I've read your forum for years. I think that I have a question that I have never seen asked, or asked in this way. What are the ethics of getting a diagnosis, or conceptualization of a problem, entirely wrong and then treating it for years, despite new information, and despite the doubts of the patient? Of course the treatment would probably have little positive effect. Perhaps it might have a detrimental effect on the emotional health of the patient. Or, perhaps it might have a detrimental effect on the quality of life of the patient. What are the ethics of doggedly staying the course? What are the ethics of using an ineffective or unproven therapy? What are the ethics of failing to recognize the patient's observation, and invalidating it due either to ego, incompetence, or ignorance? There can only be so much "let the buyer beware." There are just too many types of therapies out there with little or no proven effectiveness other than testimonial proof at best, others that have been grand fathered in, still others that have been developed by people who have gained acceptence merely by being in the right place at the right time, and too many therapists, who despite their training are bound to do this. (Don't tell me that training and licensing is a way to ensure that this won't happen. It doesn't.) Furthermore, theories are attached to therapies, validating them. And theories can perpetuate a myth for years using evidence easily manipulated and subject to the social current and other prejudices to support them. One obvious theory now dicredited maintaining homosexuals are mentally ill comes to mind. Freud's beliefs about women. There are other endless debates, and certainly other givens that go unquestioned as true. Where does the responsiblity lie for the therapist, and the field of psychotherapy? Noting that a patient doesn't stay in bad or ineffective therapy isn't true. I'm not asking about legal issues. That's another topic.
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