I agree with Chris Green, and would add  - having worked with many 
psychiatrists over the years - that the predominant model in medicine tends to 
learning by authority (one's supervisor/chief resident, etc. says "When you 
find diagnosis X, prescribe Y unless co-occurring conditions Z are present").  
Some have (tongue and cheek) referred to this model as "eminence-based 
practice" to distinguish it from "evidence-based practice."  ...Scott




Scott O. Lilienfeld, Ph.D.
Professor
Editor, Scientific Review of Mental Health Practice
Department of Psychology, Room 473 Psychology and Interdisciplinary Sciences 
(PAIS)
Emory University
36 Eagle Row
Atlanta, Georgia 30322
[email protected]
(404) 727-1125

Psychology Today Blog: 
http://www.psychologytoday.com/blog/the-skeptical-psychologist

50 Great Myths of Popular Psychology:
http://www.wiley.com/WileyCDA/WileyTitle/productCd-140513111X.html

Scientific American Mind: Facts and Fictions in Mental Health Column:
http://www.scientificamerican.com/sciammind/

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)


From: Christopher D. Green [mailto:[email protected]]
Sent: Thursday, October 15, 2009 1:59 PM
To: Teaching in the Psychological Sciences (TIPS)
Subject: Re: [tips] *Nature* on APA and clinical psychology


Marc Carter wrote:

I certainly don't want my doctor choosing a medicine on the basis of anything 
other than what's been shown to work.  Why should we expect less of therapists?

Marc, I think you've hit the nail on the head, though inadvertently. There are 
many, many physicians out there who, although they scraped through their 
initial medical training, are not able (or wanting) to read and evaluate new 
medical research as it is published. They rely mainly on their past experience, 
discussions with colleagues, and intuition (just like many clinical 
psychologists). The pharmaceutical industry figured this out a long time ago 
and exploits it to their advantage by sending physicians advertising in the 
form of easy-to-read read promotional literature that is thinly disguised as 
research summaries. And they send them a lot of "samples" to give to their 
patients (to get them in the habit of prescribing the brand), and they throw 
luxurious promotional parties that are thinly disguised as confernces.

Do I think that the original training of physicians is more scientifically 
rigorous than that of clinical psychologists? Of course, but I also think that 
medical science, in general, is more rigorous then psychological science as 
well, so the difference in training regimens is hardly surprising.

The real issue here, I think, is that there is a clinical ethos (whether in 
psychology or medicine) that is orthogonal to (or perhaps even somewhat 
negatively correlated with) the research ethos (and lets be clear -- there are 
lots of superior researchers who, despite their great knowledge, would make 
horrible clinicians). It is relatively rare to find an individual who brings 
the best of both together. That is where the problems lies.

Regards,
Chris
--


Christopher D. Green
Department of Psychology
York University
Toronto, ON M3J 1P3
Canada



416-736-2100 ex. 66164
[email protected]<mailto:[email protected]>
http://www.yorku.ca/christo/

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