I don’t know if you feel the same way I do. Looking back, I’m pretty sure its been going on for a while, but somehow I didn’t notice.
Professional books and journals fill my bookshelves and are stacked around my desk. I am, and always have been, a voracious–even compulsive–reader. In the last couple of years, the volume of material has only increased–exponentially so, if I include digital items saved to my desktop.
Now, I’ll be the first to admit: it’s hard keeping up. But that’s really not my problem.
The issue is: I feel like I’m drowning in trivia and the trivial.
How about you? When was the last time you read something truly meaningful?
Increasingly, research journals are filled with studies that are either so narrow in focus as to defy any real world application, or simply revisit the same questions over and over. Just how many more studies does the field need, for example, on cognitive-behavioral therapy? A Google Scholar search on the subject, crossed with the term, “randomized controlled trial,” returns over a million hits!
In terms of translating research into practice, here’s a sample of articles sure to appeal to almost every clinician (and I didn’t have to “dig deep” to find these, by the way, as all were in journals neatly stacked on my desk):
- Psychodynamizing and Existentializing Cognitive-Behavioral Interventions
- How extraverted is honey.bunny77@hotmail.de? Inferring personality from e-mail addresses
- Satisfaction with life moderates the indirect effect of pain intensity on pain interference through pain catastrophizing
I didn’t make these up. All are real articles in real research journals. If you don’t believe me, click on the links to see for yourself.
Neologisms (#1) and cuteness (#2) aside, their titles often belie a mind-numbing banality in both scope and findings. Take the last study. Can you guess what its about? Satisfaction with life moderates the indirect effect of pain intensity on pain interference through pain catastrophizing. And what findings do you think the authors spent 10 double-column, 10-point font pages relating in one of psychology’s most prestigious journals?
“Satisfaction with life appears to buffer the effect of pain.”
Hmm. Not particularly earth-shattering. And, based on these results, what do the authors recommend? Of course: “Further evaluation in longitudinal and interventional studies” (I foresee another study on cognitive-behavioral therapy in the near future).
Purpose, belonging, sense-making, transcendence, and growth are the foundations of meaning. Most of what shows up in my inbox, is taught at professionals workshops, and appears in scholarly publications has, or engenders, none of those qualities. The cost to our field and the people we serve is staggering. Worldwide, rates of depression, anxiety, and suicide continue to rise. At the same time, fewer and fewer people are seeking psychotherapy–34% fewer according to the latest findings. It is important to note that even when extensive efforts are made, and significant financial support is provided, 85% of those who could benefit choose not go. I just can’t believe its because therapists haven’t attended the latest “amygdala retraining” workshop, or do not know how to “psychodynamize” their cognitive-behavioral interventions.
This last week, I had the pleasure of interviewing Dr. Ben Caldwell. His book, Saving Psychotherapy: Bringing the Talking Cure Back from the Brink, speaks directly to the challenges facing the field as well as steps every clinician can take to restore meaning to both research and practice. Take listen, and then be sure to leave a comment.
Until next time,
Scott
Scott D. Miller, Ph.D.
Director, International Center for Clinical Excellence
Hi Scott,
I’ve been spending a lot of my time reading the Journal of Human Trafficking. Yes, they have a journal for that. The articles are very focused and timely.
About the only thing that I have trouble with is the extent of human trafficking. We really don’t have firm numbers on how many people are trafficked either nationally or world-wide.
If this journal ever gets to the point of publishing frivolous articles then I’ll know it’s time to move on.
All the best,
James
It is hard to separate the wheat from the chaff. I depend on recommendations about good reads. I enjoy your blog posts because they do steer me in certain directions and give good summaries. Re: not many people attending therapy I think its useful to think of certain professions like coaching and certain ” health practitioners” as providing similar services. Good ones , in both fields, satisfy the requirement of creating meaningful connections i.e. the relationship plus achieving results. If you add in those fields I think there are more people attending “therapy” (coaching, holistic treatment, etc.)
Love this interview, thank you for sharing. Yes there is something peculiar about not being educated enough, instead of finding ways to keeping our own spirit up!!! At the moment I’m planing for a workshop at the ACE conferees i Sweden in May and I`ve had the same way of thinking about therapists need to think more about why they are working with therapy than how they are doing therapy. I think that there´s a risk that therapists are so trained that they lose their own curiosity, their lust to experiment together with clients. / Gun-Eva
The basic problem with psychotherapy is that it has yet to understand the nature of the client’s experiencing, and therefore it has no idea what the most effective change agent is. Any science is effective to the extent that it understands its subject matter. The client’s experiencing is the subject matter of our beloved profession. In the current zeitgeist, there is a strong aversion towards the second most common aspect of the client’s experiencing; i.e., becoming emotionally upset (after talking). The not so understated message to practitioners is: Calm that person down as quickly as possible so she/he doesn’t get re-traumatized. If I may, just to emphasize the point, that’s “fake news.” Here’s why. There’s a basic difference between therapeutic emotional experiencing and non-therapeutic emotional experiencing. The key is whether or not emotional experiencing arises coincident with the person receiving sufficient support for their experiencing. This unforced activation of emotional experiencing is not re-traumatizing and it’s a part of what I think of as the natural healing process for a psychological “injury;” i.e., a symptom/problem that has an interpersonal cause and the effect of which cannot be significantly altered by a conscious act. So the next time a client becomes emotionally upset because you’ve done an exemplary job of being supportive of that person’s experiencing, put your midwife’s cap on and listen attentively and patiently, and assume there’s a natural process operating and that your job is to support it and not do anything to interrupt it, such as distracting the client’s attention from their experiencing. (If anyone’s interested, see Jessica: The autobiography of an infant, and the PsycINFO database.)
Scott:
Your office and desk sound exactly like mine, stacks of books and articles.
Those of us in this field have to read a lot in order to stay abreast but
with all of this comes a great sense of satisfaction. We are in the field to
help those seeking help and the only way we will be able to be of any help
is to stay informed. Drake Counseling is now in the process of implementing
Feedback-Informed Therapy.
Nobody needs therapy! Nobody needs it! People needs something else! They need to regain their trust, to rediscover how to look at things. They need introspection, they need nsights.
People needs RESULTS. They afraid of the process itself. They do not need the proces, nor the expensive expert. They need the inner way to rediscover THEMSELVES.
Experts are not able to COMMUNICATE to ordinary people about WHAT ON HELL ARE THEY DOING through this process! That is why people are running away from them!
All we have to do, as experts, is to re-learn how to communicate, how to tell people who we are and what we are doing through our logo-therapy.
Instead of scaring people with diagnosys, papers, degrees and many scientific datas, we have to simply invite them to TALK to us. It s all we have to do to break the ice.
Hi Scott, I totally agree with your blog post, it is definitely becoming more and more difficult to find meaningful new information in this field. There seems to be a lot of quantity and not a lot of quality work happening.
I’ve moved into this area from working in the advertising business and totally agree with Ben’s comments.regarding trust and developing your own unique approach. I’m based in Australia, and looking for a therapist here is almost impossible unless you have connections in the industry and can get a good recommendation. I’m going to buy his book and have a read.
Thank you for sharing the interview and for being an inspiring thought leader in this field.
Sarah
I enjoyed this conversation. Thank you, Scott & Ben. For years, I have written about the value of a clinician’s “personal philosophy” as something that is essential to practice. However, I have found many–all therapists, not clients– who disagree with me. In sum, what they say is, “A therapist’s beliefs about change, human life, etc. are irrelevant. The person of the therapist is of no consequence. Therapy is all about having a pragmatic approach that the therapist has been trained well in and follows accordingly.” My clients seem to indicate otherwise. I suppose I just live in an alternate reality.
Thanks Scott for your blog and articles. I enjoyed the interview with Dr. Ben Caldwell and look forward to reading about his ideas.
I am 72 and have been a Psychiatric Social Worker for 49 years and still engaged in private practice seeing about 25 clients per week.
Over the years of my practice, things have significantly changed especially with the lack of support for Community Mental Health Centers, the rise of managed care, and the prescription of psychotropic drugs for all kinds of psychiatric illnesses by primary care physicians after a 15 minute encounter.
The further medicalization of mental health problems with the ascendency of “brain science” has produced a new paradigm for thinking about “problems in living” as being brain problems and not emotional and psychosocial problems.
I am seeing a bit of a back lash to the medicalization of emotionally problems in the younger clients I am seeing. They increasingly don’t want drugs, they want someone to talk to. I am wondering whether the increasing disenchantment with assembly line medicine will not see a resurgence in psychotherapy? It works.
I no longer get many referrals from PCPs like I did in the 80s and 90s because PCP authorizations for care have been eliminated in my area. I am getting many more referrals from satisfied customers. This is a key indicator of a thriving private practice.
Your work, Scott, is very important in continuing to uplift the benefit of good mental health care, encouraging a humanistic and collaborate approach, inspiring practitioners to engage in deliberate practice, and validating the value of psychotherapists work.
Many thanks!
David G. Markham, L.C.S.W.
Brockport, NY
psychotherapystories.buzzsprout.com
As a graduate student, I am drowning under theory and empirical evidence rather than learning how to help a grieving widower process his feelings. I absolutely think that I am not garnering the skills and tools needed. Those extra hours that have been added to a Master’s degree are absorbed by an exhausting extent of scientific research and theory.
I think when Carl Rogers said that we should be genuine as therapists the unsaid message is to be you under all the trappings of theory. Why not be able to share an experience if it could help someone? Why aren’t we, as students, taught how to express our own emotions in response to a client? I just do not get it!
Eve…
Waht can I say, except “I feel your pain!” Personally, I don’t believe the issue is a focus on the science in general. I LOVE research. The problem, in my opinion, is the field (and much of graduate school curricula, focuses on theories and models (and their supporting research) as the best WAY to teach and do therapy. My advice? Find a practitioner/teacher/mentor you admire. For me, that was Lynn Johnson. He allowed me to watch his work, and talk about therapy for several years while I was in graduate school. I’d also suggest getting Egan’s “The Skilled Helper.” It’s pricey, but I still find myself reading it 35 years on.