Review: Science and pseudoscience in clinical psychology (Lilienfeld et al)
www.emilkirkegaard.com
Science and pseudoscience in clinical psychology - edited by Scott O. Lilienfeld, Steven Jay Lynn, Jeffrey M. Lohr. Has a good discussion of the nature of science. som interesting discussions of varius dodgy and otherwise untested ideas in clinical psychology. --- about the book: As Bob Dylan wrote, “The times they are a-changin’ .” Over the past sev eral decades, clinical psychology and allied disciplines (e.g., psychiatry, social work, counseling) have borne witness to a virtual sea-change in the relation between science and practice. A growing minority of clinicians appear to be basing their therapeutic and assessment practices primarily on clinical experience and intuition rather than on research evidence. As a consequence, the term “ scientist-practitioner gap” is being invoked with heightened frequency (see foreword to this volume by Carol Tavris; Fox, 1996), and concerns that the scientific foundations of clinical psychology are steadily eroding are being voiced increasingly in many quarters (Dawes, 1994; Kalal, 1999; McFall, 1991). It is largely these concerns that have prompted us to compile this edited volume, which features chapters by distinguished experts across a broad spectrum of areas within clinical psychology. Given the markedly changing landscape of clinical psychology, we believe this book to be both timely and important. - Similarly questionable practices can be found in the domains of psy chological assessment and diagnosis. Despite well-replicated evidence that statistical (actuarial) formulas are superior to clinical judgment for a broad range of judgmental and predictive tasks (Grove, Zald, Lebow, Snitz, & Nelson, 2000), most clinicians continue to rely on clinical judgment even in cases in which it has been shown to be ill advised. There is also evidence that many practitioners tend to be overconfident in their judgments and predictions, and to fall prey to basic errors in reasoning (e.g., confirmatory bias, illusory correlation) in the process of case formulation (Chapter 2). Moreover, many practitioners base their interpretations on assessment in struments (e.g., human figure drawing tests, Rorschach Inkblot Test, Myers-Briggs Type Indicator, anatomically detailed dolls) that are either highly controversial or questionable from a scientific standpoint (see Chap ter 3). the cite is: Grove, W. M., Zald, D. H., Lebow, B. S., Snitz, B. E., &c Nelson, C. (2000). Clinical versus mechanical prediction: A meta-analysis. Psychological Assessment, 12, 19-30. abstract: The process of making judgments and decisions requires a method for combining data. To compare the accuracy of clinical and mechanical (formal, statistical) data-combination techniques, we performed a meta-analysis on studies of human health and behavior. On average, mechanical-prediction techniques were about 10% more accurate than clinical predictions. Depending on the specific analysis, mechanical prediction substantially outperformed clinical prediction in 33%-47% of studies examined. Although clinical predictions were often as accurate as mechanical predictions, in only a few studies (6%-16%) were they substantially more accurate. Superiority for mechanical-prediction techniques was consistent, regardless of the judgment task, type of judges, judges' amounts of experience, or the types of data being combined. Clinical predictions performed relatively less well when predictors included clinical interview data. These data indicate that mechanical predictions of human behaviors are equal or superior to clinical prediction methods for a wide range of circumstances. seems interesting. What are the primary sources of the growing scientist-practitioner gap? As many authors have noted (see Lilienfeld, 1998, 2001, for a discussion), some practitioners in clinical psychology and related mental health disci plines appear to making increased use of unsubstantiated, untested, and otherwise questionable treatment and assessment methods. Moreover, psy chotherapeutic methods of unknown or doubtful validity are proliferating on an almost weekly basis. For example, a recent and highly selective sam pling of fringe psychotherapeutic practices (Eisner, 2000; see also Singer & Lalich, 1996) included neurolinguistic programming, eye movement desen sitization and reprocessing, Thought Field Therapy, Emotional Freedom Technique, rage reduction therapy, primal scream therapy, feeling therapy, Buddha psychotherapy, past lives therapy, future lives therapy, alien abduc tion therapy, angel therapy, rebirthing, Sedona method, Silva method, en tity depossession therapy, vegetotherapy, palm therapy, and a plethora of other methods (see also Chapter 7). .... - The major criticism of the Smith and colleagues (1980) meta-analytic study is that it is too inclusive; using all studies necessarily requires that good and bad pieces of research are taken into account (e.g., Howard, Krause, Sanders, & Kopta, 1997). Nevertheless, Smith et al. compared ef fect sizes on the basis of research quality. The rigor of the research had lit tle or no impact on effect size (Smith &c Glass, 1977; Smith et al., 1980). The results, thus, were not artifacts of including methodologically weak in vestigations in the meta-analysis. As efficacy research has burgeoned, so have the number of meta analyses. The primary findings of Smith and colleagues (1980) have been repeatedly affirmed (Wampold, 2001). Not only does psychotherapy appear to be effective, but there is little evidence that one therapy is signifi cantly better than another. The most comprehensive meta-analysis (Wam pold et al., 1997) and a meta-analysis of 32 meta-analyses (Grissom, 1996) have corroborated the conclusion reached 65 years ago by Rosenzweig (1936). He characterized the apparent uniform efficacy of psychotherapies at the time as the Dodo bird verdict, after the Dodo’s observation at the end of a race in Alice in Wonderland that “Everybody has won and all must have prizes” (p. 412). This conclusion bears profound implications for the field of psychotherapy, which for the past five decades has been pre occupied with unearthing the essential, specific findings of behavior change in the form of the best therapy. The verdict so far is that psycho therapies appear to share common, not specific, therapeutic features. - Recovered memory therapy (RMT): Therapists operate on the as sumption that their client’s psychological distress, lack of success, failed re lationships, and so forth are due to traumatic experiences, typically under the control of their parents. RMT often involves the belief that the inten sity of the childhood trauma was so great as to cause dissociative “ split ting” into multiple personalities, now known as dissociative identity disor der (see Chapter 5). In RMT, the process of therapy often consists of diverse methods of recovering the “ lost memories,” including hypnotic in duction, administration of “ truth serum” (sodium pentathol), group ther apy, guided fantasies, religious-based prayer, and assertions by therapists that the client’s symptoms could only have been caused by a traumatic event (see Chapter 8, for a critique of these and related methods). Given a New Age therapist’s belief in RMT, therapy becomes unending as the client is taken back into earlier past lives, additional alien abductions, and addi tional split-off personalities (known as “ alters” ; see Chapter 5). Alien ab duction therapy, one variation of RMT, holds that extraterrestrials landed on earth and abducted and then molested the individual, thereby causing the past trauma. Past lives therapy, another variation of RMT, holds that all of life’s travails are due having lived a series of past lives and having “ unfinished business” from past lives invading one’s current life. such ideas seem to dovetail beautifully with blank slate ideas. if it isnt genes or the persons own fault, it has to be somthing els. past traume fits the role nicely, yes? -
Review: Science and pseudoscience in clinical psychology (Lilienfeld et al)
Review: Science and pseudoscience in clinical…
Review: Science and pseudoscience in clinical psychology (Lilienfeld et al)
Science and pseudoscience in clinical psychology - edited by Scott O. Lilienfeld, Steven Jay Lynn, Jeffrey M. Lohr. Has a good discussion of the nature of science. som interesting discussions of varius dodgy and otherwise untested ideas in clinical psychology. --- about the book: As Bob Dylan wrote, “The times they are a-changin’ .” Over the past sev eral decades, clinical psychology and allied disciplines (e.g., psychiatry, social work, counseling) have borne witness to a virtual sea-change in the relation between science and practice. A growing minority of clinicians appear to be basing their therapeutic and assessment practices primarily on clinical experience and intuition rather than on research evidence. As a consequence, the term “ scientist-practitioner gap” is being invoked with heightened frequency (see foreword to this volume by Carol Tavris; Fox, 1996), and concerns that the scientific foundations of clinical psychology are steadily eroding are being voiced increasingly in many quarters (Dawes, 1994; Kalal, 1999; McFall, 1991). It is largely these concerns that have prompted us to compile this edited volume, which features chapters by distinguished experts across a broad spectrum of areas within clinical psychology. Given the markedly changing landscape of clinical psychology, we believe this book to be both timely and important. - Similarly questionable practices can be found in the domains of psy chological assessment and diagnosis. Despite well-replicated evidence that statistical (actuarial) formulas are superior to clinical judgment for a broad range of judgmental and predictive tasks (Grove, Zald, Lebow, Snitz, & Nelson, 2000), most clinicians continue to rely on clinical judgment even in cases in which it has been shown to be ill advised. There is also evidence that many practitioners tend to be overconfident in their judgments and predictions, and to fall prey to basic errors in reasoning (e.g., confirmatory bias, illusory correlation) in the process of case formulation (Chapter 2). Moreover, many practitioners base their interpretations on assessment in struments (e.g., human figure drawing tests, Rorschach Inkblot Test, Myers-Briggs Type Indicator, anatomically detailed dolls) that are either highly controversial or questionable from a scientific standpoint (see Chap ter 3). the cite is: Grove, W. M., Zald, D. H., Lebow, B. S., Snitz, B. E., &c Nelson, C. (2000). Clinical versus mechanical prediction: A meta-analysis. Psychological Assessment, 12, 19-30. abstract: The process of making judgments and decisions requires a method for combining data. To compare the accuracy of clinical and mechanical (formal, statistical) data-combination techniques, we performed a meta-analysis on studies of human health and behavior. On average, mechanical-prediction techniques were about 10% more accurate than clinical predictions. Depending on the specific analysis, mechanical prediction substantially outperformed clinical prediction in 33%-47% of studies examined. Although clinical predictions were often as accurate as mechanical predictions, in only a few studies (6%-16%) were they substantially more accurate. Superiority for mechanical-prediction techniques was consistent, regardless of the judgment task, type of judges, judges' amounts of experience, or the types of data being combined. Clinical predictions performed relatively less well when predictors included clinical interview data. These data indicate that mechanical predictions of human behaviors are equal or superior to clinical prediction methods for a wide range of circumstances. seems interesting. What are the primary sources of the growing scientist-practitioner gap? As many authors have noted (see Lilienfeld, 1998, 2001, for a discussion), some practitioners in clinical psychology and related mental health disci plines appear to making increased use of unsubstantiated, untested, and otherwise questionable treatment and assessment methods. Moreover, psy chotherapeutic methods of unknown or doubtful validity are proliferating on an almost weekly basis. For example, a recent and highly selective sam pling of fringe psychotherapeutic practices (Eisner, 2000; see also Singer & Lalich, 1996) included neurolinguistic programming, eye movement desen sitization and reprocessing, Thought Field Therapy, Emotional Freedom Technique, rage reduction therapy, primal scream therapy, feeling therapy, Buddha psychotherapy, past lives therapy, future lives therapy, alien abduc tion therapy, angel therapy, rebirthing, Sedona method, Silva method, en tity depossession therapy, vegetotherapy, palm therapy, and a plethora of other methods (see also Chapter 7). .... - The major criticism of the Smith and colleagues (1980) meta-analytic study is that it is too inclusive; using all studies necessarily requires that good and bad pieces of research are taken into account (e.g., Howard, Krause, Sanders, & Kopta, 1997). Nevertheless, Smith et al. compared ef fect sizes on the basis of research quality. The rigor of the research had lit tle or no impact on effect size (Smith &c Glass, 1977; Smith et al., 1980). The results, thus, were not artifacts of including methodologically weak in vestigations in the meta-analysis. As efficacy research has burgeoned, so have the number of meta analyses. The primary findings of Smith and colleagues (1980) have been repeatedly affirmed (Wampold, 2001). Not only does psychotherapy appear to be effective, but there is little evidence that one therapy is signifi cantly better than another. The most comprehensive meta-analysis (Wam pold et al., 1997) and a meta-analysis of 32 meta-analyses (Grissom, 1996) have corroborated the conclusion reached 65 years ago by Rosenzweig (1936). He characterized the apparent uniform efficacy of psychotherapies at the time as the Dodo bird verdict, after the Dodo’s observation at the end of a race in Alice in Wonderland that “Everybody has won and all must have prizes” (p. 412). This conclusion bears profound implications for the field of psychotherapy, which for the past five decades has been pre occupied with unearthing the essential, specific findings of behavior change in the form of the best therapy. The verdict so far is that psycho therapies appear to share common, not specific, therapeutic features. - Recovered memory therapy (RMT): Therapists operate on the as sumption that their client’s psychological distress, lack of success, failed re lationships, and so forth are due to traumatic experiences, typically under the control of their parents. RMT often involves the belief that the inten sity of the childhood trauma was so great as to cause dissociative “ split ting” into multiple personalities, now known as dissociative identity disor der (see Chapter 5). In RMT, the process of therapy often consists of diverse methods of recovering the “ lost memories,” including hypnotic in duction, administration of “ truth serum” (sodium pentathol), group ther apy, guided fantasies, religious-based prayer, and assertions by therapists that the client’s symptoms could only have been caused by a traumatic event (see Chapter 8, for a critique of these and related methods). Given a New Age therapist’s belief in RMT, therapy becomes unending as the client is taken back into earlier past lives, additional alien abductions, and addi tional split-off personalities (known as “ alters” ; see Chapter 5). Alien ab duction therapy, one variation of RMT, holds that extraterrestrials landed on earth and abducted and then molested the individual, thereby causing the past trauma. Past lives therapy, another variation of RMT, holds that all of life’s travails are due having lived a series of past lives and having “ unfinished business” from past lives invading one’s current life. such ideas seem to dovetail beautifully with blank slate ideas. if it isnt genes or the persons own fault, it has to be somthing els. past traume fits the role nicely, yes? -