I'm going to quote from Stanovich (_How to Think Straight about
Psychology_, 7th ed., p 167):
"In a variety of clinical domains, when a clinician is given information
about a client and asked to predict the client's behavior, and when the
same information is quantified and processed by a statistical equation
that has been developed based on actuarial relationships that research
has uncovered, invariably the equation wins."
So, yes, a clinician can make clinical judgments about an individual
tailored to that individual, when he or she does this, over the long
haul the clinician is going to err more than be correct. Using the
aggregate data means that you must accept some error in particular cases
in order to reduce overall error. There is a *lot* of research on this.
The problem with second-guessing the data is that we do not know *how*
we should deviate from the actuarial predictions. We might have a
clinical "sense," we might rely on our clinical "experience," but those
judgments are as fraught with bias as any human judgment. It's only by
(somewhat slavishly) adhering to the data that we can be even reasonably
sure we know what we're doing.
Otherwise, it seems to me, we might as well forgo the expense and time
of going to school.
m
--
Marc Carter
Baker University Department of Psychology
Assistant Professor, Itinerant Scientist,
Inveterate Skeptic, Former Surfer.
---
The test of our progress is not whether we add more
to the abundance of those who have much;
it is whether we provide enough for those who have too little.
----- Franklin Roosevelt
-----Original Message-----
From: FRICKLE, RUTH [mailto:[EMAIL PROTECTED]
Sent: Friday, December 03, 2004 2:02 PM
To: Teaching in the Psychological Sciences
Subject: RE: APA President-elect
"There is this split in the APA between those who believe that practice
should be guided by data and those who believe that practice should be
guided by anecdote."
I've been taught and teach my students that there's no such thing as
"exact science" and that the data really don't represent the individual,
they represent the aggregate. Clinicians struggle with this every day.
I agree that ethical clinicians should steer clear of oddities like
hypno-regression, or EMDR but to say that they are relying on anecdote
when they drift from strict adherence to the data, is unfair.
"There are more practitioners than academics, so it really would take a
wholesale exodus which is highly unlikely.
What we really need is a medical model: some strong contingencies
requiring scientific support for clinical practices."
The medical model is rife with problems. In an effort to deal with the
shortcomings of the model, it seems to me that physicians work with the
data in mind but bend and flex in response to the uniqueness of each
case. In the process they undoubtedly use anecdote or sheer guesswork
to help their patients.
If anyone is a clinician out there, and has been able to successfully
work with a wide range of clients & their issues with strict adherence
to the data, I'd would genuinely be interested in hearing about your
experiences.
Ruth Frickle
Department of Psychology
Highline Community College
Des Moines, WA 98198-9800
(206) 878-3710 ext. 3111
[EMAIL PROTECTED]
-----Original Message-----
From: Paul Brandon [mailto:[EMAIL PROTECTED]
Sent: Friday, December 03, 2004 7:43 AM
To: Teaching in the Psychological Sciences
Subject: Re: APA President-elect
There is this split in the APA between those who believe that
practice should be guided by data and those who believe that practice
should be guided by anecdote.
I'll leave it to the list members to decide which group has become
dominant, but I'm letting my membership lapse.
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