Research for counselors

Research on coherence therapy and neuroscience

• Toomey, B. & Ecker, B. (2007). Constructivism, coherence psychology and their neurodynamic substrates. Journal of Constructivist Psychology, 20:3, 201-245.
• Ecker, B. & Toomey, B. (2007). Depotentiation of symptom-producing implicit memory in coherence therapy. Journal of Constructivist Psychology, In press.
• Toomey, B. & Ecker, B. (2007). Competing visions of the implications of neuroscience for psychotherapy. Journal of Constructivist Psychology, In press.

Problems with psychiatric medications

• Wyatt, W. J. & Midkiff, D. (2006). Biological psychiatry: A practice in search of a science, Behavior and Social Issues, 15, 132-151.

• Contrasts the weak evidence for biological models of mental illness with its growing acceptance in our culture. Finds that there is little to no evidence from science that can explain why biological models are favored. Claims that this is due to an attempt on the part psychiatrists to protect their field from non-medically trained competitors as well as the pharmaceutical industry’s efforts to market psychiatric drugs.

• Leo, J. & Cohen, D. (2003). Broken brains or flawed studies?  A critical review of ADHD neuroimaging research, The Journal of Mind and Behavior, 24, 29-56.

  • Reports severe methodological flaws in studies that have concluded ADHD is caused by a brain abnormality. States that the brain abnormality often observed is more likely caused by the ADHD medication.

• Moncrieff, J. & Kirsch, I. (2005). Efficacy of antidepressants in adults. British Medical Journal, 331, 155-157.

  • The authors summarize: 1) recent meta-analyses show that selective serotonin reuptake inhibitors (SSRIs) have no clinically significant superiority over placebo; 2) claims that antidepressants are more effective in more severe conditions have little evidence to support them; 3) methodological artifacts may account for the very small (and clinically insignificant) statistical margin by which SSRI efficacy exceeds that of placebos; 4) antidepressants have not been convincingly shown to affect the long-term outcome of depression or suicide rates; 5) given the significant doubts about their benefits and concerns about their risks, current recommendations for prescribing antidepressants should be reconsidered.

• Kirsch, I. Moore, T. Scoboria, A. Nicholls, S. (2002). The Emperor's New Drugs: An Analysis of Antidepressant Medication Data Submitted to the U.S. Food and Drug Administration. Prevention and Treatment. Jul Vol 5(1) 23.
  • The authors find that studies by pharmaceutical companies do not show any benefits of SSRI medication over placebos. Instead, these companies do not publish studies in which they lose to placebos.
    
    
• Breggin, P. (2003/2004). Suicidality, violence and mania caused by selective serotonin reuptake inhibitors (SSRIs): A review and analysis. International Journal of Risk & Safety in Medicine, 16, 31–49.

  • Reviews a wide range of research to show that antidepressant medication leads to an increase in mania, agitation, obsessive preoccupation, akathisia, suicide and other abnormal behaviors.

• Whitaker, R. (2005). Anatomy of an epidemic: Psychiatric drugs and the astonishing rise of mental illness in America. Ethical Human Psychology and Psychiatry, 7, 23-35.

  • Reports the increase in mental health complaints over the past 50 years and reviews research that links this increase with the increase in psychiatric drugs.

• Valenstein, E. (1998). Blaming the Brain: The Truth About Drugs and Mental Health. New York: Free Press.

  • Reviews the role of pharmaceutical companies in promoting the “chemical imbalance” or biological model of mental illness. Also reviews the vast influence that this industry holds of the mental health field, from funding research to pressuring journal editors to advertising and public relations through the media.

• Lacasse JR, Leo J (2005). Serotonin and Depression: A Disconnect between the Advertisements and the Scientific Literature. PLoS Med 2(12): e392 DOI: 10.1371/journal.pmed.0020392

  • Reviews the commercial success of antidepressant medications, which are the best-selling prescription drugs on the market. Cites the connection between this success and the preponderance of direct-to-consumer advertising for the drugs. Shows the theory that SSRI’s are correcting a chemical imbalance forwarded by these advertisements to have no basis in science. 

• Joseph, J. (2006). The missing gene: Psychiatry, heredity, and the fruitless search for genes. New York: Algora Publishing.

  • Claims that twin studies to establish the genetic component of psychological conditions are flawed because they are based on a presupposition that monozygotic and dizygotic twins are reared in equal environments. In fact, monozygotic twins are treated more similarly than their dizygotic counterparts.

• Marks, I. M., De Albuquerque, A., Cottraux, J., Gentil, V., Greist, J., Hand, I., Liberman, R. L., Relvas, J. S., Tobea, A., Tyrer, P. & Wittchen, H.-U. (1989). The ‘efficacy’ of alprazolam in panic disorder and agoraphobia: A critique of recent reports. Archives of General Psychiatry, 46, 668-670.

  • Reports a very large multi-location trial on the widely prescribed benzodiazapine, Xanax (alprazolam). After 8 weeks, initial superiority over placebos had disappeared. Also, 35% of the treatment group displayed negative withdrawal symptoms of varying severity compared to none in the placebo group. Marks et al. argue that short-term relief in a normally chronic condition does not seem to justify the adverse addiction and withdrawal effects, and that it appears likely that had the study continued and drug dependency deepened, the placebo group would soon have had better scores than the treatment group.

• Breggin, P. (2002). The Ritalin Fact Book: What Your Doctor Won't Tell You About ADHD and Stimulant Drugs. Cambridge, MA: Perseus Books.

  • Reviews outcome literature of various stimulant drugs and reports that they do not improve grades, performance or emotional distress compared to a placebo. They do beat placebos with respect to teacher-reported complaints of fidgeting and whining. They also have dire side effects including addiction and brain damage.

Problems with the empirically-supported treatments movement

• Luborsky, L., Rosenthal, R., Diguer, L., Andrusyna, T. P., Berman, J. S., Levitt, J. T., Seligman, D. A. & Krause, E. D. (2002). The Dodo Bird Verdict is alive and well—mostly. Clinical Psychology: Science and Practice, 9 (1), 2-12.

  • This study “examined 17 meta-analyses of comparisons of active treatments with each other… [T]he meta-analyses yielded a mean uncorrected absolute effect size for Cohen's d of .20, which is small and nonsignificant… [W]hen such differences were corrected for the therapeutic allegiance of the researchers involved in comparing the different psychotherapies, these differences tend to become even further reduced in size and significance.”

• Baskin, T.W., Tierney, S.C., Minami, T. & Wampold, B.E. (2003). Establishing specificity in psychotherapy: A meta-analysis of structural equivalence of placebo controls. Journal of Consulting and Clinical Psycholology, 71(6), 973-979.

  • Reviews 21 studies in terms of the structural equivalence (degree of resemblance) between treatment and placebo controls. A placebo control was judged structurally equivalent when it matches the treatment in number and duration of sessions, group or individual format, and non-restriction of topics (for example, not merely psychoeducational). Well-designed, structurally equivalent placebo treatments were found to be as effective as the active treatments, whereas placebos lacking structural equivalence were less effective.

• Robinson, L. A., Berman, J. S. & Neimeyer, R. A. (1990). Psychotherapy for the treatment of depression: A comprehensive review of controlled outcome research.  Psychological Bulletin, 108, 30–49.

  • After reviewing all available data (22 qualifying studies) and correcting for researcher bias, the authors conclude “when the effects of psychotherapy [for depression] were compared with those of placebo treatments, no reliable differences emerged.”

• Luborsky, L., Diguer, L., Seligman, D. A., Rosenthal, R., Krause, E. D., Johnson, S., Halperin, G., Bishop, M., Berman, J. S. & Schweizer, E. (1999). The researcher's own therapy allegiance: A "wild card" in comparisons of treatment efficacy. Clinical Psychology: Science and Practice, 6, 95-106.

  • Analyzed 28 studies for investigator allegiance according to subsequent citations as well as ratings from colleagues and the authors themselves. The aggregate of the three ratings “explained 69% of the variance in outcomes”, vividly demonstrating that investigator allegiance “can distort comparative treatment results.”

• Wampold, B. E., & Minami, T., Baskin, T. W. & Tierney, S. C. (2002). A meta-(re)analysis of the effects of cognitive therapy versus "other therapies" for depression. Journal of Affective Disorders, 68, 159-165.

  • Examines the claims that cognitive therapies are superior to other modalities and finds, contrary to other investigators who failed to correct for allegiance, no evidence of their superior efficacy after removing studies containing non-credible control treatments from the comparison pool.

• Wampold, B. E., Mondin, G. W., Moody, M., Stich, F., Benson, K. & Ahn, H. (1997). A meta-analysis of outcome studies comparing bona fide psychotherapies: Empirically, "All must have prizes." Psychological Bulletin, 122, 203-215.

  • Reviews 114 studies and concludes, “the evidence from these analyses supports the conjecture that the efficacy of bona fide treatments are roughly equivalent.” Differential effect sizes for various treatments were evenly distributed around zero, and “under the most liberal assumptions, the upper bound of the true effect [Cohen’s d] was about .20,” an effect size considered to be of little to no clinical significance by Cohen.

This site is maintained by Tim Desmond, MFTI 51287 :: Supervised by Bruce Ecker, MFC 21355
copyright © 2007 Tim Desmond, MA. Last updated 31March2007.