[nickbarnwell]

Incredibly bearish. To summarise a few decades of common factors research poorly, our understanding of therapy's mechanism of action is limited, and it's not clear that any given technique or modality has superior curative power compared to another. The most important component is pantheoretical, the strength of the relationship between client and therapist. Alexa, Siri, et al. can not reliably determine whether I want the lights switched off in my bedroom or the living room, and we are seemingly decades away from the sort of strong AI required to hold meaningful conversations about the purpose of life or the nature of our interpersonal relationships. The Heart & Sould of Change is an approachable text on the topic if you're curious.

That's not to write it off completely; there have been adaptions of CBT and DBT into text and electronically-mediated forms that show promise among subclinical populations or as an adjunct to conventional therapy, but by and large a human is going to be necessary for a long, long time.

[citrablue]

My uneducated guess is that therapy's effective mechanism is related to the placebo effect. There is a line of thought that the placebo mechanism may be related to reduction in stress, because something else will take care of the problem.

If I go to a therapist, and they put time in to help me get better, my stress response decreases, and I feel better.

Completely made up, in case that wasn't obvious. But that's my guess.

[ndiscussion]

Sorry to be harsh, but given the replication crisis, we really don't need more made-up guesses on this.

If you are truly interested, try reading Trauma and Recovery by Judith Herman. Dense scientific book on just this type of thing.

[citrablue]

My point is that I believe even though very smart and dedicated people work in the field, and research it, the "state of the art" seems to be little more than opinion anyhow.

That is to say, it appears to me that even "dense scientific books" are either sharing opinionated descriptive analyses or just making this shit up.

While I can appreciate you trying to defend a field of research, I am also OK with keeping my own mental model of operation.

[wbl]

Dodo Bird Hypothesis is still in contention.

[q3PG23XiQKpZqpU]

Since here we are talking about placebo, I wonder if it has a meaning to say "placebo" when speaking about psychotherapy, since there is no "substance". Of course there is going to be a placebo effect as long as people think it's going to work. I think the point is that since in mild and moderate depression we have to choose between the placebo of a drug and the placebo of psychoterapy, let's choose the one with less side effects.

On the topic of placebo, I found Irving Kirsch's talk about anti-depressants vs placebo in depression [1] very interesting.

[1] https://www.youtube.com/watch?v=ISptt3CRAqc