Where do you stand on the DoDo bird verdict?

[ClinPsycMasters]

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I am referring to common factors theory, of course.

I see all kinds of crazy therapies popping up here and there. I am referring to energy/electromagnetic therapy and that sort of thing. Actually, I remember looking up a book written by an "energy therapist" on Amazon and the reviews--and there were a lot of them--were unanimously positive. I didn't know if the reviewers were associated with the therapist or if it simply speaks to people's suggestibility...or, and I really don't want to entertain this idea, that fringe therapies actually work! But in fact often enough they do work...at least temporarily. So we can call it placebo...or common factors, depending on your views.

Of course if your beliefs as a therapist lie at the extreme of the continuum you may not only believe that they do in fact work, but that the mechanism of healing is actually the same as say the one behind CBT: Common factors, such as the match between therapist and the patient personality, worldview, and values, not to mention the rapport--friendly or distant depending on the patient's expectations (culture) of what a healer is supposed to be like. Of course there are other factors too, like the rationale as explained to the patient and so forth.

At the other end of the continuum we have therapists who believe change is the result of mechanism inherent to a particular form of therapy. So if the patients are feeling better, it must be that energy therapists are actually using their energy to heal them. Or after doing more research on energy therapy, they might believe that such therapists are charlatans and that the improvement in symptoms is only temporary and nothing more than placebo effect. Common factors, they might believe, facilitate therapy but actual and lasting change occurs as a result of, say, behavioral modification in behavior therapy, not as a result of a friendly and kind therapist or alternatively a dominant overconfident authority-like therapy who looks like he knows his ****. Such changes do not last.

So where do you stand on this? I have included a poll.

 

[Ollie123]

I voted for "in the middle" because I think both have a role to play.

That said, while I believe common factors have an important role to play, I think the dodo bird has gotten blown way out of proportion. I'm sick of seeing it used to justify doing treatments there is virtually no good evidence for (e.g. long term psychodynamic treatments for OCD). I'm sick of people citing the literature without actually reading it critically (see it all the time on this board and in the peer-reviewed literature). There are a lot of problems with the common factors literature, so I'm not sure why the dodo bird seems to have been elevated to "fact" in so many programs when it has as many or more weaknesses relative to any other literature. Many of the papers insist on collapsing across diagnoses. Wampold is the only one I've seen even try to explain why, and his reasoning seemed completely nonsensical to me. A substantial portion of the common factors support did a very poor job of establishing causality (e.g. it is unclear if alliance causes positive outcomes, or is a result of positive outcome, because both were measured at the same time). I could go on about it, but I'll stop there.

 

[FadedC]

I also feel the dodo bird theory is overstated frequently. Even if you take the study at face value, it didn't find that the type of therapy had no effect. It just found that it had a smaller effect then the alliance. That doesn't mean it's not still important.

In terms of crazy therapies, I recently unwittingly saw a primal therapist who told me within a few minutes of meeting me that I had repressed memories of not being loved as a child that he could help me recover. Given the evidence against this, the warnings about this exact thing by the APA, and the suggestions this can actually cause harm, I was a bit shocked to see things like this still around. At least most people citing the dodo bird theory are at least engaged in harmless activities.

 

[ClinPsycMasters]

I also feel the dodo bird theory is overstated frequently. Even if you take the study at face value, it didn't find that the type of therapy had no effect. It just found that it had a smaller effect then the alliance. That doesn't mean it's not still important.

In terms of crazy therapies, I recently unwittingly saw a primal therapist who told me within a few minutes of meeting me that I had repressed memories of not being loved as a child that he could help me recover. Given the evidence against this, the warnings about this exact thing by the APA, and the suggestions this can actually cause harm, I was a bit shocked to see things like this still around. At least most people citing the dodo bird theory are at least engaged in harmless activities.

Very important point, I think. Assuming everything else is the same, a good rapport might facilitate change. However, what if the particular therapy potentially does more harm than good, such as the example noted above? At the very least, the person is wasting their money on these dubious therapies. At the worst, the patient is seriously harmed...and I won't get into all the possible worst-case scenarios.

By the way, primal therapy?

Hmmm, on the other hand, perhaps in 2050 somebody's gonna say:

CBT/ACT/REBT...?

 

[deleted176373]

Common factors are so powerful that although there is some contribution from the modality, I believe that it is greatly overstated. I picked common factors as the reason therapy works... I've been corrupted by Yalom.

Mark

 

[Neuropsych2be]

Common factors are so powerful that although there is some contribution from the modality, I believe that it is greatly overstated. I picked common factors as the reason therapy works... I've been corrupted by Yalom.

Mark

I voted that both are factors are involved because the data suggests that for a limited number of conditions some approaches work better than others. However, I strongly believe in the Dodo bird effect. In fact I believe in it so strongly, I went out and got a pet Dodo bird. He is usually very well mannered and polite but he is a bit miffed at me for voting this way. So to placate him, I just fed him some shredded articles by David Barlow. He finds them delicious if somewhat lacking in nutrition.

 

[ClinPsycMasters]

Common factors are so powerful that although there is some contribution from the modality, I believe that it is greatly overstated. I picked common factors as the reason therapy works... I've been corrupted by Yalom.

Mark

Yes, Yalom has some good writings though I'm not particularly a fan of his existential therapy.

I was influenced by "The Heart & Soul of Change" by Hubble et al.

Again, I do like to emphasize that everything else being equal, the common factors--which as an author once mentioned are not so common--can greatly facilitate positive change. However, the particular sort of therapy given can have absolutely terrible consequences, not short of suicide, if we are to give everybody "prizes" and only ask the practitioner to be mindful of the common factors. It's fine if you're practicing CBT vs ACT, in my view, but energy therapy?!!

 

[justme08]

Which came first the dodo bird or the egg?

Maybe we need to have one therapist conduct therapy A with people for one disorder only. It will take a while😉 but we could work our way through several therapies only looking at one disorder at a time. With each method of therapy only one therapist, experienced in the method being tested at each time, will be used ...

And, then years and years later the question still won't be definitively solved.

 

[ClinPsycMasters]

Often enough people who practice particular sort of therapy or research it, have a vested interest in it. This particularly applies to founders of certain type of therapy, people like Beck or Ellis. They constantly promote the particular therapy that they have developed, through articles, books, talks, and research. It is not very often that founder/proponent of X publishes studies that seriously question the foundation of X. Freud was no different except that in his time, case studies--not double blind experiments-- were all the rage.

 

[PsychGraduate]

I voted for "in the middle" because I think both have a role to play.

That said, while I believe common factors have an important role to play, I think the dodo bird has gotten blown way out of proportion. I'm sick of seeing it used to justify doing treatments there is virtually no good evidence for (e.g. long term psychodynamic treatments for OCD). I'm sick of people citing the literature without actually reading it critically (see it all the time on this board and in the peer-reviewed literature). There are a lot of problems with the common factors literature, so I'm not sure why the dodo bird seems to have been elevated to "fact" in so many programs when it has as many or more weaknesses relative to any other literature. Many of the papers insist on collapsing across diagnoses. Wampold is the only one I've seen even try to explain why, and his reasoning seemed completely nonsensical to me. A substantial portion of the common factors support did a very poor job of establishing causality (e.g. it is unclear if alliance causes positive outcomes, or is a result of positive outcome, because both were measured at the same time). I could go on about it, but I'll stop there.

CBT or ABA for OCD but I like psychodynamics for OCPD with CBT components.

 

[PsychGraduate]

Yes, Yalom has some good writings though I'm not particularly a fan of his existential therapy.

I was influenced by "The Heart & Soul of Change" by Hubble et al.

Again, I do like to emphasize that everything else being equal, the common factors--which as an author once mentioned are not so common--can greatly facilitate positive change. However, the particular sort of therapy given can have absolutely terrible consequences, not short of suicide, if we are to give everybody "prizes" and only ask the practitioner to be mindful of the common factors. It's fine if you're practicing CBT vs ACT, in my view, but energy therapy?!!

Some ET is quite good for the client.

 

[ClinPsycMasters]

CBT or ABA for OCD but I like psychodynamics for OCPD with CBT components.

Yeah, treating personality disorders without addressing the psychodynamics won't get you that far.

 

[ClinPsycMasters]

Some ET is quite good for the client.

Are you seriously advocating energy therapy?!

 

[PsychGraduate]

Are you seriously advocating energy therapy?!

I meant Existential Therapy.

 

[ClinPsycMasters]

I meant Existential Therapy.

I was like this is interesting, a grad student who knows the relevant research supporting energy therapy. I mean I'll give nearly everything a chance and wanted to engage you in a discussion. My next question was how does it feel when you're transferring energy as you are moving your hands over someone's body? 🙂