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Jonathan Shedler

@jonathan-shedler · 6 positions · 0 changes of mind

Clinical psychologist and clinical professor of psychiatry at UCSF. Author of the 2010 meta-analysis that established psychodynamic therapy as an evidence-based treatment, and a persistent critic of how the phrase "evidence-based therapy" is used.

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  1. Our reading

    When institutions can only offer compromised care they end up calling it best practice, and the patients who do not get better conclude that they themselves are beyond help.

    Their wordsWhen patients don't get the help they need, they don't come away thinking, I didn't get good treatment. They come away thinking, I am too broken to be helped. They leave more hopeless and demoralized than when they came. That is harm.

    ↗When Compromised Care Becomes "Best Practice"jonathanshedler.substack.com

    Psychotherapy

    Interesting
  2. 5 weeks earlier

  3. Our reading

    Telling a patient "your feelings are valid" is not therapy: it is the mirror image of "get a grip", and it makes the therapist a judge of feelings instead of a companion in them.

    Their wordsThe phrase "your feelings are valid" does not invite curiosity or deeper self-understanding, which is the point of psychotherapy. It is the mirror image of "stop whining and get a grip." One sounds warm and one sounds harsh, but neither deepens self-awareness.

    ↗Skilled Therapists Don't Say "Your Feelings Are Valid"jonathanshedler.substack.com

    Psychotherapy

    Interesting
  4. 9 years earlier

  5. Our reading

    The APA's trauma treatment guidelines should be ignored, because they rest only on trials of therapies too brief to have worked.

    Their wordsThe American Psychological Association (APA) just issued guidelines for treating trauma. Patients and therapists would be wise to ignore them.

    ↗Selling Bad Therapy to Trauma Victimspsychologytoday.com

    AmericaPsychotherapyTrauma

    Interesting

  7. Our reading

    Psychotherapy follows a dose-response curve: it takes more than 20 sessions before half of patients meaningfully improve, and more than 40 before three quarters do.

    Their wordsIt takes more than 20 sessions, or about six months of weekly therapy, before 50 percent of patients show meaningful improvement. It takes more than 40 sessions for 75 percent of patients to show meaningful improvement.

    ↗Selling Bad Therapy to Trauma Victimspsychologytoday.com

    Psychotherapy

    Interesting
  8. 4 years earlier

  9. Our reading

    "Evidence-based therapy" is a branding term rather than a scientific one, and in practice it is a code word for "not psychodynamic".

    Their wordsThe term "evidence-based therapy" is also, de facto, a code word for "not psychodynamic."

    ↗Evidence-Based Therapy: Science or Marketing?psychologytoday.com

    PsychotherapyPsychodynamic therapy

    Interesting

  11. Our reading

    No research ever showed manualized CBT to be more effective than psychodynamic therapy; it was only studied more often.

    Their wordsNo research ever suggested that manualized CBT was more effective than psychodynamic therapy. It was just more often researched. There is a world of difference between saying a treatment is less often researched and saying it has been scientifically discredited.

    ↗Evidence-Based Therapy: Science or Marketing?psychologytoday.com

    PsychotherapyPsychodynamic therapyCBT

    Interesting