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Speaking as a tenured professor of clinical psychology, this part kind of irked me a bit. It's not exactly false but it's a little misleading (like some other p
by 0o9iujhiii 2y ago
Speaking as a tenured professor of clinical psychology, this part kind of irked me a bit. It's not exactly false but it's a little misleading (like some other parts of the essay).
Lots to say about it but this is a finding that has been reported intermittently for decades. However, it's being spun a little misleadingly.
Note that the author says that untrained professors were selected for their ability to be warm and empathetic. It's not everyone (we all know not everyone is warm and empathetic), and even trainees learn very very early (like immediately in their first term) the basics of therapy. Not everyone is warm and empathetic, and people going into clinical psychology are sort of self-selected in their empathy to start with.
This research is kind of being taken out of context too. Wampold, one of the authors cited (who I have the greatest respect for) is very big on "nonspecific factors", meaning things like empathy, good social skills, and so forth. His studies in general tend to be focused not on "does training matter?" but "do specific therapy protocols matter, or is it about the clinician's social/relationship skills?"
If you want some kind of medical standards, you can't just say "oh it's ok, everyone can just be warm and empathetic". You have to train on it, grade it, hold it to some standard. Otherwise you get manipulative, self-serving therapists who do harm in the long run (the length of a study versus real settings is another issue).
Another issue is that many of these issues are not unique to psychology. In lots of medical scenarios it's been shown that the amount of training needed to competently do a wide variety of procedures is lower than current standards in the US require. Experienced clinicians in many fields have acquired biases that interfere with practice, young trainees are much more worried about performance and are more open-minded and so forth (on average a little; not trying to stereotype).
A huge, enormous volume of studies over many years have shown that therapy works compared to all sorts of placebos and controls; that some therapists are reliably better than others; but that what makes therapy "work" overall is not what protocol-driven therapies (CBT etc) assert. It's not so much that training isn't necessary, it's that the field has has been obsessed with scientific details that, although well-intended, don't matter, and healthcare in general is full of phenomena that we'd rather not admit.
- titanomachy 2y agoThanks for writing this, appreciate the point of view of someone who knows what they’re talking about. I guess my gripe is that the time-consuming and expensive training process isn’t able to reliably elevate a random young practitioner to the helpfulness level of “wise and patient professor who is offering their time to mentor and counsel even though it’s not in their job description”… but that is in fact a very high bar to hit. It’s not surprising that some people are naturally good therapists just from a lifetime of observing people, and also not surprising that some of those people end up in teaching-focused academic jobs. I guess you can train people to be empathetic if they’re motivated in the right ways but just lacking the skill. It makes sense that it’s a big part of counselor training.
- Pannoniae 2y ago"healthcare in general is full of phenomena that we'd rather not admit." What kind of things are you talking about?
- mike_hearn 2y agoThe obvious example would be the placebo effect. Drug/vaccine trials are the only area of science I can think of that are routinely held up as pinnacles of rationality, the outputs of which all Good Citizens must take on faith, and yet which attempt to control for some sort of paranormal force in which people can unconsciously fix their own bodies through psionic abilities. This regularly happens and nobody seems the slightest bit curious about why. That is, when you think about it, totally mad. I'd suggest it's got to be either: 1. The only psychology mystery worth investigating, or 2. A sign that clinical trials are actually mostly junk science Either would be hard to admit.
- inglor_cz 2y ago"some sort of paranormal force in which people can unconsciously fix their own bodies through psionic abilities." I think you are being very dismissive there. After all, the placebo effect happens in your body, which your mind inhabits. These are not two separate systems interacting by some magical means. This is one system with various subsystems that interact all the time. Concrete mechanism of the placebo effect is still unknown, but the observation that your immune system can be influenced by your mental state isn't in itself magical. Our bodies respond to all sorts of mental states. We get red in face when embarassed, and sometimes must run to the toilet when scared etc. All this "psionic" "paranormal" label stuff would only apply if someone could do it to other people without them even knowing.
- mike_hearn 2y agoSure, but I think most people would place very hard limits on what you can do to just think yourself better. Your mind can't cure cancer, eliminate viruses, regrow arms etc. Yet we routinely design clinical trials as if it can. And ... nobody seems to think this is in any way strange!