Evidence of Potentially Harmful Psychological Treatments for Children and Adolescents

This paper applies the concept of potentially harmful psychotherapies (PHTs; Lilienfeld, Perspectives on Psychological Science 2(1):53–70, 2007) to concerns about potentially harmful treatments for children and adolescents (PHTCs). I propose that such treatments can be identified by methods derived from the Adverse Childhood Experiences (ACE) Study and from the NIS-4 study of abuse and neglect, as well as by their plausibility or congruence with established child development theory and research. Five psychological treatments for children and adolescents that have been reported as harmful are examined, using evidence from published materials, journalists’ reports, legal documents and Internet sites. Details of treatment and outcomes are compared to relevant ACE and NIS-4 criteria and to plausibility, and empirical support for the treatments is examined. The examined treatments use methods that would be considered adverse childhood experiences or abusive or neglectful care events if they occurred outside a therapeutic setting. Most, but not all, lack empirical support of effectiveness and are incongruent with established information about child development. Risks associated with PHTCs can thus be identified through close examination before children are exposed to them and harmed. Prevention or reduction of PHTC use may be possible. Public and professional education about PHTCs are essential parts of child protection in this context and are arguably an ethical obligation of both social workers and psychologists.