Rick Froman wrote:
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
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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--
Scott O. Lilienfeld, Ph.D.
Associate Professor Department of Psychology, Room 206 Emory University
532 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:
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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)
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