How to spot hype in the field of psychotherapy: A 19-item checklist.

Abstract

How can consumers of psychotherapies, including practitioners, students, and clients, best appraise the merits of therapies, especially those that are largely or entirely untested? We propose that clinicians, patients, and other consumers should be especially skeptical of interventions that have been substantially overhyped and overpromoted. To that end, we offer a provisional “Psychotherapy Hype Checklist,” which consists of 19 warning signs suggesting that an intervention’s efficacy and effectiveness have been substantially exaggerated. We hope that this checklist will foster a sense of healthy self-doubt in practitioners and assist them to become more discerning consumers of the bewildering psychotherapy marketplace. This checklist should also be useful in identifying the overhyping of well-established treatments.

Awareness of and attitudes toward CBT, DBT, and ACT in an acute psychiatric sample

“…Most patients expressed that they value psychotherapy that is supported by research. This finding is notable in that many psychological services delivered in the community are not necessarily well‐supported by research (Meichenbaum & Lilienfeld, ). Despite a desire for psychotherapy supported by research, even among the current population of patients currently in treatment for mental health issues at an institution that provides EBPTs, data on patients' familiarity with the three specific EBPTs we examined were somewhat discouraging.…”

“…Furthermore, in the latter‐mentioned study, “minimally adequate treatment” for psychotherapy was defined solely based on the number of sessions attended, rather than the type of therapy. With at least 500 different types of psychotherapies existing in clinical practice (Eisner, ), many of which are of limited clinical efficacy or are actually harmful to patients (for reviews, see Lilienfeld, ; Meichenbaum & Lilienfeld, ), together with data underscoring the cost‐effectiveness of EBPTs over non‐empirically supported therapies (Okamura et al, ), suggest an overwhelming and urgent need not only for increased patient access to psychotherapy in general, but specifically for existing treatments that have been demonstrated as clinically efficacious for mental disorders (for reviews, see Cusack et al, ; Hofmann, Asnaani, Vonk, Sawyer, & Fang, ; Khoury et al, ).…”

Understanding of evidence‐based mental health care and the perceived importance of scientific information in a sample of U.S. adults

“…Focusing on consumers of mental health care is important given that “patient preference” is a primary component of EBMHC according to both the American Psychological Association's (American Psychological Association Presidential Task Force on Evidence‐Based Practice, ; Kirk, Broman‐Fulks, & Bergquist, ; Swan & Heesacker, ), and the Institute of Medicine (Barry & Edgman‐Levitan, ; Institute of Medicine, ). In addition, a history of public acceptance of pseudoscientific mental health practices may pose a significant barrier to consumer pursuit of EBMHC (Lilienfeld, ; Lilienfeld, Lynn, Lohr, & Tavris, ; Meichenbaum & Lilienfeld, ). As such, assessing current EBMHC knowledge and attitudes toward scientific information in a U.S. sample of adults may be a key starting point to inform future consumer‐directed strategies to increase demand for EBMHC.…”

Increase value and reduce waste in research on psychological therapies

“…Though not intrinsically inappropriate, the intellectual investment in an approach could function as a bias, reducing vigilance in detecting inappropriate choices in design, analysis and reporting, particularly in the presence of findings favourable for the intervention. Along the same lines, Meichenbaum and Lilienfeld (2018) proposed a 19-item "psychotherapy hype checklist", describing warning signs that an intervention's efficacy has been significantly exaggerated, grouped under promotion and marketing, and respectively research evidence.…”