What’s wrong with Clinical Psychology

1. What’s wrong with Clinical Psychology • “It’s Important to have an open mind, but not so open your brains fall out. Those who dance are thought mad by those who hear not the music.

2. What’s wrong with Clinical Psychology • Kids today have it too easy • No one is preparing them to be adults.

3. What’s wrong with Clinical Psychology • Everyone needs to understand each other’s culture to do good therapy • “You got to be one to know one.”

4. What’s wrong with Clinical Psychology • Everyone’s on meds • Everyone gets the polio vaccine, could it be good that everyone is on meds?

5. Pseudoscience What it is Ad hoc hypotheses Confirmation Testimony/anecdotes Superficial science Gurus What it’s missing Self-correction Peer review Refutation Scientific base Limitations Empirical support Burden of proof

6. So what? Opportunity cost Bad reputation Undermine science Pseudoscience

7. PseudoscienceTable 10.1Psychological Treatments to Avoid Intervention Attachment Therapies Critical Incident Stress Debriefing Grief Therapy Suggestive Techniques for Recovering Memories DID – Oriented Therapy Peer Group Interventions for Conduct Problems Scared Straight & Boot Camp Facilitated Communication Potential Harm Death Heightened Risk of PTSD Heightened Risk of Depression Production of False Memories of Trauma Iatrogenic Induction of “Alters” Exacerbation of Conduct Problems Exacerbation of Conduct Problems False Accusations of Child Abuse

8. Go, You Longhorns! BRIDGING THE CANYON Chapter 12 of Janet Jones’ “The Psychotherapist’ s Guide to Human Memory” Presented by Gordon Bower

9. INTRODUCTION: Why is so much misinformation out there? • Partly due to unqualified authors of pop psych books and TV/Radio talk shows • Considerable “balkanization” of psychology into mutually ignorant sub-disciplines • The “canyon” between experimental and clinical studies of the mind only widens. • The recovered memory battles were only the most recent symptom of the breach.

10. THE CHASM IS BORN • Mental disorders were province of neurologists and psychiatrists in asylums and hospitals; “mental disease” medical model of disorder • New “scientific psychology” distanced itself from “psychical research” with quantitative measures • Lightner Witmer founded clinical psych-- mainly for learning and/or speech disorders, IQ tests. • Psychoanalysis accepted by psychiatrists but vehemently rejected by academic psychologists like Watson, Titchener, Cattell, Woodworth.

11. Clinical Biggies

12. Experimental Biggies

13. CREATING MODERN CLINICAL PSYCHOLOGY • 80%of WWII vets requested psychological counseling to re-assimilate to civilian life. • Their needs motivated VA to fund clinical psych training programs -- needed psychotherapies quickly outpaced research validations. • Conflict with psychiatry re admitting patients, insurance payments, certification, expert testimony; now it’s over prescription privileges. • VA & APA convened Boulder conference 1949--adopted scientist/practitioner model. Rejected by many--- Ps.D. programs approved by APA- 1973.

14. The American Psychological Association (APA) • Frequent splinter groups from APA of unhappy clinicians ever since its founding in 1892. • Mid-1940s: divisions of APA arose & dropped requirement of publishing original research. “Professional” psychology goals adopted. • By 1985, 75% of APA members were clinical practitioners. Far higher percentage now. • Experimental psychologists (includes most academics) increasingly disenfranchised, formed splinter groups like Psychonomics (1959), SSPI, neuroscience. APS in 1987, now 16,000 members.

15. Growth Rates within APA • Growth rates 1960-1980: psychology up 435%; clinical expanded at 8%/yr; counseling 13%/yr; school psych 18%/yr; ALL experimental, 1%/yr. • By 1980, experimental psychologists comprise only 18% of all psychology PhDs. Includes devo, personality, cognitive, neuro, comparative, social, organizational, health & sports psych, ed psych, industrial, personnel psych -- almost all academics. Started forming specialized societies out of APA.

16. INCREASING SEGREGATION OF SUB-DISCIPLINES • Arguments for integrated psych (nat’l org., univ. depts, annual reviews, etc.) became outdated. • Difficult to keep up with other sub-fields with their specialized jargon and methodologies • Bookstores overtaken by new age, self-help pop writings with little or no discrimination by sellers. • Devaluing of “scientific” (lab) approach to understanding human behavior in humanistic, hermeneutic, or deconstructionist philosophies.

17. INCOMPATIBLE EPISTEMOLOGIES • Some clinicians/experimentalists hold conflicting views on how knowledge of mind is acquired and validated. Can we generalize laws to single case? • Utility of case studies can be improved by later controlled comparisons, e.g., compare to placebo. • Lab research and clinical case studies each have their advantages and disadvantages. • Disaffection between therapists and experimentalists have created increasing confrontations and distancing. • Need to get past fights to form a “footbridge of communication” across the psychological canyon.

18. Three Main Perspectives • 1. Experimentalus über Alles: field has its own intellectual justification; driven by its own questions; follows “hard science” model. • 2. Clinicalus über Alles: therapy is mainly “compassionate art-form”; ideographic approach; advances come from within the field. • 3. Let’s Exchange Information: both fields need each other, and should promote extensive interchanges of relevant information & collaborate in research projects.

19. JONES’ SUGGESTIONS FOR CHANGE • Stop making villains of the other camp; drop false/simplifying dichotomies. • Revise college curriculum to require spectrum of classes across exp’l/clinical. Make course content accentuate broader applications. • Continuing education for “old”professionals. • Promote collaborative research in the scientist/practitioner mode, e.g., NIDA • Teach all of us to evaluate research more rigorously, e.g., shoddy research on EMDR.

20. Jones’ Suggestions (Cont’d) • Licensure is big issue: none now required for therapists, compared to, say, plumbers, CPAs, dentists. Need stricter educational requirements on licensure. • Educate public to distinctions between good vs. shoddy therapy, and to discount 1- min. therapies on talk shows, e.g., Dr Phil; Dr Laura.

21. DISCUSSION QUESTIONS • What’s the medical model of behavioral disorders? • Is psychiatry becoming a branch of psychopharmacology? • What “APA politics” might impede acceptance of Jones’ suggestions for closing the gap between practitioners & academics?

22. We’re Friends for Life • Farewell: good luck with your studies • May all your experiments yield significant F’s • Have a Merry Christmas