Where's the science? The sorry state of psychotherapy

October 2, 2009

The prevalence of mental health disorders in this country has nearly doubled in the past 20 years. Who is treating all of these patients? Clinical psychologists and therapists are charged with the task, but many are falling short by using methods that are out of date and lack scientific rigor. This is in part because many of the training programs—especially some Doctorate of Psychology (PsyD) programs and for-profit training centers—are not grounded in science.

A new report in Psychological Science in the Public Interest, a journal of the Association for Psychological Science, by a panel of distinguished clinical scientists—Timothy Baker (University of Wisconsin-Madison), Richard McFall (Indiana University), and Varda Shoham (University of Arizona)—calls for the reform of training programs and appeals for a new accreditation system to ensure that clinicians are trained to use the most effective and current research to treat their patients.

There are multiple practices in clinical psychology that are grounded in science and proven to work, but in the absence of standardized science-based training, those treatments go unused.

For example, cognitive-behavioral therapy (CBT) has been shown to be the most effective treatment for PTSD and has the fewest side-effects, yet many psychologists do not use this method. Baker and colleagues cite one study in which only 30 percent of psychologists were trained to perform CBT for PTSD and only half of those psychologists elected to use it. That means that six of every seven sufferers were not getting the best care available from their clinicians. Furthermore, CBT shows both long-term and immediate benefits as a treatment for PTSD; whereas medications such as Paxil have shown 25 to 50 percent relapse rates.

The report suggests that the escalating cost of mental health care treatment has reduced the use of psychological treatments and shifted care to general health care facilities. The authors also stress the importance of coupling psychosocial interventions with medicine because many behavioral therapies have been shown to reduce costs and provide longer term benefits for the client.

Baker and colleagues conclude that a new accreditation system is the key to reforming training in clinical psychology. This new system is already under development: the Psychological Clinical Science Accreditation System (PCSAS www.pcsas.org).

Source: Association for (news : web)

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not rated yet Oct 03, 2009
As the source link notes, there have been long-standing difficulties between the APS and APA. This should be fun to watch.
5 / 5 (1) Oct 04, 2009
psychdoc: It is no fun to watch a loved one being "mistreated"!!!
1 / 5 (1) Oct 04, 2009
psychotherapist = the priest of the atheists...

Not my idea, I saw in a movie. But is true.

All the declining we see in some countries of the first world is plainly the result of materialism, the outcome of having false idols. Michael Jackson an idol? please, a sick society.

The paradox is that the psychotherapists are mentally ill themselves, as Freud notoriously recognized. (Or as any honest psychologist would note of its professional organizations and university departments).

The "cognitive elite" needs to be cured, the "poor rich children", because they are who have more influence in directing society. And as we can see, ill poor rich children do insane things.

Which mouse wants to put the bell in the cat's tail?
not rated yet Oct 05, 2009
@ E_L_Earnhardt: ?
I was referring to the aps/apa difficulties that are longstanding. Clients will better from this discussion, whichever way it turns. What is being discussed here are differences between two professional associations of psychology: The American Psychological Association (APA; which has heretofore been the standard bearer for clinical training), and the Association for Psychological Science (APS). The APS and the APA have a long history of trying to work things out. This looks like it might complicate things, in my opinion, which should be fun to watch.

CBT contains concepts that are more easily measured by today's technologies (both statistical and practical) and therefore tend to have more support in the scientific literature. If you measure growth according to preset standards set by the clinicians, then CBT seems to outperform others in PTSD. However, if you look generally at client report, all have historically (except the eclectic) had equal outcomes.

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