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The therapy industry is big business indeed. The global psychotherapy industry is estimated to be worth $48 billion US. In the next 10 years, that’s expected to explode to $108 billion US. That’s a whole lot of lying down and complaining to some noddy.
But are we actually any the better for it? In just the decade to 2018, anxiety skyrocketed 134 per cent and depression 106 per cent.
A cynic might say that all that therapy is making us worse, not better.
And the cynic might well be onto something, as a study on Australian teenagers suggests.
Researchers in Australia assigned more than 1,000 young teenagers to one of two classes: either a typical middle-school health class or one that taught a version of a mental-health treatment called dialectical behavior therapy, or DBT. After eight weeks, the researchers planned to measure whether the DBT teens’ mental health had improved.
The therapy was based on strong science: DBT incorporates some classic techniques from therapy, such as cognitive reappraisal, or reframing negative events in a more positive way, and it also includes more avant-garde techniques such as mindfulness, the practice of being in the present moment. Both techniques have been proven to alleviate psychological struggles.
In other words, the gamut of therapy-speak gobbledegook. But did it alleviate their psychological struggles?
But what happened was not what [Lauren Harvey, a psychologist at the University of Sydney] and her co-authors predicted. The therapy seemed to make the kids worse. Immediately after the intervention, the therapy group had worse relationships with their parents and increases in depression and anxiety. They were also less emotionally regulated and had less awareness of their emotions, and they reported a lower quality of life, compared with the control group.
Most of these negative effects dissipated after a few months, but six months later, the therapy group was still reporting poorer relationships with their parents.
Maybe they should have just rocked out to Suicidal Tendencies’ classic, “Institutionalized”, the way we young folk did in the ’80s. We didn’t have therapy, but we had rock’n’roll. Tipper Gore and her coven hated it, but we were a hell of a lot happier.
Sometimes I try to do things, and it just doesn’t work out the way I wanted to
And I get real frustrated, it’s like, I try hard to do it and like I take my time,
But it just doesn’t work out the way I wanted to, it’s like I try real hard
But it doesn’t work out, and everything I do and everything I try, it never turns out
And it’s like, I need time to figure these things out
But, as Mike Muir found, There’s always someone there going: Hey Mike, you know, we been noticing you’ve been having a lot of problems lately. All Mike wanted was a Pepsi and just to be left alone to work it out himself, but they just kept bugging him.
They’re still at it. And they’re still not helping any.
These results are, well, depressing. Therapy is supposed to relieve depression, not exacerbate it. (And, in case it’s not clear, although it’s disappointing that the therapy program didn’t work, it’s commendable that Harvey and her colleagues analyzed it objectively and published the negative results.)
And, boy howdy, do they have a lot of negative results to choose from.
But for people who study teen-mental-health treatments, these findings are part of a familiar pattern. All sorts of so-called universal interventions, in which a big group of teens are subjected to “healthy” messaging from adults, have failed. Last year, a study of thousands of British kids who were put through a mindfulness program found that, in the end, they had the same depression and well-being outcomes as the control group. A cognitive-behavioral-therapy program for teens had similarly disappointing results – it proved no better than regular classwork.
DARE, which from the ’90s to early 2000s taught legions of elementary-school students 10 different street names for heroin, similarly had little to show for its efforts. (The curriculum has since been revamped.) The self-esteem-boosting craze of the ’80s also didn’t amount to much – and later research questioned whether having high self-esteem is even beneficial. Anti-bullying programs for high schoolers seem to increase bullying.
The reason Karl Popper made falsification a key criteria that distinguished genuine science from pseudoscience is precisely because his experience with psychologists was that they routinely do the opposite of object analysis. If their hare-brained ideas seemed to work, it proved them right; if they didn’t seem to work, it also proved them right, they argued.
Psychologists are still routinely playing that game.
These types of programs tend to flop for a lot of different reasons. In the case of the Australian study, the teens didn’t opt in to the intervention; they were signed up for it, class by class. But teens don’t like being told by adults how to think or what to do, even if it’s something that could benefit them, experts told me. The Australian kids were instructed to practice the DBT exercises at home, and those who did so had better outcomes, but only about a third practiced at least weekly. This could be considered low, but does anyone really enjoy doing their “therapy homework”? Especially when they have, you know, regular homework? “It’s just another thing they are required and asked to do without any input from them,” as Jessica Schleider, a psychologist at Northwestern University, puts it.
What’s more, these complex, therapy-adjacent concepts might confound young teens – the average age of the kids in the DBT study was just 13.5. And in order to make the program palatable to so many kids, the instructors might have had to dilute DBT beyond the point where it was actually helpful.
That slight rumbling sound is Popper trying to burst out of his coffin and beat these clowns to death with a hardcover copy of On the Interpretation of Dreams.
These vultures are raking in billions and making kids sadder and more suicidal than ever.
The consistent failure of these kinds of programs is troubling, because teen mental health is now considered a crisis – one that has so far resisted even well-considered solutions.
Has it occurred to anyone to maybe, just maybe, throw the programmes into the bin?
Just do what we used to do: lock yourself in your room and listen to some really heinous music, and rock it out of your system.
