Spotlighting how psychologists have done harm to cast members and our obligation to do better

Quietly, without many realizing the extent, therapists have slowly infiltrated the reality television (TV) industry. A main reason is that awareness of the importance of mental health has increased, and consequently, so has psychologists’ presence on reality TV. There are many roles these providers can play, from “screening” cast members using psychological evaluations, to treating cast members on set, to even being featured on-screen, providing live therapy to cast members. And while I’d like to believe that the inclusion of clinical evaluations and on-set therapy was done with good intentions (at least the good intentions of the therapists who signed up for it), the truth is that the role of psychologists in this industry has become ethically murky at best, and undeniably unethical and requiring disciplinary action at worst.

I’m a clinical psychologist and founding board member of The Unscripted Cast Advocacy Network (UCAN) Foundation, a nonprofit dedicated to supporting reality TV cast members, educating the public about what happens in this industry, and advocating for the ethical production of reality TV shows. As Director of Mental Health Support, I’ve heard countless stories from former cast members about their experiences with therapists, from the evaluations used for casting, to on-set support therapists, to therapists who are part of the cast. These stories are upsetting and highlight the questionable role that the psychological profession is playing in this industry.

This is troubling, given how harsh the reality TV industry is towards the cast members that make its shows possible. Cast members are often required to sign restrictive (questionably legal) contracts, are subject to inhumane working conditions without basic needs met (e.g., lack of access to food or the restroom), are often unable to leave the show without permission from production, and have no control over how they are portrayed. As a result, more and more former reality TV personalities are speaking up about the significant mental health impact of being on these shows. They report depression, anxiety, trauma symptoms such as flashbacks and nightmares, identity crises, and some have even committed suicide. There is no question that being on reality TV is bad for one’s mental health, so we have to wonder, what’s the role of psychologists employed by these shows?

Many shows require a psychological evaluation, reportedly to ensure the show is casting people who are psychologically resilient. These evaluations can include numerous clinical interviews and standardized testing. For some shows, like the popular Netflix hit Love Is Blind, cast members sign a document agreeing they will not have access to the results of their psychological evaluations and another document waiving confidentiality, allowing the results to be shared with the show’s production team. This means cast members do not know what the tests indicate, such as if they have clinical anxiety that will likely worsen due to the strenuous environment of filming (which often includes limited sleep, lack of contact with friends/family, encouraged alcohol use, and restricted access to basic needs such as the restroom or food.) Cast members must trust the production team since they are unable to see their own psychological testing results. It’s not hard to see how problematic it is that cast members do not know what information the production team has at their disposal or how it will be used.

To demonstrate they are doing their due diligence to support cast members, many reality TV shows also claim to provide on-set support. These therapists are supposedly resources for cast members who are struggling. However, while some shows claim to have psychologists on staff, cast members across several shows have shared that they never knew a therapist was available and, even during extreme emotional distress, were not offered mental health support. Perhaps even more concerning is the shows that do have therapists available. Cast members have disclosed that they felt the on-set therapists were passing on information to the production team—information such as a cast member’s current anxiety that would be used to elicit certain emotional reactions or dramatic behavior later that day.

In the most generous view, therapists were trying to advocate for struggling cast members, and had no control over production choosing to use the information they received to push the cast members’ buttons and create more drama. I imagine this is probably what typically happens. But if there’s a chance that therapists are feeding sensitive information to production, knowing that it will be weaponized to exploit those cast members, this is inexcusable and a clear violation of the APA’s Ethics Code to do no harm. Further, if a psychologist was operating under the harm reduction model, attempting to alleviate some suffering in a generally difficult environment, once they witnessed how their presence was used to intentionally do harm to cast members, they should have immediately terminated their position and sounded the alarm to our profession.

Despite psychologists becoming increasingly involved in shows, most people do not know the concerning practices of therapists in this industry. Since reality TV is largely unregulated, rife with aggressive non-disclosure agreements that prevent people from openly talking about their experiences, even the American Psychological Association (APA) does not know the full extent of the ethical issues. Otherwise, they likely would have issued clear guidelines for how to practice ethically within this field. The only official comment I can find that touches on this issue is an APA article that states:

In the reality TV context, psychologists may be used in a very particular way, namely, to help demonstrate that a producer has exercised due diligence in the participant selection and rejection process. As you consider whether to engage in a media project, think through how success in the project will be defined by the various individuals and entities involved and explore how you fit into these definitions. Pay particular attention to how vulnerable individuals with whom you interact fit into this analysis. Put simply, ask yourself, “Who may get hurt if this project goes badly, and in whose interest does it lie to make sure that doesn’t happen?” (APA, 2008)

The advice and the proposed questions are on point, but how often are they followed? And, after witnessing the emotional anguish that contestants often suffer during and after filming, why aren’t all psychologists discontinuing their participation and advocating for clearer guidelines and regulations? From my conversations with cast members, psychologists involved in these shows are, intentionally or not, doing harm. The only way to truly ensure a therapist is practicing ethically in this industry is to provide clear guidelines. For example, details of psychological evaluations should be kept from production, and on-set therapists should be independent practitioners with decision-making power so they can protect cast members during times of emotional distress. Our profession has an obligation to assess, oversee, and regulate psychologists’ roles in this troubling industry, and I think it is time we do so.

References

American Psychological Association. (2008). Reflections on media ethics for psychologists: The media provide wonderful opportunities to educate the public, but also present psychologists with unique ethical challenges to consider. Monitor on Psychology, 39(4), 46. https://www.apa.org/monitor/2008/04/ethics