effective methods - primarily because they rely on a medical model for treatment. That medical model is based on the idea that your mental state is almost exclusively a chemical condition. While psychotherapy can be used, it's often supplementary to treatment with medication, and some who practice psychiatry even still use electric shock treatment.

I differentiated between the medical and non-medical fields in order to suggest you broaden your understanding of what is legitimate and consider not basing that judgement solely on 'scientific study.' Expecting a technique or method or treatment to work for you because it has peer reviewed literature backing up it's effectiveness may lead to further disappointment.

You might want to consider person centered therapy, which avoids medicalization, but employs a very intellectual process for examining your situation and your thoughts.
posted by jardinier at 7:31 PM on May 2, 2010 [2 favorites]

btw: I suggest PCT because you seem like a smart cookie who thinks critically about things - turning that eye inward to find solutions to how you're feeling is the goal of that kind of therapy.
posted by jardinier at 7:32 PM on May 2, 2010

Oh, and I just noticed you're in NY - so here is a link to the person centered resource center in NYC.
posted by jardinier at 7:35 PM on May 2, 2010 [1 favorite]

Response by poster: Thanks -- I'm in Albany though.
posted by jejune at 7:48 PM on May 2, 2010

I'm a counselor, and if someone at the place I work for were to use something with so little evidence they would definitely be looking at an unfriendly meeting with someone much higher up. Please don't let your experience with this one therapist prevent you from getting help; just remember that every field has some incompetent people who muddle their way through. The stories I could tell about some neurologists...
posted by Benjy at 8:25 PM on May 2, 2010

That said there's very little that is scientific or empirical about 'therapy.'

A pretty little slam, jardinier, that can be refuted by reading current peer-reviewed journals of psychotherapy.

I will agree that many therapists are not scientific in their approaches - but add that the same is true of many medical doctors, as well. I liken both to mechanics - skillful (to some degree, at least) in an arcane topic I am not skillful in, but not necessarily deeply knowledgeable about the scientific basis of their practice. Practitioners, not scientists.

That's "some" of them. Others keep themselve abreast of the latest research in their fields, and proactively adapt to the latest best-practices, in the interests of their clients' well-being.
posted by IAmBroom at 8:42 PM on May 2, 2010 [3 favorites]

To clarify - when I say that therapy isn't scientific or empirical, it's not meant as a slam - I want to ensure the OP understands that my comments come from a position where science and empiricism are not privileged.

But I'm afraid this is becoming talk, not ask.
posted by jardinier at 9:35 PM on May 2, 2010

Wow. I had to deal with this exact problem this morning with my therapist.

He suggested that I try a type of therapy that sounds very similar to TFT. I can't remember the name but it involved the same tapping on the body and head and releasing repressed memories. He claimed (no joke) that it erases Karmic debt. He couldn't give me any exact explanation of what the method involved though.

I went along with it for awhile (I'm fairly open to this sort of stuff to a point) until last week when he read from my arm that I had a repressed memory of me and my youngest sister fighting when I was 6 or 7. Trouble was my sister wasn't born until I was 8.

I called him on this and he said that the chronological timeline was out with his 'readings' and he may have meant my other sister. I told him that there shouldn't be any doubt with this stuff and as of now I didn't buy it.

He got a little funny about it and he , predictably, suggested that my resistance was an indication of it working and having touch on something important. I stayed strong and said that now that there was doubt in my mind I would continue to think so in any future sessions (which, incidentally, would have included past lives).

He was, after a bit of tension, quite cool about it and said I didn't have to continue if I didn't want to. We then had a great session where I unloaded a lot of stuff on my mind I didn't know was there.

POINT OF THE STORY? Tell her you're not keen to try it. If she doesn't take no for an answer find someone else. Just that simple.

(I'm spun out at the co-inky-dink of this posting)
posted by AzzaMcKazza at 9:36 PM on May 2, 2010 [1 favorite]

Ah, Albany - the other New York. : )

Have you used Psychology Today's therapist search? It lets you put in insurance information and you can read about the practitioners and email them for a phone consultation.

I know you have to get a referral, but you may find someone here who takes your insurance.
posted by jardinier at 9:44 PM on May 2, 2010

But I'm afraid this is becoming talk, not ask.
Looks to me like it only became "respond quite reasonably to the patently false statement made in the second comment to this AskMe post, to best ensure that the OP has correct information from informed sources".

jejune, you are by no means forced to undergo any kind of treatment in therapy that doesn't feel right to you. If you want to, you can bring it up with the therapist, or you can just plain discontinue treatment. If you feel like you've made a connection with this therapist, maybe it's worth continuing and just letting him/her know that you are not interested in TFT. If it feels better to move on to another therapist, I say go for it--I can't imagine I'd stay in therapy with someone whose expertise I no longer really trusted or believed in, myself.

(Here's where my IAAT, but IANYT part comes in) TFT is not a commonly-practiced technique among the general community of mental health professionals. It is most definitely not on the evidence-based practice list. There IS most definitely a therapist out there who will be a better match for you, though! Good luck.
posted by so_gracefully at 11:05 PM on May 2, 2010

If you want to see someone who will use only treatment methods that are believed by the scientific community to be effective, you should ask the referral service for a psychiatrist, not a psychologist, therapist or social worker.
posted by jardinier at 4:52 PM on May 2

Each of the professionals you mention in your comments have graduated from an accredited university program where they were required to learn scientific, empiricle treatement methods. What they choose to practive after graduation is their own choice.

But if you want to take pills, go to a psychiatrist. As far as therapy, psychiatrists are not required to be trained in talk therapy approaches, although some choose to.
posted by psycho-alchemy at 12:34 AM on May 3, 2010

Best answer: I've known someone who went to a psychiatrist who TFT - the person's response was basically "why are they tapping on me? Is the tapping supposed to do something?".

So yes, if you don't trust/believe in the person then move on. But don't think of the first sessions as a waste - you probably got some stuff off your chest if nothing else. It would be more of a waste to keep seeing them now you don't trust them.
posted by Coobeastie at 3:28 AM on May 3, 2010

You'll also notice that anyone can be a "therapist" as they need no certification or license.

In NYS, you do need a license.

I (a therapist) am not a big fan of "the tapping" which is historically related to NLP and EMDR and yet my highly regarded MD uses it (but, thankfully, not on me) and I saw a TV news clip in which some airline was using it (i.e. paying corporate dollars) to treat fear of flying. Unless your negative thoughts about finding a job are in any way connected to your negative thoughts about this therapist or about this form of treatment, I'd say look for someone new. (And as someone said above, it's not a waste of sessions to shop for a therapist.)
posted by Obscure Reference at 5:04 AM on May 3, 2010

Response by poster: I let the referral company know about the situation, and they apologized. (I wasn't paying them anything, so I'm not in a position to ask for a refund.) I asked for a cognitive behavioral therapist, and they're going to look for one. Thanks, everyone.

As a sidenote, the discussion of how well-supported various methods are got me thinking about how much I should actually be concerned about the scientific validity of therapy. I'm actually not one to say you shouldn't trust anything that's not supported by scientific evidence. For instance, I would talk to family and friends about my problems, and I'd feel good about this without asking whether there's empirical evidence of its effectiveness. That's just common sense. Even if a therapist is just an experienced, neutral, professional version of a close friend you can talk to, I'd be satisfied with that. But it seems like a qualitatively different issue when someone is claiming they can cure depression in 15 minutes by tapping on certain parts of the body. That is pseudoscience, whereas I wouldn't say that having the opportunity to talk to an intelligent, caring person is pseudoscience.

(Even more tangentially, I was surprised to see the assertion in the second comment that only psychiatry and no other therapy is empirically supported. Is there empirical support for this assertion, or does psychiatry just smack of "science," while other therapy seems less rigorous? Is it really true that no legitimate study has ever found that, for instance, seeing a psychologist is beneficial for people who are struggling with depression or anxiety? I'd be sort of shocked if that were the case; surely there have been studies done about that, right?)
posted by jejune at 7:42 AM on May 3, 2010

Here's an interesting article published this year, from the Journal of the APA that discusses the marginalization of psychodynamic therapy in scientific circles and the recent empirical evidence that shows how unfounded that is:

"There is a belief in some quarters that psychodynamic concepts and treatments lack empirical support or that scientific evidence shows that other forms of treatment are more effective. The belief appears to have taken on a life of its own. Academicians repeat it to one another, as do health care administrators, as do health care policymakers. With each repetition, its apparent credibility grows. At some point, there seems little need to question or revisit it because “everyone” knows it to be so."
posted by jardinier at 8:32 AM on May 3, 2010 [4 favorites]

Response by poster: Thanks, that's very interesting.

I especially liked this point, from the conclusion of the article:
In writing this article, I could not help being struck by
a number of ironies. One is that academicians who dismiss
psychodynamic approaches, sometimes in vehement tones,
often do so in the name of science. Some advocate a
science of psychology grounded exclusively in the experimental
method. Yet the same experimental method yields
findings that support both psychodynamic concepts (e.g.,
Westen, 1998) and treatments. In light of the accumulation
of empirical findings, blanket assertions that psychodynamic
approaches lack scientific support (e.g., Barlow &
Durand, 2005; Crews, 1996; Kihlstrom, 1999) are no
longer defensible.
(Of course, this has nothing to do with the validity of TFT.)
posted by jejune at 9:04 AM on May 3, 2010 [3 favorites]

Is it really true that no legitimate study has ever found that, for instance, seeing a psychologist is beneficial for people who are struggling with depression or anxiety?

No, it is not true (which is why so many people jumped in to rebut that statement, you might notice). There is a sizable body of research on the efficacy of therapy in general. There have been various meta-analysis studies of different types of therapy and how well they 'worked'; here is a short page that describes one of the most often cited studies from 1977 (Smith & Glass, Meta-analysis of psychotherapy outcome studies, American Psychologist Vol 32(9), Sep 1977, 752-760), and talks a little bit about what the meta-analysis means, regarding the efficacy of any type of therapy.

There is a lot of research to support the idea that the big/popular techniques and modalities all have pretty similar success rates, and it's essentially the relationship/connection that's built between a therapist and you that contributes the greatest part of success to outcomes. In the context of your situation, I'd say that that supports your choice to go with another therapist. :)
posted by so_gracefully at 2:58 PM on May 3, 2010 [2 favorites]

First, I agree that you should find another therapist.

Second, however, here's a link to my internist's partner (Dr.Ron Ruden) 's articles about tapping. He proposes that tapping interferes with learned responses to fear that are mediated by the amygdala.

Which doesn't mean that there aren't other ways to interfere with these ingrained responses, too (like, e.g. psychotherapy), but does offer a hypothesis regarding the possible scientific legitimacy of the tapping technique.

Personally I'm like you and am too much of a non-believer for it to work on me (and by that I mean I generate responses (thoughts and feelings) that don't allow the technique to work) (which I believe probably has to do with a need to feel in control, as opposed to receptive -- maybe similar to being non-responsive to hypnosis? I don't know)

The sad thing is that the New Age-y types throw in clear crap like concepts of "energy fields" etc. that force us to reject them, when maybe there really is something to this stuff.
posted by DMelanogaster at 11:45 AM on January 10, 2011

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