RE: APA President-elect

[Rick Froman]

I agree that most of them are not logical consequences of the others but I also don’t see them as inherently contradictory. I see them as corollaries of the medical model and believing some but not other of the corollaries would probably indicate less belief in the medical model (from which they flow) itself. It is a model which means it is a guiding metaphor for understanding psychological disorders. And all metaphors break down at some point. I do agree it is important to determine which of the corollaries a person believes before trying to engage them on the topic of the use of the medical model in psychological disorders. I think much of the confusion surrounding psychological addictions, for example, is a misunderstanding of the limits of the metaphor or even a lack of understanding that a metaphor is being used. Listeners assume a biological etiology and medical treatment for a psychological addiction because of the use of the word addiction. In that case, if the metaphor is almost certain to cause confusion, it might be better to think of another less confusing metaphor since the purpose of a metaphor (or a model) should be to elucidate, not confuse.   Rick Dr. Rick Froman Professor of Psychology John Brown University 2000 W. University Siloam Springs, AR  72761 [EMAIL PROTECTED] (479) 524-7295 http://www.jbu.edu/academics/sbs/faculty/rfroman.asp From: Scott Lilienfeld [mailto:[EMAIL PROTECTED] Sent: Friday, December 03, 2004 3:29 PM To: Teaching in the Psychological Sciences Subject: Re: APA President-elect   Rick: None of these statements is strictly logically inconsistent, but few of them logically entail any of the others.  For example, one could readily embrace (3), as all mind-body monists do, yet believe that most mental disorders are of psychosocial etiology (contradicting 1).  Or one could embrace (1), yet believe that psychosocial treatments are typically superior to biological treatments (contradicting 2).  Or one could believe that psychological disorders differ in degree rather than kind from normality (5), yet believe that they should be treated psychosocially (contradicting 2).  And so on.  So these differing views are not tightily interconnected logically, and there are a myriad of ways in which they can become entirely uncoupled.  ...Scott Rick Froman wrote: What is wrong with just saying that all eight of those statements are corollaries of the medical model? Are any of these points logically inconsistent with the others?   With regard to physical disorders, these concepts could be written as follows with no inconsistency:   1) A model that implies biological etiology of physical disorders (2) A model that implies that physical disorders should be treated biologically (3) A model that implies biological mediation of physical disorders (in reality, this is nothing more or less than mind-body monism) (4) A model that implies that physicians or other medically trained personnel should treat physical disorders (5) A model that implies that physical disorders differ categorically/qualitatively from normality (a strange definition given that many medical disorders, e.g., Type II diabetes and essential hypertension, wouldn't fit this definition either) (6) A model that focuses on physical abnormality rather than physical health (7) A model that embraces the notion that the domain of pathology can be "carved" into meaningful entities described by diagnostic labels. (8) A model that posits a strong/direct linkage between diagnosis and Treatment. Rick   Dr. Rick Froman Professor of Psychology John Brown University 2000 W. University Siloam Springs, AR  72761 [EMAIL PROTECTED] (479) 524-7295 http://www.jbu.edu/academics/sbs/faculty/rfroman.asp     -----Original Message----- From: Scott Lilienfeld [mailto:[EMAIL PROTECTED]] Sent: Friday, December 03, 2004 2:36 PM To: Teaching in the Psychological Sciences Subject: Re: APA President-elect   Ruth et al.: As a number of authors, including Paul Meehl and Paul Blaney, have noted, the term "medical model" actually refers to a large number of quite different models, many of which bear little or no conceptual relation to each other. A few years ago, I intended to begin work on an invited paper on the topic, which I never found time to write   (one of these days...). But my own admittedly informal survey of the literature and of my colleagues revealed the following different - yet widespread - meanings of the term "medical model." I'd like to argue that most of these meanings are so logically disparate as to suggest that the term is logically inchoate.   (1) A model that implies biological etiology of psychological disorders (2) A model that implies that psychological disorders should be treated biologically (3) A model that implies biological mediation of psychological disorders   (in reality, this is nothing more or less than mind-body monism) (4) A model that implies that physicians or other medically trained personnel should treat psychological disorders (5) A model that implies that psychological disorders differ categorically/qualitatively from normality (a strange definition given that many medical disorders, e.g., Type II diabetes and essential hypertension, wouldn't fit this definition either) (6) A model that focuses on psychological abnormality rather than psychological health (7) A model that embraces the notion that the domain of psychopathology can be "carved" into meaningful entities described by diagnostic labels. (8) A model that posits a strong/direct linkage between diagnosis and treatment   I'd argue that at the very least that we be explicit about which, if any, of these quite different models we are referring to when we use the   term "medical model." ....Scott   FRICKLE, RUTH wrote:     "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 likehypno-regression, or EMDR but to say that they are relying on anecdotewhen 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 theshortcomings of the model, it seems to me that physicians work with thedata in mind but bend and flex in response to the uniqueness of eachcase.  In the process they undoubtedly use anecdote or sheer guessworkto help their patients.   If anyone is a clinician out there, and has been able to successfullywork with a wide range of clients & their issues with strict adherenceto the data, I'd would genuinely be interested in hearing about yourexperiences. Ruth FrickleDepartment of PsychologyHighline Community CollegeDes 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 AMTo: Teaching in the Psychological SciencesSubject: 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.   ---You are currently subscribed to tips as: [EMAIL PROTECTED]To unsubscribe send a blank email to    [EMAIL PROTECTED]           -- Scott O. Lilienfeld, Ph.D.Associate Professor Department of Psychology, Room 206 Emory University532 N. Kilgo Circle Atlanta, Georgia 30322 (404) 727-1125 (phone)(404) 727-0372 (FAX) Home Page: http://www.emory.edu/PSYCH/Faculty/lilienfeld.html The Scientific Review of Mental Health Practice: www.srmhp.org  The Master in the Art of Living makes little distinction between his work and his play, his labor and his leisure, his mind and his body, his education and his recreation, his love and his intellectual passions.  He hardly knows which is which.  He simply pursues his vision of excellence in whatever he does, leaving others to decide whether he is working or playing.  To him – he is always doing both. - Zen Buddhist text   (slightly modified)     --- You are currently subscribed to tips as: [EMAIL PROTECTED] To unsubscribe send a blank email to [EMAIL PROTECTED] --- You are currently subscribed to tips as: archive@jab.org To unsubscribe send a blank email to [EMAIL PROTECTED]