If rationalists are trying to do therapy, they are competing with a field of tens of thousands of PhD-level practitioners with all the resources of the academic and health systems who have worked on the problem for decades.
Part of the “resources” is working inside a bureaucratic system where it’s necessary to spend a lot of time jumping through hoops. There’s another large chunk of time invested in intellectual analysis. Most of the people inside academia spend relatively little time in deliberate practice to build skills to do intervention. It’s not surprising to me to have outsiders outperform academia by a large margin.
Part of the “resources” is working inside a bureaucratic system where it’s necessary to spend a lot of time jumping through hoops. There’s another large chunk of time invested in intellectual analysis. Most of the people inside academia spend relatively little time in deliberate practice to build skills to do intervention. It’s not surprising to me to have outsiders outperform academia by a large margin.