> And many of them are being bilked as well. The fitness industry is notoriously filled with hucksters and scams, and "trainers" rarely have any real training in kinesiology or exercise science.

Many people are being bilked for almost any service one might name. There are tons of products and services with no defined stop point (heck, pretty much the entire CPG category is for products and services with no defined stop point). There are tons of products & services where the vast majority of customers are unable to discern if they are being scammed or not. Heck, when you order sushi there's notoriously a far from trivial chance that you're not getting the fish that you thought you were getting. We don't think of restaurateurs as being hucksters and scam artists (some no doubt are, but it's ridiculous to paint them all with the same brush).

My point isn't that it's impossible that they are being bilked. It's that there are all kinds of products & services that people get with no defined stop point, where customers could unknowingly be scammed, but we don't consider that to be evidence that they are being bilked. There are products and services that are beneficial for the customer even if there is no defined problem and no defined end point.

For your typical customer, spinning class isn't a class you go to until you achieve some goal. It's a service provided to help you do exercise you no doubt wanted to do anyway, in a community/context that you wanted to do it in, with the guidance of someone who ostensibly knows how to structure the process better than you do. You could very well do the spinning all by yourself, or you could organize a spinning class on your own, but you pay the professional because you expect to get better results without expending as much time or energy yourself.

Sure, there are people who claim that, if you just take the spin class, you will lose 100 lbs or become an Olympic athlete, and those people are absolutely hucksters and scam artists. There are people that will tell you that voting for the right/wrong politician will change your life (either for the better or worse). There are people who will tell you that buying gold will ensure financial security and make you a fortune. There are scams about buying jewelry. There are investment funds that claim to be able to consistently beat the market, or that will protect your money through any market collapse... and in all those cases there's no defined stop point. The product is the prop, not the scam. Sure, in the context of the scam the prop isn't worth it, but that doesn't mean anyone offering the prop is scamming you. Physical training services, votes, gold, jewelry, investment funds, etc. aren't all bunk.

> Once a year for a health checkup. Is that the norm for therapy?

So now it's the frequency that's the issue, rather than not having a defined stop point?

> The more involved answer is that "mental health" is not well-defined, so it's not developing anything.

That's your answer. That's not my answer, and it's not the answer.

> The best analogy for psychiatric therapy is physical therapy for recovering from an injury or surgery, except physical therapy has a well-defined end condition, which is when you understand how to do the exercises yourself.

I don't think you appreciate how limited your perspective on this is. Not everything is a problem that can be fixed.

This presumes that the only possible physical therapy service is education. My mother suffers from late-stage dementia. She is at risk for falling whenever she walks, and performing more involved physical activities absolutely requires guidance. It is literally impossible to educate her out of this situation, so the only stop point for the service is death. While family does sometimes provide these services for her, there's little doubt that the professionals we hire to provide these services for her are able to do the job better and more consistently than we can; there's little doubt that she is physically and mentally healthier as a consequence of their services, and that her physical & mental health would begin to decline within days of terminating those services. Now, I don't know that their particular form of physical therapy is empirically valid, and I guess they could be scamming us, but in the vast majority of cases, providing these services is not a scam. It's offensive to claim otherwise.

Now, my sister-in-law has the reverse situation: she has a physical problem and requires mental health services. She suffers from COPD that will kill her unless something else gets to her first. Above and beyond the physical condition, it is very hard for her to cope with it mentally. Again, family provides her with support, but it's not enough. She employs a mental health therapist to address her anxiety, depression and suicidal ideation. There's maybe some feint hope that the therapist will educate her to a state where she no longer experiences suicidal ideation, but nobody expects the anxiety & depression to go away, because COPD is an anxiety and depression invoking condition... a well educated, rational, COPD patient can be anxious and depressed. You could say that, with or without professional service, the failure rate is nearly 100% (helpful to consider in the context of comments about the failure rate for mental health therapy). So there's no defined stopping point for the therapy short of death. In this particular case, it's a CBT therapist, but even if it wasn't, what she needs is more than education; she needs support. While we can't rule out that she's being scammed, in the vast majority of the cases, providing these services is not a scam. It's offensive to claim otherwise.

> The more involved answer is that "mental health" is not well-defined, so it's not developing anything.

I'll try one last metaphor:

Nutrition is not well defined. We have broad ideas about what is and isn't good for you, but the specifics of what is "good nutrition" are variable & contextual; while one can have well defined nutritional goals, many people do not. There's a ton of "nutritionists" who have no formal training, who don't exercise science. There are short order cooks with no formal training, who don't exercise science. If a grocer has formal training, it is far more likely in business or marketing than anything involving nutrition. There is no defined stop point where you no longer need food. There are plenty of scams involving nutritional guidance or foods (just the categories "health food" and "diet plans" are littered with scammers). Despite all that, there is no compelling argument that restaurants, chefs, grocers, or other nutritional services are intrinsically scammers. I'm pretty sure that, if I don't eat, my health will deteriorate, and I have a hard time believing that a professional either guiding my nutritional choices or outright providing nutrition for me is intrinsically scamming me. They could well be providing me a valuable service where I get better nutrition with less time and effort than if I tended to it without them.

I get it. You are convinced therapy is intrinsically a scam, and part of the reason for that is most customers for therapy cannot reliably discern if they are being scammed or not. I'm far from an expert on the subject, so for all I know, you are right. However, the arguments you are presenting are not compelling arguments.