Science and Pseudoscience in Clinical Psychology, Part II PSYC 4500: Introduction to Clinical Psychology Brett Deacon,

1. Science and Pseudoscience in Clinical Psychology, Part II PSYC 4500: Introduction to Clinical PsychologyBrett Deacon, Ph.D.September 5, 2013

2. From Last Class • Why science matters in clinical practice • Case of Candace Newmaker • Science and pseudoscience in Wyoming • Barriers to acceptance of science-based practices among clinicians

3. A Dialogue in the Relevance of Science to Clinical Practice • Read and discuss handout

4. Questions for Pignotti (2007) paper 1. Do anecdotal observations of client improvements in TFT, or the personal experience of improvement when undergoing TFT oneself, constitute scientific evidence of its effectiveness? Why or why not? 2. What mechanisms are in place in TFT to prevent its underlying theory, and its apparent effectiveness, from being falsified? 3. In response to criticisms of TFT, Callahan did not produce data supporting his treatment but instead suggested skeptics try it for themselves so they could see how well it worked. Should honest scientists take him up on this offer? Why or why not?

5. Pseudoscience withVeterans in Wyoming • Equine therapy affiliated with the Cheyenne VA Hospital • http://www.steppingstonefarms.org/ssf/index.php?option=com_content&view=article&id=7&Itemid=5 • “Our Equine Assisted Therapy Program involves equine activities set up and facilitated by a licensed mental health professional and a horse professional. These activities are most often performed on the ground (rather than riding), and include such things as grooming, feeding, haltering and leading the horse. During the process of working with the horse, the therapist and veteran engage in talk therapy, processing feelings, behaviors and patterns. The ultimate goal for the client is to build skills such as personal responsibility, assertiveness, non-verbal communication, self-confidence, and self-control.” • “Equine assisted therapy is thought to be an effective short-term therapeutic approach for both individuals and families, addressing a number of mental health problems, including behavioral issues, depression and anxiety, low self esteem, eating disorders, ADD/ADHD, post traumatic stress disorder, and relationship problems. While there is a need for research to support anecdotal evidence of the effectiveness of Equine assisted psychotherapy, this type of animal assisted therapy is slowly gaining support among mental health professionals.”

6. What’s the Process Through Which Equine Therapy Improves Anorexia? Distorted body image Binging and purging Emotion regulation problems Recovery from Anorexia?

7. Equine Therapy • “Animal-assisted therapy has shown evidenced-based efficacy in patients including war veterans with PTSD, depression, anxiety, attention-deficit/hyperactivity disorder, conduct disorders, dissociative disorders, and other chronic mental illnesses.” • http://www.steppingstonefarms.org/ssf/index.php?option=com_content&view=article&id=7&Itemid=5 • PSYCINFO search for “equine therapy” yielded 13 hits • PSYCINFO search for “hippotherapy” yielded 25 hits • Some support for use by physical therapists and related professionals for persons with physical disabilities • Not a single empirical study on effectiveness for mental health problems

8. Equine Therapy • Effective, evidence-based psychotherapies exist for these problems • Should equine therapy be used instead? If so, under what circumstances? • Do you think veterans who are referred for participation in equine therapy are accurately informed about the scientific status of equine therapy, as well as the existence of these alternative, evidence-based psychotherapies? • Is it ethical for therapists not to provide this information? Should there be consequences?

9. Why This Topic Matters: Potential Costs of Pseudoscientific Practices • Direct harm • Opportunity cost • Wasted time, money, and effort that could have been better spent pursuing science-based practice • Reduced credibility of mental health profession (and professionals) • Comment from a former client

10. Reasons why Some Clinicians Don’t Engage in Evidence-Based Practice • Lack of training opportunities in EBP • Training that is antagonistic toward EBP • Belief that all therapies are equally effective • Belief that a good relationship is all that matters • Belief that research is inapplicable to clinical practice because all clients are unique individuals • Belief that research is inapplicable to clinical practice because research studies do not take place in real-world contexts • Belief that research is inapplicable to clinical practice because psychotherapy cannot be studied using the tools of science • Belief that clinical intuition is more valuable than scientific research in informing practice • Belief that clients do not want science-based treatment • Belief that research following the medical model is invalid • Belief that psychotherapy is an art, not an applied science