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Finding Meaning in Psychotherapy Amidst the Trivia and Trivial

April 1, 2018 By scottdm 11 Comments

drowningI 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?

guidelinesIncreasingly, 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):

  1. Psychodynamizing and Existentializing Cognitive-Behavioral Interventions
  2. How extraverted is honey.bunny77@hotmail.de? Inferring personality from e-mail addresses
  3. 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?

wait

 

“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
FIT Implementation Intensive 2018 FIT Deliberate Practice Intensive 2018

 

 

 

 

Filed Under: Behavioral Health, Conferences and Training, evidence-based practice, Feedback Informed Treatment - FIT

Comments

  1. James Venneear says

    April 3, 2018 at 8:00 pm

    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

    Reply
  2. Terry says

    April 3, 2018 at 8:09 pm

    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.)

    Reply
  3. Gun-Eva Andersson Långdahl says

    April 3, 2018 at 9:11 pm

    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

    Reply
  4. Chuck Drake says

    April 4, 2018 at 12:06 am

    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.

    Reply
  5. Bob Bertolino says

    April 10, 2018 at 6:32 pm

    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.

    Reply
  6. Eve Edeelberg says

    May 23, 2018 at 2:28 am

    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!

    Reply
    • scottdm says

      May 24, 2018 at 1:14 pm

      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.

      Reply

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