catch 22 of evidence based treatment

[Jen W]

Me, I'd rather read about creative ways to put theory into practice than heady research.

Some time ago, the grouptalk folk asked why some people aren't participating.  I didn't answer then, but I'll answer now: the conversations were too heady for me.  I tend to get into my head a lot, and one thing I like about psychodrama is that it takes me out of my head, and into creativity and emotions and spontaneity.  Plus, I'm still a beginner, and I'm just getting used to the basic concepts, so I'm not at a point where I consider finer points of these concepts.

I understand that research plays a big role in legitimizing theories.  Still, I've had a hard time with the rigid constraints research places on creative work.  I created a group program, and the grant providers required that I treat the program as a replicable pilot program, verified by research.  It was difficult for me because my supervisor insisted that each group be pretty much the same in order to make the research valid.  I could not do that, because I believe that the group needs to fit the individual needs of the specific group and the specific group members.  At the same time, I had to jump through the hoops and paperwork of the joint commission until the time spend in administration far outweighed time actually helping people.

I'm not saying research needs to be abandoned, and possibly my supervisor interpreted the constraints of research too restrictively.  Still, who are we trying to prove ourselves to?  If we prove ourselves to insurance boards and commissions, are we just creating more regulations to constrain us?

Jen

From: hvpi at hvc.rr.com
To: list at grouptalkweb.org
Subject: Re: catch 22 of evidence based treatment
Date: Sat, 1 Nov 2008 10:05:43 -0400










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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