A WOMAN WHO HAD been married for 14 years called into Dr. Laura’s radio show. The woman says she recently realized that she has never loved her husband, and she informs Dr. Laura that she has told her husband that. The couple has received marriage counseling, but Dr. Laura tells the caller that counseling is useless because of her attitude, according to a YouTube recording of the episode. The conversation continues:

Dr. Laura: “What is your question for me?”
Caller: “What type of advice can you give me to try to…?”
Dr. Laura (interrupting): “Too late, too late, you were cruel.”
Caller: “At the time …”
Dr. Laura (interrupting again): “Try to make it up to him by just being nice every day. Maybe you’re just broken in the I-can-feel-compassion-for-someone department.”

In an episode of Dr. Phil’s television show that first aired on April 1, 2009, Dr. Phil spoke to a guest who was seeking help because she gets very angry at her children and sometimes hits them. His advice: “You can stop. You can stop because you do stop for other people … It’s not that you won’t, it’s just that you don’t….”

Participants in the Dr. Laura (Schlessinger) and the Dr. Phil (McGraw) shows seek help for a variety of personal problems, and the advice the hosts provide reaches a lot of people. Earlier this year Dr. Laura’s call-in show drew more than nine million listeners per week. At about the same time, Dr. Phil attracted roughly four million viewers per program. Yet neither host claims to practice psychotherapy. What is more, both Schlessinger’s and McGraw’s typical takes on people’s troubles are at odds with much of the psychological literature, which suggests that their recommendations are unlikely to work most of the time and might even do damage.

Although Schlessinger holds a California license in marriage, child and family counseling, her Ph.D. is in physiology, not psychology, making the use of “Dr.” as a qualification for giving personal advice misleading. McGraw has a psychology Ph.D. and was licensed as a psychologist in Texas until 2006, when he let his license expire.

Blaming the Victim
McGraw and Schlessinger are right to emphasize personal responsibility and discourage blaming others for problems. Yet they often take individual accountability to an extreme, implying that people are to blame for all their difficulties when, in fact, factors such as an individual’s genetic makeup, personal history and current circumstances may contribute significantly to psychological problems. Emphasizing personal control above all else can discourage people from identifying the external issues or situations that might be contributing to their problems and that might need to be addressed.

Another drawback of the Schlessinger and McGraw styles is their lack of empathy—a willingness to understand another person’s thoughts, feelings and struggles from that person’s perspective. Schlessinger typically spends only a few minutes with callers, frequently interrupting them and sometimes referring to their behaviors with derogatory terms, such as “stupid.” Her strongly worded advice is usually based on her socially conservative and religious views and often neglects many of the specific problems that the caller is facing. McGraw typically spends somewhat more time listening, but he comes to relatively quick conclusions about the causes of and solutions for his guests’ problems, again reflecting little appreciation for the complexities of people’s lives.

Recent research suggests that a lack of empathy is a handicap when trying to help people with psychological or social problems. In a 2002 quantitative review of numerous studies psychologist Arthur Bohart, then at California State University, Dominguez Hills, and his colleagues found a correlation between high levels of empathy in therapists and successful outcomes in their patients. In a 1992 study psychiatrist David Burns, then at the University of Pennsylvania School of Medicine, and his colleagues used advanced statistical techniques for distinguishing cause and effect and found that a therapist’s ability to empathize not only is correlated with a patient’s progress but also contributes to it. Empathy is the cornerstone of psychotherapy, both because therapists need it to provide useful and relevant guidance and because patients benefit from feeling truly understood.

Breeding Resistance
Instead of trying to understand their guests, Schlessinger and McGraw are often confrontational and directive, authoritatively telling people what to do or not to do with relatively little input from the recipients of their instructions. For example, Dr. Phil told a 19-year-old man who was considering marrying a 30-year-old woman with two children after a very short courtship: “You absolutely, unequivocally should not do this!”

However much the viewer might agree, numerous studies reveal that a directive therapist style leads many people to dig in their heels and may even worsen a situation or psychological problem. In 1985 psychologists Gerald Patterson and Marion Forgatch of the Oregon Social Learning Center concluded that directives from therapists who were coaching mothers to deal with difficult children triggered more resistant responses from the mothers than did a supportive approach involving gentle encouragement and belief in a child’s ability to change. In a 1993 study psychologist William R. Miller of the University of New Mexico and his colleagues found that therapists who used more directive and confrontational statements elicited more opposition from patients who were problem drinkers. In addition, the more directive the therapists were, the more the clients drank a year after the therapy.

Most psychotherapists know that merely telling people to stop their problem behaviors is rarely helpful, and indeed no data exist to show that anyone has benefited from Schlessinger’s or McGraw’s advice. After a thorough search of the research literature and the Internet, we could not find a single follow-up study of the participants, formal or informal.

Because Schlessinger’s and McGraw’s practices are unsubstantiated, we believe that these well-known hosts need to demonstrate that they are not causing harm. Calling what they do “entertainment” or “education” does not exclude them from this requirement. Both shows inaccurately portray how mental health professionals understand and help people. Most psychological problems do not simply reflect a lack of self-control and cannot be changed by simple directives. Believing that they can could lead millions of people to ignore important biological or social causes of their troubles and fail to seek effective treatments for themselves or others.