Hi Don:
 
> I don't know what kind of IRB you have at your school, but I can't imagine
> the proposal getting past any of ours. Think about it for a minute.

I do understand what you are saying.  And I certainly hope that this kind of research 
would not get past an IRB.  That is not the point I was trying to make.
 
I was trying (and perhaps poorly) to make the point that our knowledge is based upon 
more than just the randomized clinical trial or prospective research design.  There 
are some studies that we will not be able to conduct because of the ethical or 
practical limitations.  Some on this list have suggested (either explicitly or 
implicitly) that if we don't have the experimental design to show a particular 
conclusion, then we can't reach the conclusion.  I would argue against that line of 
reasoning.  I would also agree with Sherry Ferguson and some others that we don't 
necessarily need scientific evidence in order to believe something.  I am not in favor 
of the widespread proliferation of handguns and, even if scientific research were to 
show that owning handguns did not increase the rate of unitentional injuries or 
homicides, I would still choose to not own a handgun.  I would also not allow anyone 
in my household to own a handgun.  The same thing goes with aggressive or salacious 
television programming.  Regardless of what the research shows, I am still not going 
to let my school-aged child watch Natural Born Killers or Sex in the City on HBO.  We 
make decisions in life on more than just the results of the experimental research 
study.  Hopefully we do not stick our heads in the sand and ignore the results of 
psychological and medical research, particularly those results that are consistent 
across studies and time.  But most if not all of us also have sources of values other 
than scientific research.
 
Thank you for providing the meta-analysis references.  I will look them up.
 
> So, where does this leave us?  The way I see it we have data that suggests
> that there are  strong factors that affect violent behaviour (economic
> disparity, guns, etc.) and weak or non-existent factors (TV, video games,
> rap music, etc.). What advice should you give to parents? Well, If a
> client came to me inquiring  if s/he was being compulsive about
> disinfecting the toilet on a daily basis I would not enter into the
> discussion if I noticed that the house was on fire.

I'm not sure if you are understanding my point on this one.  Parents may have very 
little that they can do to reduce economic disparity in our country or to reduce the 
gun rate (other than not owning one themselves).  When parents come to therapy they 
are often greatly concerned about their children and families.  To suggest to them 
that they should first work on reducing world poverty or the spread of handguns is 
disrespectful and dismissive of their concerns.
 
Good metaphor about "toilets" (television watching) and the larger "fire in the house" 
(economic disparity and handguns).  You are right that if a parent is focusing 
exclusively on violent television programming as the only source of the child's 
behavior problems, then it would be unethical if we ignored that the larger fire in 
the house.  To extend your metaphor, however, I would suggest that economic disparity 
and handguns is not the "fire in the house," but rather the "deteriorating condition 
of the community" in which the house is located.  I would suggest that the "fire in 
the house" might be a permissive or authoritarian style of parenting.  It might be the 
level of overt verbal or physical conflict between the parents.  It might be the lack 
of consistent discipline.  It might be the substance abuse of one of the parents.  It 
might be problems between the child and his or her siblings.  It might be academic 
problems the child is experiencing.  The list goes on.  I am all in favor of anyone 
going out into the broader community to address the more pervasive societal problems 
that impact individual and family behavior (such as economic disparity or handguns).  
But when parents come into therapy, they first and foremost want to know how to stop 
the fire in their house, not how to fix societal problems.  If they are focusing only 
on cleaning their toilets, I will certainly help them to address the fire in the 
house.
 
A related point is that just because we don't have any empirical data showing a causal 
relationship between television wathcing and aggressive behavior, it does not mean 
that on an individual level there is no causal relationship.  Therapists should 
certainly inform parents about the current scientific research, and we need research 
to guide our thinking, but we also need to think scientifically and identify specific 
causal factors on an individual basis.  In medicine, we know from randomized clinical 
trials that nortriptyline is an efficacious treatment for certain types of neuropathic 
pain.  Even though we have the scientific data to show this, we also know that some 
individuals do not respond to nortriptyline.  We can use this research to guide us, 
but we will still need to evaluate individual situation on a case-by-case basis.      
 
Thanks for your thoughts!
 
Rod

 

 

 

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