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Mindful : February 2015
But as Lilienfeld and four colleagues explained in a 2014 paper in Perspectives on Psychological Science, dozens of cognitive biases ca n lead psychologists to err in t wo ways: therapists see client improvement where there may be none, or they attribute improvement to their inter- vention when in fact some- thing else is the cause. Surely a professional ther- apist ca n’t err on something so basic as whether a client improved. Guess again. In a 2005 study, 49 psychother- apists at college counseling clinics estimated that 91% of the 500-plus students they treated got better. In fact, when the students were (unbeknownst to the thera- pists) assessed by a standard, objective measure of sy mp- toms, only 40% had improved. The number who got worse was a remarkable 15 times greater than the therapists estimated. These huge misses in estimates of effectiveness reflect optimism bias. When clients get better, psychologists natura lly take credit, a bias that even creeps into published research. Take, for example, a 2007 study of people with severe depression. Researchers randomly assig ned volunteers to receive either cognitive- behavioral or interpersona l therapy. The verdict: both worked. But the study lacked a crucial third arm, a group that received no therapy. Piles of research show that a high percentage of depres- sion dissipates on its own, as people’s circumstances change or a life event lifts them out of the psychological abyss: A client experiencing unemployment or illness or divorce may improve when the impact of these events recedes or the situation turns around, but the clinicia n may erroneously attribute the improvement to treatment. Studies of patients with major depression have found that about half improve spon- ta neously, a nd that half of depressive episodes last less than 13 weeks. The longer someone is in therapy, the more cha nces she has for sponta neous remission, natu- ral healing, coping, or positive experiences to help her get better. As psychoana lyst Karen Horney wrote in 1945, “ Life itself still remains a very effective psychotherapist.” Consider some of the other cognitive pitfalls leading psy- chologists to take more credit than evidence supports. Naive realism—seeing is believing. A clinicia n who “sees the change with my own eyes” believes that’s sufficient to know a n inter- vention was effective. This is also an example of the post hoc, ergo propter hoc fallacy: just because improvement follows therapy doesn’t mea n therapy caused the improve- ment. Clinicians base their judgments of effectiveness on clients they see, but they don’t follow clients who drop out. Yet research shows that clients who are not improving are especially likely to quit. Psychologists tend to take credit for clients’ recoveries, but just because improvement follows therapy doesn’t mean therapy caused the improvement. 20 mindful February 2015 brain science Beginner’s Mind Zen Retreat Karen Maezen Miller April 17–19, 2015 Radical Responsibility: A Pathway to Personal Freedom, Self-Empowerment & Authentic Relationships Fleet Maull April 24–26, 2015 Mindful Self-Compassion Workshop Steven Hickman & Michelle Becker April 26–May 1, 2015 The Mindful Leader: How Mindfulness Meditation Cultivates Natural Leadership Talents Michael Carroll May 1–3, 2015 Mindful Communication: Living Compassionately with Others and Ourselves Dian Killian May 8–10, 2015 Introducing Connecticut’s Premier Retreat Center for Mindfulness and Contemplative Practice. copperbeechinstitute.org Offering more than 40 transformational retreats, professional trainings, and MBSR courses to help you live a life of compassion, calm, and true happiness.