Comments on: Therapy should come with a warning http://www.greythinking.com/2008/06/05/therapy-should-come-with-a-warning/ "being aware of your crap and actually overcoming your crap are two very different things." - christina, grey's anatomy Sat, 14 Jan 2012 23:26:18 +0000 hourly 1 http://wordpress.org/?v=3.1.2 By: behindthecouch http://www.greythinking.com/2008/06/05/therapy-should-come-with-a-warning/comment-page-1/#comment-53 behindthecouch Tue, 19 Aug 2008 10:09:43 +0000 http://greythinking.wordpress.com/?p=42#comment-53 Hi, I just wanted to say that I love this post. I agree with most of your points, especially #7! Too many people get in to therapy thinking it's a cure-all without knowing what they are really getting in to and a lot of therapists do little to help educate clients. I like the passion of your posts - you really believe what you are writing. Hi, I just wanted to say that I love this post. I agree with most of your points, especially #7! Too many people get in to therapy thinking it’s a cure-all without knowing what they are really getting in to and a lot of therapists do little to help educate clients. I like the passion of your posts – you really believe what you are writing.

]]> By: Flower Child http://www.greythinking.com/2008/06/05/therapy-should-come-with-a-warning/comment-page-1/#comment-48 Flower Child Thu, 10 Jul 2008 22:54:46 +0000 http://greythinking.wordpress.com/?p=42#comment-48 Your analysis is right on, especially #6 and #8. I always disliked having to go back to work after a session and having to remind the therapist which client I am, so much so that I've stopped therapy. I'd rather talk to a friend. Your analysis is right on, especially #6 and #8. I always disliked having to go back to work after a session and having to remind the therapist which client I am, so much so that I’ve stopped therapy. I’d rather talk to a friend.

]]> By: Jane Cawley http://www.greythinking.com/2008/06/05/therapy-should-come-with-a-warning/comment-page-1/#comment-52 Jane Cawley Mon, 09 Jun 2008 15:21:20 +0000 http://greythinking.wordpress.com/?p=42#comment-52 Right, the study didn't show very impressive results for any treatment. I didn't get the impression that the researcher thought the outcomes were good. To my mind it's just as important to find out what doesn't seem to work as to find out what does. I agree that toughest cases were excluded. It seems to me that in the real world very often people with AN do not have access to the IP or IOP until they are quite ill (they don't qualify for insurance coverage for that level of care early on.) It also seems likely to me even in the most treatable cases it makes a lot of sense to include treatment to get a handle on symptoms no mater what else is pursued. If you're interested in a comprehensive report on evidence based treatment you might want to look at this (though it's not especially cheering.) http://www.ahrq.gov/downloads/pub/evidence/pdf/eatingdisorders/eatdis.pdf Right, the study didn’t show very impressive results for any treatment. I didn’t get the impression that the researcher thought the outcomes were good. To my mind it’s just as important to find out what doesn’t seem to work as to find out what does.

I agree that toughest cases were excluded. It seems to me that in the real world very often people with AN do not have access to the IP or IOP until they are quite ill (they don’t qualify for insurance coverage for that level of care early on.) It also seems likely to me even in the most treatable cases it makes a lot of sense to include treatment to get a handle on symptoms no mater what else is pursued.

If you’re interested in a comprehensive report on evidence based treatment you might want to look at this (though it’s not especially cheering.)
http://www.ahrq.gov/downloads/pub/evidence/pdf/eatingdisorders/eatdis.pdf

]]> By: Grey House http://www.greythinking.com/2008/06/05/therapy-should-come-with-a-warning/comment-page-1/#comment-51 Grey House Mon, 09 Jun 2008 01:13:19 +0000 http://greythinking.wordpress.com/?p=42#comment-51 I agree that the above study shows how much more research needs to be done regarding AN treatment, and there are a few aspects of it that I would like to comment on. First, regardless of the other conclusions of the study, I think that this data is the most striking of all: "9% of the subjects had a very good outcome and a further 21% had improved considerably; 70% either did not complete treatment or made small or no gains." In other words, who cares which of the three therapies was best - 70% of those who participated made small or no gains! Moreover, if you read the exclusion criteria, it says that the researchers excluded people with "chronic, refractory course of anorexia nervosa." In other words, the study participants are supposed to be the non-chronic patients that in theory are the most treatable. Yet in this study 70% of these "most treatable patients" either dropped out or were not helped at all. Clearly, research needs to be done to figure out how to keep people in meaningful treatment. Furthermore, the researchers seem surprised that clinical management had the best outcome, but as someone who has been in treatment for an eating disorder, this does not surprise me at all. Clinical management sounds to me like the first phase of inpatient or intensive outpatient treatment - focus on the food and nutritional stabilization. Usually even with CBT, one sees a nutritionist on the side to deal with the food specific aspects of treatment. In short, what this study really shows is that a lot more work needs to be done to figure out how to keep individuals in treatment, and how to best integrate the nutritional aspect of treatment with therapy. I agree that the above study shows how much more research needs to be done regarding AN treatment, and there are a few aspects of it that I would like to comment on. First, regardless of the other conclusions of the study, I think that this data is the most striking of all: “9% of the subjects had a very good outcome and a further 21% had improved considerably; 70% either did not complete treatment or made small or no gains.” In other words, who cares which of the three therapies was best – 70% of those who participated made small or no gains! Moreover, if you read the exclusion criteria, it says that the researchers excluded people with “chronic, refractory course of anorexia nervosa.” In other words, the study participants are supposed to be the non-chronic patients that in theory are the most treatable. Yet in this study 70% of these “most treatable patients” either dropped out or were not helped at all. Clearly, research needs to be done to figure out how to keep people in meaningful treatment. Furthermore, the researchers seem surprised that clinical management had the best outcome, but as someone who has been in treatment for an eating disorder, this does not surprise me at all. Clinical management sounds to me like the first phase of inpatient or intensive outpatient treatment – focus on the food and nutritional stabilization. Usually even with CBT, one sees a nutritionist on the side to deal with the food specific aspects of treatment. In short, what this study really shows is that a lot more work needs to be done to figure out how to keep individuals in treatment, and how to best integrate the nutritional aspect of treatment with therapy.

]]> By: Jane Cawley http://www.greythinking.com/2008/06/05/therapy-should-come-with-a-warning/comment-page-1/#comment-50 Jane Cawley Sun, 08 Jun 2008 19:04:04 +0000 http://greythinking.wordpress.com/?p=42#comment-50 Interesting study comparing three different therapies for AN. Clearly we have a long way to go... http://ajp.psychiatryonline.org/cgi/content/full/162/4/741 Interesting study comparing three different therapies for AN. Clearly we have a long way to go…
http://ajp.psychiatryonline.org/cgi/content/full/162/4/741

]]> By: » Therapy should come with a warning http://www.greythinking.com/2008/06/05/therapy-should-come-with-a-warning/comment-page-1/#comment-49 » Therapy should come with a warning Thu, 05 Jun 2008 18:08:37 +0000 http://greythinking.wordpress.com/?p=42#comment-49 [...] wsws (reposted) wrote an interesting post today onHere’s a quick excerpt [...] [...] wsws (reposted) wrote an interesting post today onHere’s a quick excerpt [...]

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