• Many therapies have been tested in controlled clinical trials and found to be safe and effective for the treatment of specific problems. See the below list for some specific examples.
• Some other therapies, such as memory recovery therapy, are so obviously harmful that it would be unethical to conduct a prospective controlled clinical trial on human subjects, but retrospective studies of patient case histories compared to randomly selected control cases have clearly shown the therapy to be harmful.
• Many--perhaps most--therapies fall into a gray area in between. Because these therapies have never been tested for safety and effectiveness, we simply don't know whether they are safe or unsafe and whether they are effective or ineffective. Such untested therapies are very similar to untested medications. We don't know whether they will help, harm, kill, or do nothing at all besides wasting the client's time and money. It's sad that so many therapists are willing to risk their patients' health by exposing them to therapies that have never been tested, and that such therapists are willing to cash checks and profit personally by doing this while doing nothing to push for industry reforms and research to solve the problem.

• Some therapists may be genuinely ignorant of the last thirty years of research and be basing their practice on whims, improvisation, "clinical experience" uninformed by research and lacking controls, or nineteenth century essays by Freud.
• More commonly, such therapists don't want to admit to themselves that some therapies have been tested and found to be safe and effective because if they do, they will be forced to admit that their own pet therapies may be less safe and less effective because they have no basis in science and no evidence for safety and effectiveness. Therapists in denial! If it weren't so tragic, it would be funny!
• Finally, some therapists may know full well that some therapies have been tested for safety and effectiveness, yet be consciously lying about this when asked because they enjoy the freedom of today's therapeutic anarchy and fear the rigor and discipline that will come from subjecting their industry to the rule of science.

Therapies can be tested for safety and effectiveness, and they should be. Prescribing therapies that haven't been tested for safety and effectiveness is just as dangerous as prescribing medicines that haven't been tested for safety and effectiveness, and just as unethical. The disastrous and widespread effects of the lobotomy fad of the 60s and the memory recovery fad of the 80s and 90s are the proof. Until all therapies are tested for safety and effectiveness and all therapists refuse to apply therapies that haven't been tested, there's no reason to think that patients and their families won't be devastated by future fads as well.

In case you ever meet a therapist who is so ignorant, incompetent, or unethical as to claim that therapies can't be tested for safety and effectiveness, refer them to this partial list. Ask the therapist whether the therapies they use have been tested for safety and effectiveness, and if they haven't, ask why.
 

• Beck's cognitive therapy for depression: Dobson (1989)
• Behavior modification for developmentally disabled individual: Scotti et al (1991)
• Behavior modification for enuresis and encopresis: Kupfersmid (1989); Wright & Walker (1978)
• Behavior therapy for headache and for irritable bowel syndrome: Blanchard et al. (1987); Blanchard et al. (1980)
• Behavior therapy for female orgasmic dysfunction and male erectile dysfunction: LoPiccolo & Stock (1986); Auerbach & Kilmann (1977)
• Behavioral marital therapy: Azrin, Bersalel et al. (1980); Jacobson & Follette (1985)
• Cognitive behavioral therapy for chronic pain: Keefe et al. (1992)
• Cognitive behavior therapy for panic disorder with and without agoraphobia: Barlow et al. (1989); Clark et al. (in press)
• Cognitive behavior therapy for generalized anxiety disorder: Butler et al (1991); Borkovec et al (1987); Chambless & gillis (1993)
• Exposure treatment for phobias (agoraphobia, social phobia, simple phobia) and PTSD: Mattick et al. (1990); Trull et al. (1988); Foa et al. (1991)
• Exposure and response prevention for obsessive compulsive disorder: Marks & O'Sullivan (1988); Steketee et al. (1982)
• Family Ed. programs for schizophrenia: Hogarty et al (1986); Falloon et al. (1985)
• Group cognitive behavioral therapy for social phobia: Heimberg et al. (1990); Mattick & Peters (1988)
• Interpersonal therapy for bulemia: Fairburn et al. (1993); Wilfley et al. (1993)
• Klerman and Weissman's Interpersonal therapy for depression: DiMascio et al. (1979); Elkin et al. (1989)
• Parent training programs for children with oppositional behavior: Wells & Egan (1988); Walter & Gilmore (1973)
• Systematic desensitization for simple phobia: Kazdin & Wilcoxin (1976)
• Token economy programs: Liberman (1972)

• Applied relaxation for panic disorder: Ost (1988); Ost & Westling (1991)
• Brief psychodynamic therapies: Piper et al (1990); Shefler & Dasberg (1989); Thompson et al. (1987); Winston et al. (1991); Woody et al. (1990)
• Behavior modification for sex offenders: Marshall et al (1991)
• Dialectical behavior therapy for borderline personality disorder: Linehan et al. (1991)
• Emotionally focused couples therapy: Johnson & Greenberg (1985)
• Habit reversal and control techniques: Azrin, Nunn & Frantz (1980); Azrin, Nunn & Frantz-Renshaw (1980)
• Lewinsohn's psychoeducational treatment for depression: Lewinsohn et al. (1989)

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