Any psychotherapeutic approach should be performed cautiously, which is why throughout the United States psychotherapy cannot be practiced unless one is highly trained and licensed. However, certain approaches have been shown to be particularly harmful to clients and, if used at all, need to be conducted in controlled settings by highly trained therapists. Some approaches have been shown to be so harmful to clients that they have been deemed unethical by professional associations and illegal in some areas of the country. Although they have little in common with one another theoretically, attack therapy, psychedelic therapy, rebirthing, recovered memory therapy, and sexual orientation change efforts (SOCE) have all shown cause to be listed under the category of cautious, dangerous, and/or illegal practices.