Pseudoscience in Clinical Psychology

1. Pseudoscience in Clinical Psychology By Elise Simonds

2. Clinical Psychology: • Concerned with the nature, diagnosis, classification, treatment, and prevention of mental disorder and disabilities

3. Psychology is a Science(or should be one) • Just like any other science, they employ the scientific method when testing a hypothesis or a theory • Falsifiable • Replicable • Testable • Lacking in bias • But there are a lot of other psychologists who give us a bad name

4. Deeper look at: • Facilitated Communication (FC) for autistic children • Questionable Psychological Assessment Techniques • St. John’s Wort and Other Herbal Treatments for Psychological Disorders

5. Facilitated Communication (FC): • Used for individuals with Autism and other disorders that severely effect their ability to communicate with others. • Autism: • a disease which causes verbal, communicative, and relational problems • Onset is 2 years old • Usually, communication is completely absent

6. Facilitated Communication (FC): • To help autistics communicate • Involves initial hand-over-hand and/or arm support, pulling the hand back after each selection, slowing down the movements, assistance in isolating the index finger, verbal reassurances, and encouragement • How do we know the facilitators are only supporting rather than influencing what the patient is typing? • Could be conscious or unconscious • Regardless of empirical support, it became very popular in the 90’s and has not subsided • Last week’s People Magazine ran an article supporting its use

7. Facilitated Communication (FC):Research • Studies on FC present pictures, movies, objects, or verbal questions to see if patients can type in correct answers • Most studies attempt to prevent the facilitator by influencing responses by keeping him uninformed of the stimulus or task’s goal: • Ask patient questions, but not the facilitator  incorrect answers • Present questions or information in the absence of the facilitator  no correct responses • Use a table divider to compare trials when the facilitator cannot see stimulus to trials when he can see stimulus  incorrect responses • Compare trials where facilitator provides no help, hand-over-hand assistance without prevention of errors, and hand-over-hand assistance with prevention of errors  correct only when facilitator was aware of the stimulus and full support was provided • Some cases have even described children who get correct answers without attending to the keyboard or the stimulus!

8. Facilitated Communication (FC): Obviously no paying attention to what he’s doing, so how can he possibly independently produce correct answers?

9. Facilitated Communication (FC):The Supporters’ Side of the Story • These studies were done in a lab where performance was compromised due to the unfamiliar environment • Studies done at two children’s schools disproved this argument • The Facilitated Communication Institute at Syracuse University claims “There is empirical research to support the validity of FC:” • “Controlled studies (e.g. Intellectual Disabilities Review Panel, 1989; Calculator & Singer, 1992; Vazquez, 1994; Weiss, Wagner & Bauman, in press), observational studies (Biklen, 1990 and 1993; Attwood & Remington Gurney, 1992; Biklen, Saha & Kliewer, 1995) and autobiographical accounts (e.g. Eastham, 1992; Oppenheim, 1974; Nolan, 1987; and Crossley & McDonald, 1980) provide evidence that the method works.” • “The method may be useful for any individuals who cannot speak or whose speech is highly echoed or in other ways limited and who cannot point independently *and* reliably. But we have not selected a random group of people classified as autistic or developmentally disabled and tried the method with them, so we cannot say with what percentage it might work.” (Biklen, 2005) • They can’t even state with confidence that it works!! • They’re openly admitting to a serious lack of empirical data on their part!!

10. Conclusion: Does FC Work?NO!

11. Psychological Assessment Tests: • Used by psychologists to measure personality and psychological functioning • Two kinds: • Projective Tests – present an ambiguous stimulus and asked a series of open-ended questions • Self-Report Inventories – a statement is made and you must indicate if you agree it is true for you • To gain acceptance as scientifically sound assessments, they must meet the following criteria: • Standardization – of test so results can be replicated by any other assessor • Reliability – internal consistence, inter-rater reliability, and retest reliability • Validity – measures what it claims to measure • Norms – cutoff scores to determine the meaning of the test results

12. Psychological Assessment Tests:TheRorschach Inkblot Test • Projective test • Shown ten cards and asked what you see • Assessors focus on: • The nature of what is seen • What aspects of the card are used in the responses • The sequence of responses given during testing • The examinee's nonverbal reactions to the inkblot

13. Psychological Assessment Tests:TheRorschach Inkblot Test • Does it measure up? • Standardization – Yes & No; Exner developed a system (The Comprehensive System) to ensure standardization, but many do not use it • Reliability – No; inconclusive results • Validity – No; some scales may be valid, but overall there is no correlation between it and other more supported tests of personality and psychological functioning • Norms – No; good norms set for the different age groups, but not for minorities who tend to score differently • Conclusion: insufficient scientific evidence to justify the continued use of the test in clinical settings

14. Psychological Assessment Tests:Myers-Briggs Type Indicator (MBTI) • Self-report inventory • 126 M.C. questions based on Jungian personality theory • Classifies people into 16 types which are used to identify personalities and make predictions for ideal job placement

15. Psychological Assessment Tests:Myers-Briggs Type Indicator (MBTI) • Does it measure up? • Standardization – Yes; good when administered properly, but there are questions regarding the type cutoffs • Reliability – No; mixed results, more research is needed • Validity – No; no proof it makes accurate predictions • Norms – Yes; good norms set for both sexes, all ages, all occupations, and across minority groups and cultures • Conclusion: The MBTI lacks strong empirical support for its use and should not be heavily relied on for its predictive capabilities

16. Psychological Assessment Tests:Thematic Apperception Test (TAT) • Projective test • 31 picture cards used to reveal dominant drives, emotions, and conflicts of the personality • Conclusion: There may be a promising future for the TAT, but there is no support for it as it is currently employed

17. Psychological Assessment Tests:Projective Drawings • Projective test • Draw a person, a house, a tree and a person, or a family engaged in some joint activity • Among the ten most commonly used assessment strategies by clinicians • Measures psychological functioning, emotional intelligence, and intellectual functioning • Conclusion: Should not be heavily relied on due to their vulnerability to many weaknesses and errors in administration, scoring, and interpretation

18. Psychological Assessment Tests:Anatomically Detailed Dolls (ADDs) • A.K.A. anatomically correct dolls or anatomically explicit dolls • Projective test • Primarily used for young children with restricted cognitive and verbal skills to determine existence of sexual abuse • Conclusion: lack of support for the use of these dolls to screen for sexual abuse

19. Herbal Treatments for Psychological Disorders: • Becoming increasingly popular with the current trend towards natural, holistic, and ecological approaches to life • Used by about 12 to 42% of Americans • Not regulated by the FDA • Puts people at risk because the use of these treatments may stop seriously ill individuals from seeking medical attention • People assume that everything natural must be good and harmless, but this is not necessarily accurate

20. St. John’s Wort (hypericum): Used to treat depression Conclusion: Lacks strong empirical support and should not be used to replace traditional medicines Ginkgo Biloba: Claims to slow down aging process and to diminish the cognitive deficits of old age Conclusion: a look at the research renders mixed results, leading one author to conclude that although Ginkgo may slightly improve your memory, so will a candy bar Herbal Treatments for Psychological Disorders: • Kava Kava: • Used in rituals in the islands of the Pacific and as a relaxant • Conclusion: Inadequate research designs with questionable results has led to close scrutiny of its usefulness. Additionally, long term use has been reported to lead to severe liver damage and liver failures

21. Conclusion: • Just because a professional psychologist or the media supports an idea does not mean they are necessarily correct • Unsupported theories and practices are frequently advertised as the newest answer to your biggest problems • If something sounds questionable or too good to be true, do your own research; pop-psychology is all around us