Who is a "real" Psychologist?

Re: Idea

Hi Blackbird,

Parenthetically, how did you get the Beatles pix in your sig line?

Now on to the subject matter at hand.

First, I have always liked you and find your posts enlightening, intelligent, articulate, and stimulating. You are a wonderful breath of fresh air on this forum.

However, I have never thought of the therapeutic modalities you mention as anything but "fads" and "junk science." This is why I prefer the American Psychological Society over the American Psychological Association.

Remmeber, a few of these modalities were heavily used during the '80's in the repressed memory days that saw literally hundreds of people falsely accused and wrongfully imprisoned.

Regarding NLP, although early on, it relied heavily on the work of Satir, Erickson, and Pearls, it has since evolved into a model, not a theory.

The difference is that a model doesn't have to be accurate, it only has to be useful in a given situation, for which it has been designed. If it isn't, it can be discarded which is not very fail safe.

EMDR's success appears to be inexplicit and based on casual observations. Has Shapiro ever been able to clearly explain the theoretical basis for its declared success?

Remember too that Shapiro said of EMDR, "EMDR has undergone a number of modifications, rendering the original articles obsolete."

Additionally, she said "Theories that explain why EMDR works have arisen after the fact and have not yet been confirmed. However, the lack of definitive explanation of the underlying mechanisms of EMDR in no way detracts from the demonstrated effectiveness of the method."

Am not that familiar with EFT (Emotional Freedom Technique). From what I can remember it reminds me of Roger Callahan's TFT (Thought Field Therapy), which is another highly suspicious modality.

Now, let me admit, I have not actually paid much attention to the field since leaving agency counseling several years ago. I am sure there is research I am not aware of nor familiar with. I have focused on theology and ministry of late and trying to get a locksmithing business going.

Having said all this, I pay attention to the latest works of people like Peter Breggin, Michele Weiner-Davis, Aaron Beck, Judith Beck, William Glasser, and Jay Haley.

I also read and devour the works of Robin Dawes, August Piper, Thomas Szasz, Richard Ofshe, Terrence Campbell, Elizabeth Loftus, Harrison Pope, Lucy Johnstone, Charlotte Prozan, Richard Gosden, Loren Mosher, Kevin McCredy, and a host of others who are at the forefront of making sure Primo non nocere actually occurs in therapy.

Again, nothing personal. Just my opinion, my friend.

 

Thoughts

Thank you, Jimmy! Those a very kind words! I appreciate it.

On the Beatles, if I remember correctly, I think I put the coding " in the signature.

Here is an example that you can look at the coding by clicking on "quote" when responding. This gives you the text and the coding:



As for the alternative modalities, I understand that many of these are considered "fad" but that was many years ago. Most modalities start as fads. Some come and some go. I know that Callahan has been criticized in California only, to my recollection. EFT is a refinement by one of his disciples. It works with a 95% consistency in my experience as opposed to Callahan's original methods. I have noticed that many of the textbooks on Techiques in Counseling (used is required counselor courses) borrow heavily from the works of Grinder and Bandler (creators of NLP), and, yes, Milton Erickson. Authors seldom give them credit, from what I have observed. I have used NLP for the last 15 years, even when I was a church planter/pastor. I had psychotherapists bringing me their wives. I continue to bump and hear from past clients/patients, even years after, and the changes have held consistently. Without knowing what modalities you consistently use, I tend to think that those who use strict psychological testing modalities and strict CBT processes, while rejecting psychodynamics, are folks that live a form of disconnect from their feelings and intuition. These gravitate towards more Newtonian/Linear processes. In Christianity it is comparable to the Pentecostals versus the Presbyterians/Baptists who are on opposite spectrums (emphasis on an intuitive relationship with God versus a cognitive relation with God). Both are simultaneously needed, despite positionalities and rhetoric.

On the EMDR, there is more and more literature being pumped out by very good researchers who have "hands-on" experience. The psychologist that I sometimes work with has been in the field over 20 years, having been a director of a very large hospital's rehabilitation and pain managment program. He compares EMDR with 21 Century technology versus 20th Century stuff that is still being taught in grad school. He has a very high level of documented successes that far outstrip his strickly CBT days. A good literature search would show the many books and articles published since EMDR first came out.

I can honestly say that I consistently see "miracles" almost every day in counseling... very dramatic healing from severe sexual trauma, emotional and physical abuse issues, phobias, gender-abuse based issues, anger, grief, depression, etc. I also install resources that are akin to rapid emotional development due to obtaining a new enbedded criteria that kicks in AutoPilot. My patients/clients usually receive therapy anywhere from 1-6 times max.

My purpose for this is not to say I am better or that the other modalities do not work but rather to stimulate openness to alternative approaches, which all approaches were at one time.

I hope that your locksmith business is successful.

God bless.

 

Re: Thoughts

Thank you, Black Bird, although I didn't appreciate your using my photo as an example.

Actually, he resembles Freud.

I will certainly look into the latest research regarding the alternative therapies. I will concede that during the refinement process, modalities can become more scientifically validated and the research can show a multitude of positive, successful outcomes.

Didn't know you used to be a pastor. Thanks for the comment on the locksmithing business. It's slow. It takes money to make money and advertising is so high nowadays.

It's always nice to have something to fall back on, isn't it?

Take care and I want you to know your civility is highly appreciated. Not many would respond with such polish in light of my using terms such as "fads" and "junk science."

You're a real gentleman!

 

JIMMY: I did provide a list of specific references.

SIMON: Yes, but none that conclusively demonstrate the superiority of CBT over psychodynamic psychotherapy in the treatment of personlity/characteriologically disordered patients.

JIMMY: Every therapist has his or her specific therapeutic modality he or she uses and can cite reference after reference and study after study to validate that modality. The cite you provide is a case in point.

SIMON: Yes, many therapists favor certain psychotherapeutic modalities or techniques. However, the longer therapists are in practice the more likely they will be eclectic in their approach and tailor the therapy to the needs of the client and not based on the fact that they favor a particular theoretical orientation. Furthermore, the point of the site that I referenced is that the authors, Hubble, Scott, and Duncan, are basing their conclusions not on their opinions or personal beliefs or anecdotal examples of positive outcomes with a specific therapeutic modality but on substantive research and survey data. Without such research many therapists will come to erroneous conclusions regarding the reasons for successful therapeutic outcomes. For example although they may believe that a patient recompensated due to the use of a particular CBT, Psychodynamic or EDMR intervention the improvement they observe may actually be due to the interpersonal relationship itself or some other variable. Substantive research identifies those factors that may have been due to the treatment modality or due to the personal characteristics of the clinician or to extratherapeutic factors.

JIMMY: I have used CBT with a wide range of the so-called mental illnesses and have been highly successful.

When I worked in agency mental health, I had a client that had the BPD dx. The psychiatrist on staff said this client had the worse case of BPD she had ever seen.

The client was assigned to me. Within two years, using CBT, this person made such significant improvements I was told by other therapists--social workers, psychologists, psychiatrists--that they had never seen her doing so well.

Another case was a client who had an eating disorder and had been sexually abused. I argued for nearly 45 minutes on the phone with this person's insurance company that CBT would be efficacious. Finally, she authorized eight sessions. The CBT tx was successful.

One other case. I had a schizophrenic client. The psychiatrist was at wit's end and stopped the therapeutic process prescribing only meds. She asked me to see this person.

After two years of CBT this person became productive in spite of developing Tardive Dyskinesia from years of medication.

SIMON: Your examples of successful outcomes may have been due been to a number of variables or perhaps only one! Perhaps, it was your skill as a therapist or a particular technique or the relationship itself or due to the concern and care you projected to the client perhaps augmenting their hope/expectancy for future improvement or perhaps they just inherited one hundred thousand dollars or perhaps they merely experienced a spontaneous recovery!

JIMMY: Simon, each person will use what has worked. No good therapist will limit himself or herself to any one modality. I use CBT more than any other type because it has worked for my clients.

SIMON: I respect your belief in the efficacy of CBT but until I am clear as to what specifically is going on in your therapy with the clients you noted, it remains uncertain as to whether it is CBT or some other factor/variable that is actually bringing about the positive change you observed in your clients.

 

And your therapeutic experience is?

 

Obviously just a layman ;--).

 

Thanks for your honesty.

My friend, you will find, if you enter the mental health profession, that what one learns in the classroom--theory--is of little value in the field. Practical experience supercedes theory when it comes to dealing with the problems of the human experience.

 

My friend, I was not exactly being that "honest" because I didn't wish to engage in a "who can piss the furthest"contest with you.

In fact I don't reveal information relating to my professional background, experience or credentials in ANY cyberspace forum. However, if it is of importance to you, it is substantial.

Furthermore, I don't disagree with your comments regarding theory versus practical experience in relation to conducting counseling/psychotherapy in the "real" world. However, this is not what we are talking about in this thread. We are discussing whether a particular mode of therapy, in this case CBT, is superior to pscychodynamic interventions. In addition we are discussing whether CBT is the actual technique bringing about a positive therapeutic outcome or is it due to such factors as the clinician's personality characteristics, traits, or some factor intrinsic to the therapeutic relationship or due to extratherapeutic factors or to happenstance.

 

And just how do we determine this if not via practical experience in the real world?

 

Although 'practical experience" may provide useful anecdotal indications of therapeutic success it by no means conclusive or definitive or meets the criteria of a rigorous research protocol in order to prove what specifically is bringing about change in clients.

Primarily, the meaning of "Practical experience" and the interpretation of what constitutes a positive therapeutic outcome emanating from such experience may differ from one therapist to another. Therefore, obtaining feedback from a diverse group of therapists regarding their purported positive therapeutic outcomes emanating from their "practical experience" is extremely questionable because we have not defined what is meant by practical experience or delineated what constitutes a "positive outcome".

 

How can you engage in such double talk? Have you reread all your posts and compared them with what you just said?

Personally, I don't think you know what the hell you're talking about!

 

I hadn't realized that you'd begun your practice. Congratulations!
Jack

 

Now, now try to maintain your composure because losing control is not the way an "experienced" therapist such as yourself with "practical experience" wishes to be perceived. Or is this the way you deal with people with whom you disagree? Perhaps your anger is a modified Rogerian technique with CBT that you are utilizing to modify my tendency to question others who make assertions that can not be supported by the research literature (just kidding)?

In fact it is unnecessary to state that you don't understand what the "hell" I am talking about. From the very beginning of our interaction when you grossly misinterpreted everything I stated and began to read into my posts that which was not there and displayed an inordinate level of defensiveness and contentiousness I realized "something" was awry and that this discussion should cease.

So let us just conclude that we don't know what the hell either of us are talking about. I can live with that. Can you?

 

Well Jack what can I tell you. I'm a neophyte who is learning the trade from others with "practical experience". Obviously I don't have any. Simon

 

Here are some of my concerns, Jimmy. Do I see a HIPAA violation? No. Do I see an ethical violation? I’m not sure. I know the APA Ethical Principles; I’m not familiar with the ethical codes of other disciplines. My preference is to conduct conversations like this ‘behind closed doors.’ I ‘get’ what’s going on in this thread; its some bright guys engaging in spirited debate but I don’t know if the thousands of laypersons around the globe who read this do. I’m around spirited, young clinicians-in-training every day and I’m familiar with the drill. It’s the therapists’ equivalent of name that tune: My approach is the best and I can cure that phobia in, hmm, three sessions. My main concern is the law of unintended consequences. One of the primary reasons people avoid seeking help is concern about privacy. Is it possible someone reading this thread that might benefit from psychological assistance might misperceive the intent and refrain from help-seeking? I think so. I’m concerned a layperson might conclude something along the lines of, “I’m not going to go see some shrink; he’ll probably talk about my problem on the internet.” I’m also concerned about the potential for inadvertently undermining someone’s therapy work by discussing time frames and modalities of highly successful cases. Is it possible a person who is seeing a competent clinician might decide to terminate or quit taking meds if the time frame or modality doesn’t match reports of cases described here? I don’t think you can rule out the possibility

 

Cyberspace chat rooms and forums have potential for abuse, violation of codes of ethics and professional conduct by mental health practitioners. In regard to David's observations they are valid in that a perspective patient may potentially be put off by the cavalier manner in which discussions of patient psychotherapy and care are presented. Does this constitute a violation of ethical codes of conduct? No. Is it a statement about the person who is presenting significant although anonymous clinical material in such a braggadocio manner? Yes. It is revealing but not an ethical violation of professional misconduct.

 

Your points are well taken, David. But any potential client can pick up a book by any of America's foremost therapists and read exactly what you are afraid they might read here or on some other forum.

They can read about time frames, modalities, clinicians who are against meds and those who support meds. I find most of the clients I have had over the years were very familiar with the works of Glasser, Beck, Haley, Weiner-Davis, Breggin, O'Hanlon, and especially Burns.

How many people today have read the works of people like Thom Armstrong and question the ADD/ADHD dx or the efficacy of Ritalin and other such drugs?

The Internet is chock full of anti-medication, anti-psychiatry, anti-medical model sites. I give potential counselees some credit for being intelligent. Just because they are in crises doesn't mean they are stupid.

 

More harm is done in the therapy room than can ever be harmed on the Internet!

How many people believed they were sexually abused or abducted by space aliens because a therapist implanted memories by suggestion?

How many female clients have been sexually abused by a therapist while in session?

How many clients have committed suicide because of shoddy therapy?

How many clients have been murdered (rebirthing process) by therapists?

How many children have been abused by therapists?

How many clients have been injured by medications due to misdiagnosis?

How many clients have suffered organic brain damage because of unnecessary medications?

I could go on and on and on...but you get the picture!

 

This will be my last reply to you because you are simply too confused and cannot present consistent thoughts from one post to another and are now trying to establish some lost credibility.

The presentation of "significant although anonymous clinical material" can be found an any book by just about any psychologist, psychiatrist, social worker, or mental health counselor.

Braggadocio? First you question a particular modality and then you condemn someone for showing that modality has worked.

I find you to be a very confused, inconsistent person who needs to do more studying than lecturing!

 

Jimmy, patients/clients are more than just intelligent, they are also computer literate. Of late, I have them come in to the initial eval with stacks of computer printouts that affirm their diagnoses. Sometimes they are right, sometimes they are not. I don't think very many people will be swayed by what is discussed here. Those that might be can find a lot more material on the APA website or some other psychological website in addition to WebMD. So let us not fool ourselves into thinking we are discussing something here that is not readily available on the WWW.