Science and Pseudoscience in Clinical Psychology

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This book offers a rigorous examination of a variety of therapeutic, assessment, and diagnostic techniques in clinical psychology, focusing on practices that are popular and influential but lack a solid grounding in empirical research. Featuring chapters from leading clinical researchers, the text helps professionals and students evaluate the merits of novel and controversial techniques and differentiate between those that can stand up to scientific scrutiny and those that cannot. Reviewed are widely used ...
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Overview

This book offers a rigorous examination of a variety of therapeutic, assessment, and diagnostic techniques in clinical psychology, focusing on practices that are popular and influential but lack a solid grounding in empirical research. Featuring chapters from leading clinical researchers, the text helps professionals and students evaluate the merits of novel and controversial techniques and differentiate between those that can stand up to scientific scrutiny and those that cannot. Reviewed are widely used therapies for alcoholism, infantile autism, and ADHD; the use of EMDR in the treatment of posttraumatic stress disorder; herbal remedies for depression and anxiety; suggestive techniques for memory recovery; and self-help models. Other topics covered include issues surrounding psychological expert testimony, the uses and abuses of projective assessment techniques, and unanswered questions about dissociative identity disorder. Offering a balanced, constructive review of available research, each accessibly written chapter concludes with a glossary of key terms.
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Editorial Reviews

From the Publisher

"As a text for students, this book effectively illustrates the importance of becoming an evidence-based practitioner. It inoculates aspiring clinicians against the bandwagon appeal of 'fashionable' interventions and the seductive claims of pseudoscientific treatment studies."--Allen Rubin, PhD, School of Social Work, The University of Texas at Austin

"This unique and timely book may avert the advent of the Dark Ages into which the discipline of psychotherapy seems to be heading. By clearly articulating the fundamental differences between 'science' and 'pseudoscience,' it forewarns that anecdotes are not evidence, and demonstrates how to separate fact from conjecture. I cannot think of anyone who would not benefit from a thorough perusal of its contents, but it is particularly essential reading for those conducting any form of counseling or psychotherapy."--Arnold A. Lazarus, PhD, ABPP, Distinguished Professor Emeritus of Psychology, Rutgers University

"At last--a book that pulls no punches, names, and isn't afraid to portray junk science for what it is. This will be invaluable reading for anyone in the mental health professions and an essential reference for students."--Harrison G. Pope, Jr., MD, Department of Psychiatry, Harvard Medical School

"This superb volume is an instant classic and one of the most important books published in the last 20 years in psychology or law. These well written and exhaustively documented chapters provide a much needed antidote to the epidemic of pseudoscience that has too often stained the integrity of the mental health and legal systems. Mental health professionals, lawyers and judges should all view these chapters as essential information for basic professional competence."--R. Christopher Barden, PhD, JD, LP, psychologist, attorney, expert witness, legislative consultant; President, National Association for Consumer Protection in Mental Health

Journal of the American Medical Association

"Represents a most welcome attempt to separate the wheat from the chaff in mental health practices....Engaging, incisive, and illuminating."--Journal of the American Medical Association
APA Review of Books

"[An] excellent and important book."--APA Review of Books
Journal of Social Work Education

"This is clearly a text that should be read by every social worker and social work student."--Journal of Social Work Education
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Product Details

  • ISBN-13: 9781572308282
  • Publisher: Guilford Publications, Inc.
  • Publication date: 12/1/2002
  • Edition number: 1
  • Pages: 474
  • Product dimensions: 9.40 (w) x 6.32 (h) x 1.47 (d)

Meet the Author


Scott O. Lilienfeld, PhD, is Associate Professor of Psychology at Emory University. He has authored or coauthored approximately 100 articles and book chapters, serves on the editorial boards of several major journals, and is founder and editor of [i]The Scientific Review of Mental Health Practice[/i]. Dr. Lilienfeld is past president of the Society for a Science of Clinical Psychology and a recipient of the David Shakow Award for Early Career Contributions to Clinical Psychology from Division 12 (Society for Clinical Psychology) of the American Psychological Association.

Steven Jay Lynn, PhD, ABPP (Clinical, Forensic), is a licensed clinical psychologist and Professor of Psychology at the State University of New York at Binghamton. A former president of the American Psychological Association's Division 30 (Psychological Hypnosis), he is a recipient of the division's award for distinguished contributions to scientific hypnosis. Dr. Lynn is a fellow of many professional organizations and an advisory editor to a number of professional journals. He is the author of 11 books and more than 200 articles and chapters.

Jeffrey M. Lohr, PhD, is Professor of Psychology at the University of Arkansas/n-/Fayetteville. He has been a licensed psychologist in Arkansas with a part-time independent practice since 1976. Dr. Lohr's research interests focus on anxiety disorders, domestic violence, and the efficacy of psychosocial treatments.

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Science and Pseudoscience in Clinical Psychology


The Guilford Press

Copyright © 2004 The Guilford Press
All right reserved.

ISBN: 1-59385-070-0


Chapter One

Science and Pseudoscience in Clinical Psychology

Initial Thoughts, Reflections, and Considerations

SCOTT O. LILIENFELD STEVEN JAY LYNN JEFFREY M. LOHR

As Bob Dylan wrote, "The times they are a-changin'." Over the past several decades, clinical psychology and allied disciplines (e.g., psychiatry, social work, counseling) have borne witness to a virtual sea-change in the relation between science and practice. A growing minority of clinicians appear to be basing their therapeutic and assessment practices primarily on clinical experience and intuition rather than on research evidence. As a consequence, the term "scientist-practitioner gap" is being invoked with heightened frequency (see foreword to this volume by Carol Tavris; Fox, 1996), and concerns that the scientific foundations of clinical psychology are steadily eroding are being voiced increasingly in many quarters (Dawes, 1994; Kalal, 1999; McFall, 1991). It is largely these concerns that have prompted us to compile this edited volume, which features chapters by distinguished experts across a broad spectrum of areas within clinical psychology. Given the markedly changing landscape of clinical psychology, we believe this book to be both timely and important.

Some might contend that the problem of unsubstantiatedtreatment techniques is not new and has in fact dogged the field of clinical psychology virtually since its inception. To a certain extent, they would be correct. Nevertheless, the growing availability of information resources (some of which have also become misinformation resources), including popular psychology books and the Internet, the dramatic upsurge in the number of mental health training programs that do not emphasize scientific training (Beyerstein, 2001), and the burgeoning industry of fringe psychotherapies, have magnified the gulf between scientist and practitioner to a problem of critical proportions.

THE SCIENTIST-PRACTITIONER GAP AND ITS SOURCE What are the primary sources of the growing scientist-practitioner gap? As many authors have noted (see Lilienfeld, 1998, 2001, for a discussion), some practitioners in clinical psychology and related mental health disciplines appear to making increased use of unsubstantiated, untested, and otherwise questionable treatment and assessment methods. Moreover, psychotherapeutic methods of unknown or doubtful validity are proliferating on an almost weekly basis. For example, a recent and highly selective sampling of fringe psychotherapeutic practices (Eisner, 2000; see also Singer & Lalich, 1996) included neurolinguistic programming, eye movement desensitization and reprocessing, Thought Field Therapy, Emotional Freedom Technique, rage reduction therapy, primal scream therapy, feeling therapy, Buddha psychotherapy, past lives therapy, future lives therapy, alien abduction therapy, angel therapy, rebirthing, Sedona method, Silva method, entity depossession therapy, vegetotherapy, palm therapy, and a plethora of other methods (see also Chapter 7).

Moreover, a great deal of academic and media coverage of such fringe treatments is accompanied by scant critical evaluation. For example, a recent edited volume (Shannon, 2002) features 23 chapters on largely unsubstantiated psychological techniques, including music therapy, homeopathy, breath work, therapeutic touch, aromatherapy, medical intuition, acupuncture, and body-centered psychotherapies. Nevertheless, in most chapters these techniques receive minimal scientific scrutiny (see Corsini, 2001, for a similar example).

Additional threats to the scientific foundations of clinical psychology and allied fields stem from the thriving self-help industry. This industry produces hundreds of new books, manuals, and audiotapes each year (see Chapter 14), many of which promise rapid or straightforward solutions to complex life problems. Although some of these self-help materials may be efficacious, the overwhelming majority of them have never been subjected to empirical scrutiny. In addition, an ever-increasing contingent of self-help "gurus" on television and radio talk shows routinely offer advice of questionable scientific validity to a receptive, but often vulnerable, audience of troubled individuals (see Chapter 15).

Similarly questionable practices can be found in the domains of psychological assessment and diagnosis. Despite well-replicated evidence that statistical (actuarial) formulas are superior to clinical judgment for a broad range of judgmental and predictive tasks (Grove, Zald, Lebow, Snitz, & Nelson, 2000), most clinicians continue to rely on clinical judgment even in cases in which it has been shown to be ill advised. There is also evidence that many practitioners tend to be overconfident in their judgments and predictions, and to fall prey to basic errors in reasoning (e.g., confirmatory bias, illusory correlation) in the process of case formulation (Chapter 2). Moreover, many practitioners base their interpretations on assessment instruments (e.g., human figure drawing tests, Rorschach Inkblot Test, Myers-Briggs Type Indicator, anatomically detailed dolls) that are either highly controversial or questionable from a scientific standpoint (see Chapter 3).

Still other clinicians render confident diagnoses of psychiatric conditions, such as dissociative identity disorder (known formerly as multiple personality disorder), whose validity remains in dispute (see Chapter 5, but see also Gleaves, May, & Cardena, 2001, for a different perspective). The problem of questionable diagnostic labels is especially acute in courtroom settings, where psychiatric labels of unknown or doubtful validity (e.g., road rage syndrome, sexual addiction, premenstrual dysphoric disorder) are sometimes invoked as exculpatory defenses (see Chapter 4).

STRIKING A BALANCE BETWEEN EXCESSIVE OPEN-MINDEDNESS AND EXCESSIVE SKEPTISM

It is critical to emphasize that at least some of the largely or entirely untested psychotherapeutic, assessment, and diagnostic methods reviewed in this volume may ultimately prove to be efficacious or valid. It would be a serious error to dismiss any untested techniques out of hand or antecedent to prior critical scrutiny. Such closed-mindedness has sometimes characterized debates concerning the efficacy of novel psychotherapies (Beutler & Harwood, 2001). Nevertheless, a basic tenet of science is that the burden of proof always falls squarely on the claimant, not the critic (see Shermer, 1997). Consequently, it is up to the proponents of these techniques to demonstrate that they work, not up to the critics of these techniques to demonstrate the converse.

As Carl Sagan (1995b) eloquently pointed out, scientific inquiry demands a unique mix of open-mindedness and penetrating skepticism (see also Shermer, 2001). We must remain open to novel and untested claims, regardless of how superficially implausible they might appear at first blush. At the same time, we must subject these claims to incisive scrutiny to ensure that they withstand the crucible of rigorous scientific testing. As space scientist James Oberg observed, keeping an open mind is a virtue but this mind cannot be so open that one's brains fall out (Sagan, 1995a; see also Chapter 9). Although the requirement to hold all claims to high levels of critical scrutiny applies to all domains of science, such scrutiny is especially crucial in applied areas, such as clinical psychology, in which erroneous claims or ineffective practices have the potential to produce harm.

WHY POTENTIALLY PSEUDOSCIENTIFIC TECHNIQUES CAN BE HARMFUL

Some might respond to our arguments by contending that although many of the techniques reviewed in this book are either untested or ineffective, most are likely to prove either efficacious or innocuous. From this perspective, our emphasis on the dangers posed by such techniques is misplaced, because unresearched mental health practices are at worst inert.

Nevertheless, this counterargument overlooks several important considerations. Specifically, there are at least three major ways in which unsubstantiated mental health techniques can be problematic (Lilienfeld, 2002; see also Beyerstein, 2001). First, some of these techniques may be harmful per se. The tragic case of Candace Newmaker, the 10-year-old Colorado girl who was smothered to death in 2000 by therapists practicing a variant of rebirthing therapy (see Chapter 7), attests to the dangers of implementing untested therapeutic techniques (see Mercer, in press). There is also increasing reason to suspect that certain suggestive techniques (e.g., hypnosis, guided imagery) for unearthing purportedly repressed memories of childhood trauma may exacerbate or even produce psychopathology by inadvertently implanting false memories of past events (see Chapters 7 and 8). Even the use of facilitated communication for infantile autism (see Chapter 13) has resulted in erroneous accusations of child abuse against family members. Moreover, there is accumulating evidence that certain widely used treatment techniques, such as critical incident stress debriefing (see Chapter 9), peer group interventions for adolescents with conduct disorders (Dishion, McCord, & Poulin, 1999), and certain self-help programs (Rosen, 1987; see Chapter 14) can be harmful. Consequently, the oft-held assumption that "doing something is always better than doing nothing" in the domain of psychotherapy is likely to be mistaken. As psychologist Richard Gist reminds us, doing something is not license to do anything.

Second, even psychotherapies that are by themselves innocuous can indirectly produce harm by depriving individuals of scarce time, financial resources, or both. Economists refer to this side effect as "opportunity cost." As a consequence of opportunity cost, individuals who would otherwise use their time and money to seek out demonstrably efficacious treatments may be left with precious little of either. Such individuals may therefore be less likely to obtain interventions that could prove beneficial.

Third, the use of unsubstantiated techniques eats away at the scientific foundations of the profession of clinical psychology (Lilienfeld, 1998; McFall, 1991). As one of us (Lilienfeld, 2002) recently observed:

Once we abdicate our responsibility to uphold high scientific standards in administering treatments, our scientific credibility and influence are badly damaged. Moreover, by continuing to ignore the imminent dangers posed by questionable mental health techniques, we send an implicit message to our students that we are not deeply committed to anchoring our discipline in scientific evidence or to combating potentially unscientific practices. Our students will most likely follow in our footsteps and continue to turn a blind eye to the widening gap between scientist and practitioner, and between research evidence and clinical work. (p. 9)

In addition, the promulgation of treatment and assessment techniques of questionable validity can undermine the general public's faith in the profession of clinical psychology, and lead citizens to place less trust in the assertions of clinical researchers and practitioners.

(Continues...)



Excerpted from Science and Pseudoscience in Clinical Psychology Copyright © 2004 by The Guilford Press. Excerpted by permission.
All rights reserved. No part of this excerpt may be reproduced or reprinted without permission in writing from the publisher.
Excerpts are provided by Dial-A-Book Inc. solely for the personal use of visitors to this web site.

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Table of Contents


1. Science and Pseudoscience in Clinical Psychology: Initial Thoughts, Reflections, and Considerations
Scott O. Lilienfeld, Steven Jay Lynn, and Jeffrey M. Lohr

I. Controversies in Assessment and Diagnosis
2. Understanding Why Some Clinicians Use Pseudoscientific Methods: Findings from Research on Clinical Judgment
Howard N. Garb and Patricia A. Boyle
3. Controversial and Questionable Assessment Techniques
John Hunsley, Catherine M. Lee, and James M. Wood
4. The Science and Pseudoscience of Expert Testimony
Joseph T. McCann, Kelley L. Shindler, and Tammy R. Hammond
5. Dissociative Identity Disorder: Multiple Personalities, Multiple Controversies
Scott O. Lilienfeld and Steven Jay Lynn

II. General Controversies in Psychotherapy
6. Toward a Science of Psychotherapy Research: Present Status and Evaluation
John P. Garske and Timothy Anderson
7. New Age Therapies
Margaret Thaler Singer and Abraham Nievod
8. The Remembrance of Things Past: Problematic Memory Recovery Techniques in Psychotherapy
Steven Jay Lynn, Timothy Lock, Elizabeth F. Loftus, Elisa Krackow, and Scott O. Lilienfeld

III. Controversies in the Treatment of Specific Adult Disorders
9. Novel and Controversial Treatments for Trauma-Related Stress Disorders
Jeffrey M. Lohr, Wayne Hooke, Richard Gist, and David F. Tolin
10. Controversial Treatments for Alcoholism
James MacKillop, Stephen A. Lisman, Allison Weinstein, and Deborah Rosenbaum
11. Herbal Treatments and Antidepressant Medication: Similar Data , Divergent Conclusions
Harald Walach and Irving Kirsch

IV. Controversies in the Treatment of Specific Child Disorders
12. Empirically Supported, Promising, and Unsupported Treatments for Children with Attention-Deficit/Hyperactivity Disorder
Daniel A. Waschbusch and G. Perry Hill
13. The Myriad of Controversial Treatments for Autism: A Critical Evaluation of Efficacy
Raymond G. Romanczyk, Laura Arnstein, Latha V. Soorya, and Jennifer Gillis

V. Controversies Regarding Self-Help and the Media
14. Self-Help Therapy: The Science and Business of Giving Psychology Away
Gerald M. Rosen, Russell E. Glasgow, and Timothy E. Moore
15. Commercializing Mental Health Issues: Entertainment, Advertising, and Psychological Advice
Nona Wilson
16. Science and Pseudoscience in Clinical Psychology: Concluding Thoughts and Constructive Remedies
Scott O. Lilienfeld, Steven Jay Lynn, and Jeffrey M. Lohr

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