If they are better, why haven’t they been more widely adopted by mainstream medicine?
Part of it is that the effectiveness of therapy is often hard and slow to study, so it’s hard to get unambiguous evidence of one being better than another. E.g. many therapists, even if working within a particular school of therapy, will apply it in an idiosyncratic style that draws upon their entire life/job experience and also knowledge of any other therapy styles they might have. That makes it hard to verify the extent to which all the therapists in the study really are doing the same thing.
My impression is that CBT got popular in part because it can be administered in a relatively standardized form, making it easy to study. But that means that it’s not necessarily any better than the other therapies, it’s just easier to get legible-seeming evidence on.
Another issue is that therapy can often take a long time, and lots of the quantitative measures (e.g. depression questionnaires, measures of well-being) used for measuring its effects are relatively crude and imprecise and it can be hard to know exactly what one should even be measuring.
So overall it can just be relatively hard to compare the effectiveness of therapies, and particular ones get more popular more slowly, e.g. by therapist A hearing that therapist B has been doing a new thing that seems to get better results that A does and then getting curious about it. Or by word of mouth through therapy clients when a new approach is found that seems to work better than conventional therapies, as has been happening with IFS.
Why should a disinterested third party, without firsthand experience, recommend these therapies over CBT given the relative lack of evidence?
E.g. Other than those who practice them and their clients, do they have any reputable backers? Has it been shown by disinterested parties to work better on certain types of people? Is there any other source of evidence that backs the notion that they are predictably superior for at least a subset of the population?
I’m not sure if there is any reason that should be strongly persuasive to a disinterested third party, at the moment. I think the current evidence is more on the level of “anecdotally, it seems like a lot of rationalists and EAs get something out of things like IFS”.
But given that one can try out a few sessions of a therapy and see whether you seem to be getting anything out of it, that seems to be okay? Anecdotal evidence isn’t enough to strongly show that one should definitely do a particular kind of therapy. But it can be enough to elevate a therapy to the level of things that might be worth giving a shot to see if anything comes out of it.
Part of it is that the effectiveness of therapy is often hard and slow to study, so it’s hard to get unambiguous evidence of one being better than another. E.g. many therapists, even if working within a particular school of therapy, will apply it in an idiosyncratic style that draws upon their entire life/job experience and also knowledge of any other therapy styles they might have. That makes it hard to verify the extent to which all the therapists in the study really are doing the same thing.
My impression is that CBT got popular in part because it can be administered in a relatively standardized form, making it easy to study. But that means that it’s not necessarily any better than the other therapies, it’s just easier to get legible-seeming evidence on.
Another issue is that therapy can often take a long time, and lots of the quantitative measures (e.g. depression questionnaires, measures of well-being) used for measuring its effects are relatively crude and imprecise and it can be hard to know exactly what one should even be measuring.
So overall it can just be relatively hard to compare the effectiveness of therapies, and particular ones get more popular more slowly, e.g. by therapist A hearing that therapist B has been doing a new thing that seems to get better results that A does and then getting curious about it. Or by word of mouth through therapy clients when a new approach is found that seems to work better than conventional therapies, as has been happening with IFS.
Why should a disinterested third party, without firsthand experience, recommend these therapies over CBT given the relative lack of evidence?
E.g. Other than those who practice them and their clients, do they have any reputable backers? Has it been shown by disinterested parties to work better on certain types of people? Is there any other source of evidence that backs the notion that they are predictably superior for at least a subset of the population?
I’m not sure if there is any reason that should be strongly persuasive to a disinterested third party, at the moment. I think the current evidence is more on the level of “anecdotally, it seems like a lot of rationalists and EAs get something out of things like IFS”.
But given that one can try out a few sessions of a therapy and see whether you seem to be getting anything out of it, that seems to be okay? Anecdotal evidence isn’t enough to strongly show that one should definitely do a particular kind of therapy. But it can be enough to elevate a therapy to the level of things that might be worth giving a shot to see if anything comes out of it.