Psychology for Sale: The Ethics of Advertising Professional Services

Canadian Psychology, May 2004 by Shead, N Will, Dobson, Keith S

The major issue raised by Edwards is that advertising psychological services that have not yet been scientifically validated is a problem, in and of itself. While he acknowledges that innovation is necessary, he claims that promoting services that are not yet proven effective is potentially dangerous and thus unethical. In contrast, Poikolaincn (2000) suggests that "encouraging" results from small preliminary studies promote widespread use of a new intervention before a proper scientific investigation has been conducted. However, if a new service is never made known to the public, its effectiveness will never be challenged. Researchers are more likely to thoroughly investigate an intervention if it has notoriety as a publicly used service than if it has simply been proposed for further investigation. Researchers will always have a proclivity for finding scientific truth in controversial issues. If all interventions that have not been unequivocally proven to be effective are relegated to a "waiting list" for proper scientific investigation, separating effective from ineffective services will unfold at a very slow pace indeed.

Several arguments can be made against the use of treatments that only have preliminary empirical support. For example, Poikolainen (2000) criticized one treatment program because it reported a high success rate based on data that did not include a control group and did not include patients who dropped out of the program. It can be argued that advertising such treatment as proven highly effective is misleading. It also can be argued that the treatment has not been proven totally ineffective either. At the very least, this treatment appears to have demonstrated a placebo effect. Poikolaincn's argument concerning placebo treatments is that they should be "simple, safe and cheap" but "controversial treatments are often risky, expensive, exploited for purely commercial reason, interfere with other simultaneous treatments and delay effective treatment" (p. 1766). What if an advertised treatment with only preliminary empirical support is simple, safe, and cheap? What if the advertised treatment is the only treatment appealing enough to motivate an individual to seek treatment? In these instances, advertising preliminary results docs inform the public of a service's potential benefits. As long as the results are accurate, identified as preliminary in nature, and are not exploited for the purpose of commercial gain, there should he no advertising prohibitions.

While it is reasonable to discourage the advertisement of services that have absolutely no empirical support, it is not reasonable to prohibit advertisements that have found preliminary evidence to support claims. As long as there is some data available to support the claim being made, and as long as the data have some scientific grounding, the claim should not be banned. Intense scrutiny likely will follow the publication of advertisements with impressive claims. Allowing such claims to be made will promote good science and a more knowledgeable public. Recently, the Clinical Psychology Division of APA and the Clinical Psychology section of CPA have endorsed the development and promotion of empirically supported therapies, with explicit criteria for claims of efficacy (Dobson & Craig, 1998). It is argued, then, that psychologists should have the freedom (indeed, the obligation) to publish claims about the effectiveness of their services so that consumers may compare services and service providers.