A rant about Capella from one of its grads...

A few thoughts on the thread content.

1.I agree there are many more opportunities for training in applied psychology than was case when I finished undergrad. President Bush and I were C+ students and while I never aspired to his degree of success in life I have to admit I felt like I hit the homer that won the world series when I was admitted to an APA-approved counseling psychology program. GME, if you ever track down the numbers from the 60s v. the present I'm interested in what you find.
2.I haven't kept up with the literature on counseling effectiveness. In retrospect, I'd have to say I learned to manage a wider range and much more difficult cases in my doctoral program.
3.There is more to a psychology degree than research and treatment. Historically, psychology got its start in measurement and assessment hasn't been mentioned.
4.I'm too old a dog to want to chase prescriptive authority so I don't have a dog in the fight. For those who are interested look up Morgan Sammons. Sammons is a member of the demonstration project of DOD psychologists who were trained to and successfully prescribed. I think he was Navy.

 

You didn't have any specific MBAs in mind, now, did you?

 

Quite right. LCSWs were the first masters level clinicians and remain, I believe, the only such clinicians who can get medicaid/medicare reimbursement.

Do you happen to know, by the way, what their original scope of practice was intended to be?

I ask, because, in addition to the birth of the masters level clinician, there has been (at least in California in the case of MFTs) a general expansion of scope of practice. The CA MFT was originally envisioned as a therapist who would primarily work in a systems approach with families.

Rather quickly they expanded into individual psychotherapy and were sued (I think by psychologists). A court case determined that they could conduct individual psychotherapy as part of thier practice.

Regards,
GME

 

[/B][/QUOTE]

Greetings Simon,

Since the poster is providing his personal impressions, it might be more accurate to describe his opinions as "subjective" rather than objective. By nature, personal opinion is subjective.

 

Hi Simon,

You say that many people suffering from mental and behavioral disorders are "recalcitrant to psychotherapeutic interventions" and thus are unable to be treated by mental health professionals until they are stabilized with medications. This is simply not ture with regard to behavioral changes. The Transtheoretical Model of stage-based change together with Motivational Interviewing are specifically designed to treat people who were previously considered in denial or resistant or difficult to treat. It approaches clients where they are in the process of change and moves them forward from there.

Also, if a client is resistant to psychotherapy, they are also highly likely to be non-compliant with medications.

Yet another fact is that there have been a number of empirical studies that show that talk therpies are just as effective, if not more so, than medicating for many mental health problems. Perhaps we are overmedicating people in our zest for simple solutions and for medical doctors to make money.

 

Doctor to be Tug,

What school are you in at Capella? What will your Ph.D. be in at Capella? I'm 3-6 months away from my Ph.D. degree in the school of psychology at Capella.

 

DOCTORTUG: You say that many people suffering from mental and behavioral disorders are "recalcitrant to psychotherapeutic interventions" and thus are unable to be treated by mental health professionals until they are stabilized with medications. This is simply not ture with regard to behavioral changes.

SIMON: You tend to extrapolate and misrepresent quotes that distort my original statements. In fact what I clearly stated was that many patients with severe mental illness are "OFTEN recalcitrant to psychotherapeutic interventions that necessitates medication evaluations and interventions in order to stabilize these individuals who are often in crisis. Yes, after such a patient is stabilized with medication they may be ready for psychotherapeutic intervention but many in fact are amotivational and not good candidates for psychotherapy".

In fact you are revealing your inexperience by your statement above. WHEN a clinician is working with patients with severe psychiatric problems it is OFTEN esssential to initially assess their needs for psychotropic medication interventions prior to developing and implementing treatment plans for psychotherapy.
Many patients with psychotic disorders, mania, severe depressions, and severe characterological disorders are not viable candidates for behavioral change while experiencing severe pathology. END OF STORY.

DOCTORTUG: The Transtheoretical Model of stage-based change together with Motivational Interviewing are specifically designed to treat people who were previously considered in denial or resistant or difficult to treat. It approaches clients where they are in the process of change and moves them forward from there.

SIMON: Please do not attempt to obfuscute or attempt to impress others with fancy nomenclature such as "Transtherorectical Model of stage based change.....". It is inconsequential what technique or modality a clinician uses when dealing with individuals with are experiencing severe psychopathology (ie, hallucinations, paranoid delusions, sociopathy, mania, projective identification, severe acting-out, etc).

DOCTORTUG: Also, if a client is resistant to psychotherapy, they are also highly likely to be non-compliant with medications.

SIMON: Who said otherwise? It is obvious that you are biased in favor of psychotherapy over medication in treating patients with severe pathology. That is fine as long as we are clear that your personal perspective does not represent facts in managing such patient populations.

DOCTORTUG: Yet another fact is that there have been a number of empirical studies that show that talk therpies are just as effective, if not more so, than medicating for many mental health problems. Perhaps we are overmedicating people in our zest for simple solutions and for medical doctors to make money.

SIMON: Yes that is true when we are discussing patients who are motivated, are in psychic pain with relatively intact insight and who are therefore motivated to relieve their symptoms. So please I am no longer interested in discussing your personal belief systems regarding the superiority of psychotherapy over psychotropic medication. You are entitled to believe whatever you wish but reality dictates the actual course of treatment of individuals with severe psychotherapy.

 

<<GME: On the plus side, the more liberal entrance requirements often seem to attract folk who will ultimately make better therapists (as opposed to researchers).

SIMON: In fact in many cases it appears to be attracting individuals with significantly less academic and intellectual capability that does not necessarily translate into being a better therapist. I have not not seen any research literature that supports the premise that graduates of Psy.D programs become better therapists than their colleagues with a Ph.D.>>

I'm not aware of any such research either. However, it is a fact that a PsyD is intended to train clinicians and many PhD programs are not. (I'm thinking particularly of schools like UCLA with very highly regarded clinical PhD programs that don't even pretend to try to train therapists - UCLA even suggests that those wanting to become therapists not apply to their program).

Regards,

GME

 

Greetings Simon,

Since the poster is providing his personal impressions, it might be more accurate to describe his opinions as "subjective" rather than objective. By nature, personal opinion is subjective. [/B][/QUOTE]

SIMON: Isn't it interesting that when another poster expresses their opinion and observations in an objective manner that you see it as subjective. However, when you verbalize very slanted and biased personal beliefs regarding the supremacy of psychotherapy over psychotropic medications for individuals with severe mental illness that you present it as objective fact when it is obviously your subjective opinion! Unbelievable!

 

SIMON: Yes, Psy.D programs primarily train students for clinical work. However, there are many Ph.D programs in Clinical and Counseling Psychology that focus with equal emphasis on clinical and research competencies. The graduates of these programs are very well trained clinicians and as has been stated there is no research that we are aware of that demonstrates the superiority of graduates of either program in terms of clinical perspicacity, therapeutic intervention skills or clinical outcomes.

 

SIMON: Isn't it interesting that when another poster expresses their opinion and observations in an objective manner that you see it as subjective. However, when you verbalize very slanted and biased personal beliefs regarding the supremacy of psychotherapy over psychotropic medications for individuals with severe mental illness that you present it as objective fact when it is obviously your subjective opinion! Unbelievable! [/B][/QUOTE]

Simon obvioulsy you think that your unsubstantiated diatribes and uniformed positions have superior merit to the opinions of others. It appears you are woefully uninformed and misleading people regarding the current status of how patients who are amotivational are being addressed regularly. This is unfortunate in that you are fostering outdated and erroneous notions. That you are ignorant of the stages of change and motivational interviewing underpins your lack of knowledge regarding this topic. Perhaps you should learn more and pontificate less. ENOUGH SAID SIMON!

 

SIMON: Isn't it interesting that when another poster expresses their opinion and observations in an objective manner that you see it as subjective. However, when you verbalize very slanted and biased personal beliefs regarding the supremacy of psychotherapy over psychotropic medications for individuals with severe mental illness that you present it as objective fact when it is obviously your subjective opinion! Unbelievable! [/B][/QUOTE]


Allow me to put this a bit simplier for you Simon. There is a major difference between objective and subjective information, the former typically having empirical support. Unfortunately, you appear to consider your beliefs and opinions as scientific fact and those of people who disagree as inferior subjective opinions. The fact is that all personal perceptions and opinions are subjective including yours and those of the poster whose material is being discussed. I guess your response was merely a case of "attack when one does not have the facts on one's side." Simon, opinion and ovservations are all "SUBJECTIVE" even if they are yours. Hard as that may be to believe, it is true. You are going to school where?

 

DOCTORTUG: Simon obvioulsy you think that your unsubstantiated diatribes and uniformed positions have superior merit to the opinions of others.

SIMON: Let us stick to the issues. YOU broached the issue of my misusing the term subjective and in turn I presented an example of how you are subjective in the information you have presented as fact. Thats all! SO what do you do? You come back at me in a vindicative manner with an inappropriate level of anger in an attempt to negate my opinions. Well my troll "friend" such attacks will not not work! Personal attacks do not substitute for substantive positions and so far all you have been presenting is YOUR SUBJECTIVE personal beliefs, opinions and anger!

SIMON:It appears you are woefully uninformed and misleading people regarding the current status of how patients who are amotivational are being addressed regularly. This is unfortunate in that you are fostering outdated and erroneous notions.

DOCTORTUG: "PATIENTS WHO ARE AMOTIVATIONAL"! Once again my troll "friend" you are extrapolating piecemeal terms (amotivational) that I have used and conveniently leave out the rest in orded to attempt to bolster your spurious attacks! I specifically noted in several posts that the patients I was referring to manifested SEVERE MENTAL ILLNESS, and being amotivational is only one of the symptoms I mentioned. To refresh your selective memory, I also noted a host of other symptoms that you conveniently failed to mention such as delusional ideation, mania, sociopathy, severe acting-out behavior, etc.

SIMON:As I metioned in another thread today this is going absolutely nowhere. You are an "armchair" Psychologist in the making (do you guys recall the thread regarding the quality of students being accepted into doctoral psychology programs by distance graduate programs?). You are personalizing this issue but your arguments are spurious and lack any substance but rely on your so called doctoral candidacy in psychology and your throwing around all sorts of textbook terms you have learned to attempt to dazzle your audience with superficiality. However, it does not add up to anything substantive.

DOCTORTUG: That you are ignorant of the stages of change and motivational interviewing underpins your lack of knowledge regarding this topic. Perhaps you should learn more and pontificate less. ENOUGH SAID ENOUGH!

 

DOCTORTUG: Simon obvioulsy you think that your unsubstantiated diatribes and uniformed positions have superior merit to the opinions of others.

SIMON: Let us stick to the issues. YOU broached the issue of my misusing the term subjective and in turn I presented an example of how you are subjective in the information you have presented as fact. Thats all! SO what do you do? You come back at me in a vindicative and angry manner in an attempt to negate my opinions. Well my troll "friend" such attacks will not not work! Personal attacks do not substitute for substantive positions and so far all you have been presenting is YOUR SUBJECTIVE personal beliefs, opinions and anger!

SIMON:It appears you are woefully uninformed and misleading people regarding the current status of how patients who are amotivational are being addressed regularly. This is unfortunate in that you are fostering outdated and erroneous notions.


SIMON: "PATIENTS WHO ARE AMOTIVATIONAL"! Once again my troll "friend" you are extrapolating piecemeal terms (amotivational) that I have used and conveniently leave out the rest in orded to attempt to bolster your spurious attacks! I specifically noted in several posts that the patients I was referring to manifested SEVERE MENTAL ILLNESS, and being amotivational is only one of the symptoms I mentioned. To refresh your selective memory, I also noted a host of other symptoms that you conveniently failed to mention such as delusional ideation, mania, sociopathy, severe acting-out behavior, etc.

As I metioned in another thread today this is going absolutely nowhere. You are an "armchair" Psychologist in the making (do you guys recall the thread regarding the quality of students being accepted into doctoral psychology programs by distance graduate programs?). You are personalizing this issue and your arguments are spurious and lack any substance but rely on your so called doctoral candidacy in psychology and your throwing around all sorts of textbook terms you have learned to attempt to dazzle your audience with superficiality. However, it does not add up to anything substantive.

DOCTORTUG: That you are ignorant of the stages of change and motivational interviewing underpins your lack of knowledge regarding this topic. Perhaps you should learn more and pontificate less. ENOUGH SAID SIMON!

SIMON: "ENOGH SAID SIMON".

SO why don't you stop talking? You are saying absolutely nothing of value but engaging in exhibitionistic behavior such as referring to yourself as DOCTORTUG when in fact you are not a doctor; throwing around psychotherapeutic principles and terminology that you just learned from a textbook and making outrageous claims of helping severely ill mentallly ill patients based on YOUR SUBJECTIVE beliefs that psychotherapy is the superior and firstline approach to treating severely mentally ill patients rather than performing a careful mental status exam including an assessment of clients' medication needs. UNBELIEVABLE!

 

One final thought on this issue. PsyD programs were developed in the first place because it was thought that PhD programs were not doing a particularly good job at training clinicians. That said, there are certainly plenty of PhD programs that train fine clinicians.

I guess the point I'm really trying to make is that being a therapist is not -primarily- an intellectual exercise. IMO, there is as much art as science in the practice (even in such manualized interventions as cognitive behavioral therapy). Outstanding therapists can come from PhD, PsyD, Masters and Pastoral programs. Of course, lousy ones can come from the same programs too.

Regards,
GME

 

GME: I guess the point I'm really trying to make is that being a therapist is not -primarily- an intellectual exercise. IMO, there is as much art as science in the practice (even in such manualized interventions as cognitive behavioral therapy). Outstanding therapists can come from PhD, PsyD, Masters and Pastoral programs. Of course, lousy ones can come from the same programs too.

Regards,
GME



SIMON: Very good points. In fact there are individuals without any formal training who possess the personal characteristics and levels of empathy and ability to listen with the proverbial "third ear" who are naturally gifted therapists. My step-father was of this caliber and I will never be able to replicate his natural therapeutic style no matter how much training and experience I accumulate. Regards, Simon

 

doctortug/Simon - Please don't put me in a position where I have to lock this thread as well.
Thanks,
Jack