Psychotherapy, research, etc. (was all kinds of things)
Tim A. Connor
There's been so much to respond to in this thread(s) that it's hard to
know where to begin...
I'd like to start by proposing a somewhat radical notion: that the role of
experimental clinical psychology is to provide a critique of clinical
practice, and that clinical practice, properly understood and carried out
(as it too rarely is) is a research activity. On one level, it is (or
should be) a scientific inquiry into the distress experienced by one
individual or family, making use of theoretical constructs and empirical
data drawn from similar (though never identical) cases, and the
identification of effective methods of alleviating the client's complaint.
The cookbook approach to diagnosis and treatment fostered by managed care
and some advocates of "empirically verified treatment" is not terribly
compatible with this.
On a higher conceptual level, clinical practice is where the basic data of
clinical psychology are gathered and theoretical conceptualizations
formulated. It is analogous to field research in anthropology, ecology,
geology, meteorology, and a host of other sciences in which the complexity
of the basic problems is such that they can never be fully replicated in a
controlled experiment. Unfortunately, some psychologists (clinicians as
well as researchers) seem intent on following a model drawn from the
relationship between chenistry or physics and engineering, in which
techniques are invented in the lab and then applied in a purely technical
manner to real world problems (never mind that it doesn't really work like
that, even in those fields--at least not all the time).
In the model I'm proposing, the relationship between psychotherapy and
experimental psychology is a circular one, in which data and
conceptualizations developed in the field are refined and tested in the
lab, and the results fed back into the clinical process where they are
tested for ecological validity and contribute to the formation of new
clinical theories, and so on. The breakdown of this circularity has led to
increasing distance and even hostility between clinicians and
experimentalists. The lab types complain that clinicians don't do what
they're told; the therapists that the research coming from the labs is
rarely applicable to actual clinical situations. There is no
institutional setup for gathering clinical data, which experimentalists
regard as merely anecdotal anyway, and clinicians, having been trained to
think of themselves as "applied scientists" rarely approach the clinical
problem in a truly investigative, rather than a purely technical manner.
Clinicans need theory in order to organize the complexity of the phenomena
they encounter in practice; experimentalists seem to have such a profound
distrust of theory that they resist any effort to organize the data
they've worked so hard to generate.
I'd like to think it doesn't have to be that way...
Regards,
Tim
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Tim Connor, M.S. "Psychotherapy is not
Pacific University an applied science, it
School of Professional Psychology is a basic science in
2004 Pacific Avenue which the scientists
Forest Grove, OR 97116 USA are the client and his
<con...@pacificu.edu> therapist"
--George Kelly
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Jason Seidel
Excellently put, Tim!
Leave it to a student from a professional school to put this discussion
in the proper perspective. Somehow, I get the feeling that the
navel-gazing and lack of perspective-taking that so often plagues the
psych research community is *partly* caused by the pressures to
constantly defend the worth of what they are doing so they can eat more
than Top Ramen for dinner at night, and not have to put their kids up
for adoption. Economic pressures hardly contribute to a sound
epistemology of psychological research.
"You don't understand. This finger-tapping protocol is the first of its
kind! I've gotta make a poster to present this before the fiscal year
ends!" Uh, yeah.
The groovy thing about meteorology is that you don't see too many
meteorologists shouting on TV or in magazines about how their model of
forecasting "X" effect is true on any given day for any given place on
the planet. Why are we content to just hear about this city, this week,
and not demand some formula that is true for all time? Why don't we
expect the same degree of assurance and simplicity of weathercasters as
we do of clinicians? And weather is *tangible material*--just a wee bit
easier to study than a basketful of hypothetical constructs and
intervening variables such as "chemical imbalances" and "depression."
In any case, as Bob Dylan says, I don't need a weatherman to tell which
way the wind blows. Like increasing numbers of old-timer clinicians, I'm
headed for a private practice devoid of insurance ties. Will I one day
wind up in jail or on the street for malpractice--practicing Rogerian or
analytic therapy? God help me.
-Jason S.