catch 22 of evidence based treatment

[HV Psychodrama]

Dear Reg,
Your timing for this note is very interesting. The ASGPP  council is making arrangements with Springer to publish the ASGPP journal as an online journal only, which is what many scholarly journals are becoming now. For me there is a dilemma here. While I understand the need for scholarly research as a way of making our method relevant, I personally am much more interested in a process journal, much like the ANZPA or BPA offer. Part of this is because of the dearth of qualified research in our field. 
  I wonder if our field can support scientific research....and if not, why pretend to? Why not make out journal something our membership actually wants to read. And yet, if we do that, does that further diminish our 'marketability" as you put it?
Rebecca Walters
  ----- Original Message ----- 
  From: REGINA SEWELL 
  To: list at grouptalkweb.org 
  Sent: Saturday, November 01, 2008 9:25 AM
  Subject: catch 22 of evidence based treatment


  This morning, I was listening to a Stanford math professor talking about the history of statistics on NPR.  The piece reminded my of my distrust of statistics - or perhaps, more honestly, of the people who compile and manipulate them.  They seem to be fairly accurate (within the margin of error) as long as you have a random sample and large enough number of respondents/measured units (say 1000)  They have become so embedded in the cultural conserve that we use them as the measure of everything.  Anything that can't be measured gets dismissed as irrelevant.  

  They govern my field of Sociology in that jobs and tenure and esteem in the field is based on the amount of publications one produces in a year.  The catch here is that it's very difficult to get published using any research methodology other than statistics.  

  Statistics are also the base for determinations of what mental health treatment is the best and who gets funding.  The catch is that studies exploring treatment options rarely if ever use random samples and usually don't have very large sample sizes.  Add to this the reality of our field - what works well for one person with one therapist/counselor doesn't always work for the next person with the same or different therapist.  So if 60 percent of a sample improves with the introduction of a treatment method - what about the 40 percent who don't, who might even get worse (like the people who get suicidal with the introduction of prozac).  

  We as a field are in a bit of a bind.  On one hand, few of us have put our energy into publishing statistically based studies - especially not using random samples and including 1000 participants.  On the other, simply jumping in and following the cultural conserve does nothing to change the stagnant cultural conserve that has led our nation to use norm based student tests (remember when you measure against a norm, 50 percent of the sample has to be less than average - which in Ohio means they "fail") and statistics to determine which teaching techniques are most able to get the desired results (ie teach to the test)  which leads to a further and further loss of creativity and spontanaity.   

  So we're in a bind because the cultural conserve does not support our methods in part because of our lack of statistical research (valid or not) at the same time as part of our treatment program is to help our clients break from from the shakles of the cultural conserve that has them feeling stuck in roles that are no longer satisfying, perhaps even to feeling like robotrons, simply going through the motions of life.  

  What I'm looking for is a way we as a field can reframe ourselves, to "market" ourselves in a way that rebuilds our field and enables us to fulfill our mission.

  regina sewell, Ph.D.



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