I’d like to second what Ali wrote. I’ve been learning so much from this thread. Thanks for setting up the opportunity to play with the heavy weights, -Chance Sent from my iPhone > On Mar 16, 2018, at 6:27 AM, Kenny, Alexis Catherine - kennyac <[log in to unmask]> wrote: > > Gregg, > > Really well done. This letter helped me give language to my own response to the issue. > > Warmly, > > Ali > > Alexis (Ali) Kenny, M.A. > > > Pronouns: Please feel free to ask! > Clinical and School Psychology Doctoral Candidate > > Division 52 - International Psychology: Membership Committee, Co-Chair > > James Madison University - Harrisonburg, VA > > email: [log in to unmask] > > De: tree of knowledge system discussion <[log in to unmask]> en nombre de Henriques, Gregg - henriqgx <[log in to unmask]> > Enviado: jueves, marzo 15, 2018 12:23:23 PM > Para: [log in to unmask] > Asunto: FW: Letter to Clinical Psychologist/List of Key Issues > > Dear ToK Society, > In case folks are interested, here is a post I just sent the Clinical/Counseling Division 24 list. It refers to ongoing issues pertaining to the science practice relation stemming from the PTSD guidelines. > > Best, > Gregg > > From: Henriques, Gregg - henriqgx > Sent: Thursday, March 15, 2018 10:47 AM > To: [log in to unmask] > Subject: Letter to Clinical Psychologist/List of Key Issues > > Hi List, > > Attached is a current draft of my four page letter to the editor of The Clinical Psychologist. I share it here for edits and suggestions if folks want to take the time. I very much appreciate the thoughts that have been shared. I have read through them and tried to at least have the key ones in my mind as I wrote this. Of course, four double spaced pages do not allow for a full treatment of the issues. > > Let me share a couple of thoughts. First, I think this has been a productive discussion on a central issue. Second, I think this SIG should seriously consider trying to develop some sort of consensus statement that, at the very least, identify the key issues. I am going to list some of the key issues that I see and the maybe we can start a process of delineating them. > > 1. The domains of interest and intersection are: 1) the work of the practitioner (the phenomena of doing the actual work of assessment and therapy with real clients in real contexts); 2) empirical research (systematic attempts to gather data and information that allows one to make claims about factual states of affairs); and 3) the conceptual scheme that links the two. We can idealize (or perhaps, more appropriately, develop caricatures) of these three domains. The first is the Romantic Humanistic Practitioner who views the work of therapy in very idiographic ways and experiences each encounter almost as a work of creative expression, perhaps not unlike a work of art. The second is embodied by the (staunch) Empirical Clinical Scientist (for me, exemplified by Dr. Richard Gist, who feels completely justified in voicing how folks should practice psychotherapy as a health epidemiologist, with the vision of the psychologist as a clinical scientist who decides, via empirical methodology, what should be done). And, finally, the Coherent Rationalist. (I would consider myself an exemplar (or caricature J) of this view, at least in relationship to the extremes of the other two views. As I learned about the field, I found both many interesting and useful frames, but also no general coherent frame. And, I endeavored to adopt a metatheoretical perspective one to achieve this view, and found a scheme that I argue does it better than any others). > > 2. The nomothetic versus idiographic element. This point has been raised by several folks. It relates to the empirical clinical scientist versus romantic practitioner some, but exactly how can vary quite a bit (depending on conceptual scheme, perhaps). I consider Jim Lamiell’s stuff on aggregate versus individual levels of analysis to be very relevant here. I also think that there is a very valuable perspective from phenomenology here, in that we must be near to the thing-in-itself (i.e., the practice of psychotherapy). One of the most striking elements I saw, first hand, in running a RCT for Beck, was how remarkably removed the write up was from the thing-in-itself. And how much the conceptual scheme (i.e., promoting the brand of Beckian cognitive therapy for individuals who recently made a suicide attempt was the driving force in how that translation happened). I would also say that Skinner and his N of 1 approach in ABA is an interesting angle on this issue. > > 3. Process of psychotherapy versus Specific Psychological Treatment. There is a difference between considering the general process of psychotherapy versus specific psychological treatments matched for specific disorders. This is a way of reframing Wampold’s Great Psychotherapy Debate. I think this is the basic division between the IoM treatment guidelines and the in-progress professional practice guidelines. From my perspective, in my long brainstorm document, I commented that I differentiate counseling from psychotherapy from psychological treatment from inpatient treatment. I also believe that we would benefit from the delineation of a general approach to psychotherapy for clinically significant problems that can be characterized as “the neurotic cluster.” Then, from that, move from that to the refined psychological treatments that demonstrate the capacity to beat a general, bona fide psychotherapy. > > 4. Paradigm issues and conflicts. Within professional psychology, the CBT versus psychodynamic versus humanistic/existential (or whatever) plays a huge role. The field is both rich with insights. And a conceptual mess (at least to those of us who seek deep coherence). The paradigms frame the practice, the way research is conducted and, for adherents to them, represent the conceptual scheme. > > 5. The practice areas and the identity of professional psychology and training models. As a clinical psychologist who then joined and for 12 years directed a “Combined-Integrated” program that was conceptualized as a “Clinical-Counselling-School” Integrated program, this is MAJOR issue that gets relatively limited play. I think Joe commented that the move to “Health Service Psychology” by the APA was problematic. Folks may be interested to know that that move was indirectly responsible for that move (so Joe and I might disagree about that as well J). But, the point here is that we are talking very much about the meaning of “clinical” psychology, both as a small “c” and as a discipline relative to counseling and school (and, perhaps other specialty areas). These issues cut to the identity of what the professional arm of psychology is. It is central to my deep seated struggles and critiques of the clinical science model of training. > > 6. Translation issues: Does this happen directly from research findings or is there an intermediate step from research to principles of practice? My first and primary critique in my letter is that the Guidelines are a literature review, and that does not directly inform practice per se. Rather, I argue that the task of practice guidelines is to develop principles of practice. This difference is connected to the difference between a straight empirical scientist and a coherent rationalist approach, but it is important enough to warrant its own bullet point in my estimation. It also goes back to a point Stefan made, which is who is this for? For me, clinicians and patients want good principles. They do not want (or need) a series of manuals defined by the DSM categories. The need for that arises out of RCT/empirical epistemology. > > 7. Generalization issues, especially pertaining to cultural diversity. Related to all the above, but placed in direct contexts, perhaps with particular attention to issues of culture and diversity that Dennis and Joe commented on. > > Ok, well, I need to run. This is meant to be a beginning and a brainstorm document. I think at a minimum we should do a blog, and maybe try to develop a statement for the Journal or something that can be shared. Perhaps we can get a list of folks who are interested in contributing this this document. > > Best, > Gregg > > > > > ############################ > To unsubscribe from the TOK-SOCIETY-L list: write to: mailto:[log in to unmask] or click the following link: http://listserv.jmu.edu/cgi-bin/wa?SUBED1=TOK-SOCIETY-L&A=1 > > ############################ > To unsubscribe from the TOK-SOCIETY-L list: write to: mailto:[log in to unmask] or click the following link: http://listserv.jmu.edu/cgi-bin/wa?SUBED1=TOK-SOCIETY-L&A=1 ############################ To unsubscribe from the TOK-SOCIETY-L list: write to: mailto:[log in to unmask] or click the following link: http://listserv.jmu.edu/cgi-bin/wa?SUBED1=TOK-SOCIETY-L&A=1