Randomised controlled trials and unintended consequences: a cautionary tale from the world of psychotherapy

10 PRACTICAL DIABETES Vol. 39 No. 3 Copyright © 2022 John Wiley & Sons T are many reasons why I wanted to become a clinical psychologist. Among them, I distinctly remember watching the Oscar-winning film ‘Ordinary People’ when I was a teenager. At the heart of the film is perhaps the first Hollywood depiction of a therapeutic relationship, and, although fictional, the film captures the drama and power of psychotherapy. Watching it was both fascinating and emotional. In the 1990s when I began formal training, psychotherapy had become an acceptable and desirable way of addressing psychological distress and an attractive way of making a living. This sentiment is reflected in the common responses received whenever I told people I was training to be a psychologist. People would invariably say either, ‘Ooh, I would like to be a psychologist myself’, or, ‘I think everyone would benefit from a bit of therapy’. As I learned more, I realised that what makes psychotherapy effective is also what makes the profession appealing.