Psychology Holy Wars

It's bad enough that when a person has a problem in their lives, they're not quite sure who to turn to. More often than not, when that problem is of the mental health variety, they turn to their primary care doctor. That physician will then evaluate the concern in the few minutes they have time to spend with the patient, make a prescription (more often than not for something like an antidepressant or antipsychotic medication), and sometimes even make a referral to a mental health professional.

The vast majority of people never even make it that far. Most people don't ever seek out professional help for their mental health concern, whether it is depression, anxiety, bipolar disorder or something else. Previous research has shown that most people simply try and get by on their own, suffering in silence.

But let's say you're in the minority of people who actually seek out the help of a mental health professional. Who do you turn to?

If you're like most people, you find a therapist through a variety of methods, such as through your insurance company's list of therapists, through the recommendation of your physician or a trusted friend, or through an online directory. Then you're confronted with the mishmash of professionals available, the various degrees, professions, credentials, and what-not. It's enough to dissuade someone from even contacting one of them.

Enter into the fray the long-running battle between ivory-towered academics who believe that only through research will people find the most effective forms of treatment, and clinicians, who believe that the real world is a bit more complex and messy than most research takes into account.

The latest battle takes place among clinical psychologists. Led by Timothy Baker in a article slated for publication next month in the journal Perspectives on Psychological Science, researchers claim that psychologist training has become lax and hopelessly dumbed-down. Their solution? Yet another credential, but this time for the psychology training programs themselves (not the professionals who actually practice). Conveniently, two of the three researchers are a part of the organization that will offer this new credentialing program.

Sharon Begley, writing in Newsweek, gobbles up the researcher's conclusions without batting a critical eye at their argument. Their reasoning, however, leaves a lot to be desired, holding up medicine as the perfect historical example of how psychologists should reinvent themselves through offering more rigorous research-oriented training programs. But physicians themselves haven't been practicing evidence-based medicine until far more recently in their profession, in a movement that's still picking up steam. Even today, most doctors use research to help inform their clinical judgment and experience, and not the other way around.

This uneasy relationship between researchers and practitioners is nothing new. Researchers have long decried the lack of adoption of their findings among the clinicians who see actual patients (in both medicine and psychology). But it's rare to see such animosity directed toward a subset of clinical psychologists as Baker and his colleagues directed toward those who have graduated from a specific type of clinical psychology program.

Could psychologists in practice do a better job integrating research findings into their everyday clinical practice? Certainly, as could all health care professionals across the board. The answer isn't more credentials, which would create a two-tiered, elitist system of mental health care -- those who can afford to go to the psychologist who graduated from such a program, and those who did not.

Instead, psychologists should be working to build bridges not only between themselves, but between the mental health professions. The problem isn't that psychotherapy isn't effective enough or that psychologists don't help people, it's that most people never seek out a psychotherapist in the first place for their mental health concern.

The profession of psychology will indeed be marginalized if they don't clearly demonstrate how their profession can help people feel better, faster, than other professions. This latest holy war will do little to meet that goal. Instead, it will only further fragment psychologists, and make it more confusing for most people on what kind of therapist to choose.

Follow Dr. John Grohol on Twitter: www.twitter.com/docjohng

Comments

[RadicalRepublican]

Wow, people are actually being treated fo normal mental health issues. Must be nice. I've got bones that weren't set after being broken. Odd medical system we've got here.