> From: Stephen Black <[EMAIL PROTECTED]>
>
> Good quibble. But the graduate student suggestion (sorry, forgot who
> made it) is one way around this. My understanding of this suggestion
> is that graduate students (or hired paraprofessionals, if grad
> students are too well informed) could be instructed in both therapies, and
> would be suitably motivated to believe in each.
That doesn't hold very well. In my experience with training graduate
students, they tend approach the field of psychotherapy already forming their
own unique theories and ideas about how people become troubled and the
best ways (for the therapists) to help solve those problems.
Plus, therapy is largely an interpersonal process. It is not simply a matter of
choosing a technique and applying it. Therapy trainees who come to the
field with that attitude get frustrated quickly when they realize they are not
only applying a strategy but building a relationship.
> BTW, conventional talk therapists would probably object to the use of
> paraprofessionals, because no one but a highly qualified professional is
> competent to give treatment.
This is tired.
>But behaviour modifiers believe otherwise
> (and evidence is on their side).
Not exactly. I refer you to, for example, "Are all psychotherapies
equivalent?" (Stiles, Shapiro, & Elliott) published in AP, 1986. They review a
large body of research that shows, across the board, different
psychotherapies show equivalent results.
Fortunately, psychotherapy research has moved on from pitting one therapy
against another. It is more a matter of finding which types of therapies
and/or therapeutic interventions work best for which clients and client
problems. Behavioral therapies work very well in some settings, not so well
in others.
> So here's my recipe, revised
>
> -take two therapies, one the experimental, the other
> attention-placebo
> -ensure that they are equally credible to the clients; confirm
> afterwards
> -randomly assign clients to one or the other of the treatments
> -administer therapy by specially-trained paraprofessionals who
> have been led to believe equally in the efficacy of the two
> treatments
> -assess by independent judges who do not know which client has
> received which therapy
You're overlooking one-half of the experiment -- the client. You need to try to
match clients based on client problem, problem severity, so many other
variables. That's a very difficult task.
This kind of experiment won't work very well, mostly because clients are very
unique. Now, I realize that in ALL experiments, each subject is different from
one another. But, in a typical lab setting, the experimenter usually has a fair
amount of control over the procedure and the setting, right?
Not in this case -- no client can be counted on to simply sit back and let the
therapist apply the appropriate therapy.
Part of the problem with therapy is that the therapist often has to overcome
the client's ambivalence about change. Paraprofessionals work very well
with people who are eager to get help; experience comes in more and more
with more disturbed and resistant individuals.
*************************************************************************
Jim Guinee, Ph.D. Director of Training, Counseling Center
Adjunct Professor, Dept. of Psychology/Counseling
Dept. of Health Sciences
President-Elect, Arkansas College Counselor Association
University of Central Arkansas
313 Bernard Hall Conway, AR 72035 USA
(501) 450-3138 (office) (501) 450-3248 (fax)
"When you are angry, do not sin; do not let
the sun go down on your wrath." Ephesians 4:26
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