Read SSCP Members Dr. Dean McKay and Dr. Scott Lilienfeld's recent article in Psychology Today! 

https://www.psychologytoday.com/blog/your-fears-and-anxieties/201509/therapy-the-effective-kind

Dean McKay & Scott O. Lilienfeld

Dr. Jeffrey Lieberman of Columbia University, Past President of the American Psychiatric Association, recently took to Twitter to proclaim that psychology is in  dire straits (https://twitter.com/DrJlieberman/status/637085819505737728).  Dr. Lieberman pointed to the recent evidence, published in the prestigious journal Science, revealing that many social and cognitive psychology studies have failed to replicate (http://www.sciencemag.org/content/349/6251/aac4716.full).  These recent findings prompted Dr. Lieberman to conclude that psychology is “in shambles.” In addition, Dr. Lieberman referred to an op-ed in the New York Times as ‘lame,” largely because the author suggested that psychology’s problems with replication were scarcely different from those of other sciences (see op-ed here: http://www.nytimes.com/2015/09/01/opinion/psychology-is-not-in-crisis.html?ref=opinion&_r=0 and see Dr. Lieberman’s tweet here: https://mobile.twitter.com/DrJlieberman/status/638654836842430465).

SSCP’s take on these issues is rather different.

To be sure, psychology has its challenges with replicability, and the recent Science article underscores them.  As the authors of the Science article note, however, their findings do not mean that the original findings were incorrect (although they have been widely misinterpreted in this fashion). They mean only that we should place less stock in the initial findings than we typically have, and that we will need to await further replication efforts – and ultimately meta-analyses – before sorting out which results are genuine and which are not.  The bottom line is that we need to change the way we commonly think about research in psychology, psychiatry, and allied disciplines.  Each new finding needs to be viewed not as anything remotely close to the final word, but rather as one piece of a large puzzle that will eventually be filled in.

Just as important, there’s ample reason to believe that replication difficulties are not unique to psychology.  Despite its notable achievements in alleviating the suffering of individuals with mental illness, psychiatry too has struggled with its share of replication problems, such as those regarding the efficacy of transcranial magnetic stimulation for depression (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2993526/), the search for dependable biomarkers for psychopathology (http://www.nature.com/mp/journal/v17/n12/abs/mp2012105a.html), and the trustworthiness of most candidate gene studies of psychopathology, (http://ajp.psychiatryonline.org/doi/abs/10.1176/appi.ajp.2011.11020191). More broadly, John Ioannidis’ now famous analyses point to rampant problems with replicability in medicine, including psychiatry (http://jama.jamanetwork.com/article.aspx?articleid=201218), with many initially reported effects failing to hold up in later studies.  There are even reasons to doubt that findings in many domains of psychology are less replicable than those in physics, such as particle physics (see http://psycnet.apa.org/journals/amp/42/5/443/). When it comes to replicability challenges, we’re all in this together.

One essential point missing from Dr. Lieberman’s communications is that the field of psychology has taken the lead in highlighting difficulties with replicability (http://pps.sagepub.com/content/7/6/528.short). Moreover, psychology - arguably more than any domain of science - has undertaken concerted efforts to estimate the magnitude of the replicability problem and to develop methodological safeguards against it.  Such painstaking and at times painful self-examination is a sign of scientific strength, not weakness. Indeed, the beauty of psychological science has been its longstanding capacity to use psychological science to enhance the quality of psychological science.  To the extent that we identify endemic shortcomings with some of our methodologies, we will do so by using science – and we will use science to root them out.

Those of us in psychological science certainly have our work cut out for us with respect to replicability.  Fortunately, by engaging in rigorous self-scrutiny (as demonstrated by the recent article in Science), psychology is taking the initiative in attempting to confront this problem and place its profession on firming scientific footing.  We very much hope that Dr. Lieberman will encourage his colleagues in psychiatry to join forces with psychology and follow suit.

David Morris (“After PTSD, More Trauma”, Sunday Review, January 19, 2015) courageously shares his struggles in overcoming posttraumatic stress disorder (PTSD) and describes his negative experiences with prolonged exposure (PE) treatment.  There is a critical element missing from Mr. Morris’ account, and it could reasonably explain why he withdrew from treatment.  An axiomatic principle of PE as commonly delivered is a gradual build-up to the more distressing treatment components.  This process allows clients to develop the coping skills needed to progress in therapy.  Just as one should  build up to the full distance when preparing for a marathon, one must typically build up to the more demanding aspects of treatment when undergoing PE.

 

The efficacy of exposure therapies for a wide range of problems, ranging from phobias to PTSD, is supported by decades of research.  Although treatment may have been delivered improperly in Mr. Morris’ case, it is at least equally plausible that he is in the minority of clients who experience a short-term symptom worsening following PE.  Studies have shown that such exacerbation is unrelated to negative treatment outcomes, and that most clients who experience this worsening improve soon afterwards. 

 

We advise people with PTSD to seek out interventions that have been consistently demonstrated to be effective. Should that intervention fail to yield benefits following an adequate dose, it is in clients’ best interest to try another evidence-based approach, as Mr. Morris did when undergoing cognitive processing therapy.

 

 

Dean McKay, Ph.D.

Scott O. Lilienfeld, Ph.D.

 

The authors are, respectively, Professor of Psychology, Fordham University and Samuel Candler Dobbs Professor of Psychology, Emory University.  The authors are members of the Science of Clinical Psychology (SSCP). SSCP is Section III of Division 12 of the American Psychological Association (APA), and an organizational affiliate of the Association of Psychological Science (APS), but we are writing on behalf of SSCP, not APA or APS. 

Are the benefits of cognitive-behavioral therapy massively oversold?  That was the claim in a recent article in the Mail Online bearing the provocative title “CBT is a scam and a waste of money” featuring psychologist Oliver James (http://www.dailymail.co.uk/health/article-2828509/CBT-scam-waste-money-Popular-talking-therapy-not-long-term-solution-says-leading-psychologist.html).  Because the article was intended for the general public and advances extremely strong assertions, it warrants a closer look.  Let’s look at the evidence.

Cognitive-behavior therapy (CBT) is a structured psychotherapy.  In contrast to some treatments, which can go on indefinitely, CBT tends to be time-limited.  The approach has benefited countless clients suffering from a diverse array of problems, including major depression, anxiety disorders, posttraumatic stress disorder, psychological adjustment following medical procedures, eating disorders such as bulimia, and addictions; it can also be useful in general stress management.  The scientific evidence for CBT is extensive, with hundreds of trials conducted over the past five decades that document the effectiveness of this approach for many of the disorders listed in the Diagnostic and Statistical Manual of Mental Disorders (DSM). In two-year (or longer) follow-up studies for treatment trials for many forms of mental illness, clients treated with CBT remain as well as, or in some cases better, than they were when treatment ended.  Indeed, data suggest that in contrast to medication, CBT has lasting benefits that extend beyond the intervention itself.  Further, when compared with some traditional psychotherapies, such as psychodynamic therapies (treatments influenced by the theories and techniques of Freud and his followers), CBT is consistently associated with better outcomes for mood, anxiety, and eating disorders.  Finally, because CBT is a short-term treatment, sufferers of psychological distress can enjoy relief far more rapidly than with most other psychotherapies.

Some proponents of traditional psychotherapies have long asserted that CBT merely provides a ‘quick fix,’ because the root causes of the illness are not resolved, clients supposedly remain at risk for re-developing the same mental illness, or related problems.  This criticism overlooks a critical point: CBT is based on theories of mental illness that emphasize different causes than those depicted in traditional psychotherapies.  As a result, the components of mental illness targeted in treatment with CBT are the root causes, but these are not the same as those targeted in other treatments, such as psychodynamic therapy.   For example, a client seeking CBT for depression may be assisted in identifying and changing specific patterns of thinking that promote depressed mood.   That is because the theory underlying CBT suggests that thinking style itself is a root cause of depression.  In contrast, this same client might begin a quest to identify specific unconscious conflicts that give rise to depression while undergoing psychodynamic therapy.  The difference in these root causes is also the difference in the time for treatment: With CBT treatment, relief would typically require three to four months, whereas treatment with psychodynamic psychotherapies would commonly require one or more years.  Further, research has consistently failed to support the assertion that failure to address the root causes proposed by psychodynamic psychotherapies will lead to a re-emergence of symptoms, or the development of other symptoms.

When we consider the best research evidence, rather than which theory ‘feels right,’ the findings are compellingly in favor of CBT.  As with all treatments, psychological or otherwise, some individuals will not benefit fully.  On balance, however, CBT has been found to be superior to traditional psychotherapies, at least for mood, anxiety, and eating disorders.  

Let’s now return to James’ strong criticisms of CBT. Contrary to Mr. James’ claim, extensive evidence shows clearly that children and adults treated with CBT for anxiety and depression typically remain well at 2-year follow-up, and several studies demonstrate that improvement is maintained as long as six years after treatment.  Moreover, contrary to Mr. James’ assertion, CBT is consistently superior to placebo in treating anxiety and depression. 

The Mail Online article leaves readers with the unsupported impression that the root causes posited by psychodynamic therapy are unquestionably valid, that CBT merely glosses over problems associated with mental illnesses rather than addresses their true causes, and that the benefits of CBT are only temporary.  As we have seen, these criticisms are contradicted by research. 

The Society for a Science of Clinical Psychology (SSCP) believes that conclusions regarding treatment effectiveness must be based on research evidence rather than opinions.  Specifically, SSCP believes that the unsupported criticisms voiced in the Mail Online article, which neglect large bodies of data, can mislead the public into seeking ineffective or untested therapies, some of which may inadvertently prolong psychological distress.   We believe that the public will be better served by the understanding that CBT is based on a fundamentally different model of mental illness than most traditional psychotherapies, and that the research evidence for CBT’s long-term effectiveness is compelling.

Additional Reading:

Ginsberg, G.S., Becker, E.M., Keeton, C.P., Sakolsky, D., Piacentini, J., Albano, A.M., Compton, S.N., …, & Kendall, P.C. (2014).  Naturalistic follow-up of youths treated for pediatric anxiety disorders.  JAMA Psychiatry, 71, 310-318.

Hofmann, S. G., Asnaani, A., Vonk, I. J. J., Sawyer, A. T., & Fang, A. (2012). The efficacy of cognitive behavioral therapy: A review of meta-analyses. Cognitive Therapy and Research, 36, 427-440.

The authors, including lead author Dr. Dean McKay, are members of the Public Education and Media Committee, which is part of the Society for a Science of Clinical Psychology (SSCP).  SSCP is Section III of Division 12 of the American Psychological Association (APA), and an organizational affiliate of the Association of Psychological Science (APS), but we are writing on behalf of SSCP, not APA or APS. 

In the October 10, 2014 episode of the “Academic Minute,” an influential podcast developed by Inside Higher Ed, Dr. Erika Berg of North Dakota State University discussed an ongoing pilot study examining the efficacy of equine assisted psychotherapy (EAP) in the treatment of adolescents with conduct problems (https://www.insidehighered.com/audio/2014/10/10/equine-therapy).  Although we commend Dr. Berg and her colleagues for investigating EAP and fully support the pursuit of new and more effective treatments for mental illness, we wish to voice several serious concerns with the content of her discussion.

During the podcast, Dr. Berg noted that her study will compare “traditional talk therapy” with EAP and that preliminary results indicate favorable outcomes for those in EAP but not the comparison condition.  The meaning of “traditional talk therapy,” however, was unclear.  Many treatments with varying levels of scientific support could be referred to as “talk therapy” and the degree to which they are considered “traditional” probably depends upon who is being asked.  In this sense, EAP is being compared with an unknown entity and the degree to which evidence exists supporting these (or other) approaches in the treatment of adolescents with conduct problems went unmentioned.  The importance of these points is highlighted by a recent review article that noted that no controlled studies demonstrate EAP is effective and/or efficacious in the treatment of any mental illness (http://onlinelibrary.wiley.com/doi/10.1002/jclp.22113/abstract).  Nevertheless, the lack of research support for EAP was not acknowledged, let alone discussed, in the podcast.  Furthermore, studies that examine the efficacy of EAP and related approaches are plagued by a variety of design flaws (e.g., lack of comparison group, lack of diagnostic information, lack of long-term follow-up) that render their results impossible to interpret.  These studies fall far below the threshold of scientific integrity necessary for a treatment to be considered evidence-based.  That threshold has been clearly outlined with respect to adults (http://www.div12.org/PsychologicalTreatments/index.html), as well as children and adolescents (http://www.effectivechildtherapy.com/).

As Dr. Berg correctly noted in the podcast, costs associated with the upkeep and administration of EAP can be high and need to be justified.  We would take this point a step further by noting the importance of opportunity costs.  When individuals with mental illnesses are directed away from treatments with strong empirical evidence and towards untested treatments that are associated with sweeping claims, these individuals are vulnerable to a longer duration of symptoms and to the financial costs of additional required treatment.  These individuals are also less likely to seek out treatment after a failed course of ineffective intervention, further compounding the opportunity cost.  Although Dr. Berg noted the importance of establishing an evidence base to support coverage of EAP by insurance companies, compelling research support is needed to justify the presence of EAP in the treatment marketplace in the first place.  Treatment centers offering EAP should therefore be required to note the lack of evidence supporting their approach, as well as the overwhelming research support for other treatment modalities for specific mental illnesses.  Future research may demonstrate that EAP is markedly effective in treating specific conditions in specific populations.  Until then, it is vital that advocates of EAP test their assumptions, and provide explicit disclaimers to clients regarding the experimental nature of the treatment and the current lack of scientific support for its use.

The authors, including lead author Dr. Michael Anestis, are members of the Public Education and Media Committee, which is part of the Society for a Science of Clinical Psychology (SSCP). SSCP is Section III of Division 12 of the American Psychological Association (APA), and an organizational affiliate of the Association of Psychological Science (APS), but we are writing on behalf of SSCP, not APA or APS. 

In a Time magazine article published on September 23, 2014, Daniel Siegel and Tina Payne Bryson (http://time.com/3404701/discipline-time-out-is-not-good/) report that time-out, a widely used behaviorally based approach to discipline for children, has indirect harmful consequences on social development.  They assert that time-out exerts this effect by producing social isolation.  Siegel and Bryson go on to suggest that time-out is generally ineffective as a disciplinary strategy because children do not develop any skills when this method is used.  The Society for a Science of Clinical Psychology (SSCP) takes issue with their conclusions, contends that their assertions overlook two extremely important features of behavioral treatment and are in contrast to a large body of empirical support for time-out.

First, time-out does not imply social isolation.  In fact, when properly implemented, time-out involves the presence of a caregiver, but requires that other activities the child might find rewarding are unavailable for the duration of time-out. This practice is in keeping with the origin of the term, which is time-out from reinforcement (or reward).  Siegel and Bryson argue that time-out sends an implicit message to the child of “I’m only interested in being with you and being there for you when you’ve got it all together.”  In contrast, we maintain that when properly administered, the message is quite different, and closer to “I’m here regardless of what you do, and look forward to rewarding you for your successes.” Decades of controlled research has shown that programs based on behavior management techniques, including time-out, are highly effective and have no adverse effects.

Second, time-out should never be a stand-alone intervention.  Any properly developed program of behavior management includes copious opportunities for reward, and discipline applied only when absolutely necessary.  Further, the proper implementation of time-out implies that there is ‘time-in,’ wherein the child has opportunities for reward.  During ‘time-in’, the caregiver has a responsibility to ensure that the child can be rewarded for doing well, and for progressing in learning new tasks.  The caregiver can create the opportunities for children to obtain these rewards.

In addition to the above two points, Siegel and Bryson assert that time-out makes children angrier and less capable of regulating their emotions.  This claim is contrary to the findings from numerous well controlled studies showing the opposite, that time-out is in fact a useful means of helping children better manage their emotional states.  However, it is again only in the context of a comprehensive approach to behavioral management.  That is, what happens after time-out is over is just as important as implementing time-out.  It is here that caregivers can provide guidance to ensure that time-out is implemented sparingly.

We are alarmed at how time-out has been mischaracterized by Siegel and Bryson.  The efficacy of comprehensive behavioral programs on children has been well established and is a true success story in psychological treatment.  Erroneous claims and reliance on assessments of reactions to time-out, out of context from a full program of treatment, can steer well-meaning parents away from an otherwise acceptable, effective, and compassionate approach to child behavior management. Parents who wish to find resources that present time-out as part of a full program of behavior management should consider consulting Alan Kazdin’s “The Everyday Parenting Toolkit.”

We agree with Siegel and Bryson that social isolation is detrimental to children.  However, with proper implementation, there are no harmful effects of time-out, because it does not involve social isolation. Behavioral management has a decades-long record of efficacy, but only when applied comprehensively.  This means that all the core components must be in place – reward for desired behavior, time-out only when necessary, and extensive opportunities for ‘time-in’. 

The authors are members of the Public Education and Media Committee, which is part of the Society for a Science of Clinical Psychology (SSCP).  SSCP is Section III of Division 12 of the American Psychological Association (APA), and an organizational affiliate of the Association of Psychological Science (APS), but we are writing on behalf of SSCP, not APA or APS. 

In a verdict announced on August 13, 2014, the Israeli Supreme Court upheld the conviction of a father, Benny Samuel, for raping his daughter - who is now 38 - when she was a child.  What made this conviction unique is that it was based entirely on a recovered memory of a dream experienced by the daughter more than a decade after the ostensible sexual abuse ended. 

The daughter, who had moved from Israel to New York City as a young adult, reported that she had no prior memory of the sexual abuse until she had a nightmare that brought back horrific recollections of her father raping and sodomizing her.  Around the same time, she says, she began to read about the unconscious mind and its capacity to store repressed memories.  Following the dream, she soon recalled further memories of rape dating back to age 3, and continuing until age 11.  Following the accusations, Samuel became estranged from his daughter, and he and his wife divorced. 

Although Samuel had initially been convicted in 2007 and sentenced to twelve years in prison, he appealed to the district court, which upheld the conviction.  Three expert witnesses on behalf of the prosecution argued that the daughter’s symptoms of anxiety and posttraumatic stress disorder, combined with her realistic memories, provided clear-cut evidence for incest. Samuel vehemently denied the charges and eventually took his case all the way to the Supreme Court, which rejected his appeal two and half years later.  

The Society for a Science of Clinical Psychology (SSCP) is deeply disturbed by the Israeli Supreme Court decision, which runs counter to the best available psychological science.  There is no known psychological mechanism whereby memories of repeated traumatic events can be completely forgotten and then suddenly recalled following a dream.  Moreover, there is well-established research evidence that many or most purported recovered memories of early abuse are actually confabulations - sincerely held but false or distorted recollections.  Indeed, most psychological experts doubt that genuine recovered memories are even possible given what we know about how memories are created. Even those experts who hold a different view concur that recovered memories should not be accepted as genuine without compelling corroboration from other sources. 

SSCP believes strongly that legal decisions, many of which can affect the lives and livelihoods of individuals and their families, must be based on the best available scientific evidence.  As a consequence, SSCP takes strong issue with the Israeli Supreme Court decision, which lends credence to extremely dubious psychological claims. 

SSCP is Section III of Division 12 of the American Psychological Association (APA), and an organizational affiliate of the Association of Psychological Science (APS), but we are writing on behalf of SSCP, not APA or APS. 

                One impediment to the promotion of psychological science is the fact that many members of the general public appear not to know the difference between psychologists and other mental health professionals, including psychiatrists, or perhaps even know that such a difference exists.  For example, in a survey of over 1000 Americans sponsored by the American Psychological Association (APA), psychologist Rhea Faberman found that large percentages of laypersons “cannot tell one mental health professional from another.”  Similarly, a 1994 survey by University of Northern Iowa psychologist Jane Wong revealed that only half of a sample of 286 college students and staff felt that they could distinguish among psychologists, psychiatrists, and psychoanalysts.  This “role diffusion,” as it has been called, makes it difficult for the public and policy-makers to appreciate the distinctive scientific contributions of clinical psychology. 

Specifically, in contrast to psychiatrists and most mental health professionals, doctoral-level clinical psychologists, including all of those with Ph.D. degrees and many of those with Psy.D. degrees, are trained explicitly to design, conduct, and interpret research.  In addition, most doctoral-level psychologists acquire extensive training in the science and practice of psychological assessment, including intellectual, neuropsychological, and personality testing.  Ideally, clinical psychologists also use evidence-based therapeutic and assessment methods in their clinical practice, supervision and consultation.  These differences can be important to current and would-be consumers of psychotherapy.  Because they are formally trained in research, well trained doctoral-level psychologists are in an ideal position to evaluate the scientific evidence-base for psychological treatments, and to distinguish well-supported from poorly supported treatments. 

                  The latest example of the confusion between psychologists and psychiatrists can be found in an August 25^th, 2014 article in the Washington Post’s Health and Science section entitled, “When psychiatrists are on Facebook, their patients can get a case of TMI,” authored by staff writer Steven Petrow (http://www.washingtonpost.com/national/health-science/when-psychiatrists-are-on-facebook-their-patients-can-get-a-case-of-tmi/2014/08/25/ed31e522-110a-11e4-9285-4243a40ddc97_story.html).  The article describes some of the potential hazards of psychotherapists’ casual use of Facebook and other social media, including a diminution of their credibility and a blurring of therapeutic boundaries.  Ironically, although the article focuses largely on psychologists, and even includes advice from psychologist Stephen Behnke, Director of the APA Ethics Office, the article’s title refers only to psychiatrists, implying to readers that most or all psychotherapists are psychiatrists (psychiatrists, in contrast to doctoral-level psychologists receive an M.D.).  In fact, psychiatrists comprise only a small minority of psychotherapists, and recent data suggest that decreasing percentages of psychiatrists are supplying psychotherapy (as opposed to prescribing medication) to most of their patients. These data may be relevant to mental health consumers, because research evidence demonstrates that for a number of psychological conditions, including major depression, the addition of psychotherapy to medication yields substantial boosts in long-term improvement.

The public’s confusion between psychologists and psychiatrists probably stems in part from misleading coverage by the entertainment media.  For example, a content analysis published in 1997 by psychologist Kisten von Sydow and psychiatrist Christian Reimer, both of the University of Hamberg, demonstrated that many popular films refer to psychologists and psychiatrists interchangeably, or muddy the boundaries between psychologists and psychiatrists by depicting the former individuals as prescribing medication.  Furthermore, in a 1999 review, psychologists Richard Bischoff of the University of Nebraska at Lincoln and Annette Reiter of Marriage of Family Counseling of Pinellas in St. Petersburg, Florida reported that only 6% of psychotherapists in movies are identified as psychologists, with most described as psychiatrists or other physicians.

Regrettably, the recent Washington Post headline only fuels this confusion.  We urge health and science writers and editors to familiarize themselves with the key differences between psychologists and other mental health professionals, including psychiatrists, and to better understand the distinctive contributions that scientifically trained clinical psychologists can provide in their research, practice, and teaching.  The following resources are a helpful start in this regard:

http://www.webmd.com/mental-health/features/psychology-vs-psychiatry-which-is-better

http://www.webmd.com/mental-health/guide-to-psychiatry-and-counseling

http://healthland.time.com/2010/10/01/psychology-vs-psychiatry-whats-the-difference-and-which-is-better/

http://www.crossroadspsych.net/differences.html

 

Written by the Public Education and Media Relations Committee of the Society for a Science of Clinical Psychology

Committee members: Scott Lilienfeld (Chair), Mitch Prinstein, Joye Anestis, Michael Anestis, Kristy Benoit, Rosanna Breaux, Gerald Davison, Todd Finnerty, Dean McKay, Shari Steinman, David Tolin, Kristin Weinzierl

SSCP is Section III of Division 12 of the American Psychological Association (APA), and an organizational affiliate of the Association of Psychological Science (APS), but we are writing on behalf of SSCP, not APA or APS. 

The article “A revolutionary approach to treating PTSD” presented an overview of an experimental approach to the treatment of PTSD.  We appreciate efforts to improve the treatment of this important problem as well as any other mental illness; however, as clinical psychological scientists we are concerned that this article misrepresents the research base on the treatment of PTSD and risks encouraging individuals to pursue a treatment of unknown utility when well-tested alternatives exist.  Specifically, in contrast to the treatment featured within the article, there is a strong research base for Prolonged Exposure and Cognitive Processing Therapy for PTSD.  Although the author noted the lack of research evidence for the experimental treatment, this issue was presented as an afterthought, rather than as a primary criterion for selecting a treatment.  It is difficult for consumers of mental health care to know which treatments have the strongest research support.  It is thus imperative that media provide a clear, unambiguous statement regarding evidence for and against treatments, while also directing readers to other relevant resources (e.g., www.psychologicaltreatments.org, www.effectivechildtherapy.com, http://www.div12.org/PsychologicalTreatments/index.htm).  The public should be advised to select treatments that have been shown scientifically to work before trying untested treatments that have no evidence for their efficacy, and may even be potentially harmful. 

Submitted on behalf of the Society for a Science of Clinical Psychology (SSCP; https://sites.google.com/site/sscpwebsite/) by

Michael D. Anestis, Ph.D., Assistant Professor of Psychology, University of Southern Mississippi

Bethany Teachman, Ph.D., Professor of Psychology, University of Virginia (SSCP President)

Mitch Prinstein, Ph.D., Distinguished Professor of Psychology, University of North Carolina at Chapel Hill (SSCP President-elect)

SSCP is Section III of Division 12 of the American Psychological Association (APA), and an organizational affiliate of the Association of Psychological Science (APS), but we are writing on behalf of SSCP, not APA or APS.