Guevarra, D. A., Webster, C. T, et al. (2024).
Applied Psychology Health and Well-Being.
Abstract
Research suggests that placebos administered without deception (i.e. non-deceptive placebos) may provide an effective and low-effort intervention to manage stress and improve mental health. However, whether non-deceptive placebos administered remotely online can manage distress for people at risk for developing high levels of affective symptoms remains unclear. Volunteers experiencing prolonged stress from the COVID-19 pandemic were recruited into a randomized controlled trial to examine the efficacy of a non-deceptive placebo intervention administered remotely online on affective outcomes. COVID-related stress, overall stress, anxiety, and depression were assessed at baseline, midpoint, and endpoint. Compared with the control group, participants in the non-deceptive placebo group reported significant reductions from baseline in all primary affective outcomes after 2 weeks. Additionally, participants in the non-deceptive placebo group found the intervention feasible, acceptable, and appropriate for the context. Non-deceptive placebos, even when administered remotely online, offer an alternative and effective way to help people manage prolonged stress. Future large-scale studies are needed to determine if non-deceptive placebos can be effective across different prolonged stress situations and for clinical populations.
The article is linked above.
Here are some thoughts:
Non-deceptive placebos (NDPs) have shown promise as an effective and low-effort intervention for managing stress and improving mental health, even when administered remotely online. A randomized controlled trial examined the efficacy of NDPs on volunteers experiencing prolonged stress from the COVID-19 pandemic. The study found that participants in the NDP group reported significant reductions in COVID-related stress, overall stress, anxiety, and depression compared to the control group after just two weeks. The effect sizes were comparable to those seen in self-guided online cognitive behavioral therapy programs. Participants in the NDP group also reported high expectations of benefits and found the intervention feasible, acceptable, and appropriate for the context. These findings suggest that NDPs, even when administered remotely, can help moderately at-risk individuals manage their psychological health during prolonged stressful situations. The study's results are consistent with previous research showing positive effects of NDPs on affect-related outcomes. However, the researchers noted some limitations, including a small and demographically limited sample size, potential response bias, and the need for more diverse and larger-scale studies. Despite these limitations, the study highlights the potential of NDPs as a scalable, easily implementable secondary intervention to help prevent medium-risk populations from progressing to clinical levels of affective symptoms. Future research should focus on examining the efficacy of NDPs across different stress situations and for clinical populations, as well as investigating the mechanisms through which NDPs exert their effects.
I often think about psychotherapy's potential placebo effects (and how to possibly incorporate this into my informed consent to treatment). Psychotherapy's relationship to placebo effects is a complex and debated topic in the field of mental health. While psychotherapy shares some key mechanisms with placebos, such as the importance of patient expectations, the therapeutic alliance, and nonspecific factors like empathy and attention, it would be overly reductive to label psychotherapy as merely a placebo. Psychotherapy has specific, theorized mechanisms of action and has been shown in well-designed studies to outperform placebo controls, albeit sometimes by small margins. However, the similarities between psychotherapy and placebo effects highlight the importance of these "common factors" in treatment outcomes. Mental health professionals need to consider the potential placebo effects in psychotherapy.
