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Christian Counseling - A Response to Newsweek's Essay (October 12, 2009) on "Ignoring the Evidence"

The subtitle to "Ignoring the Evidence" (Newsweek-10/12/09) asks the question, "Why do psychologists reject science?" Some research psychologists hold that "many clinicians fail to 'use the interventions for which there is the strongest evidence of efficacy' and 'give more weight to their personal experiences than to science.'" Even more scalding are comments, such as, it "is an unconscionable embarrassment" and "It's very threatening to think our profession is a charade."
For some clinicians who fail to remain informed and give due consideration to psychological science, they would do well to rethink the use of it and expand their continued education experience. But, the article, and comments from researchers, took a shaming approach with the hope of discrediting those in the field who fail to do what the research says because they think it is the best psychology has to offer and the moral thing to do (italics mine).

Many clinicians would likely agree a gap exists, perhaps a widening gap, between research and practice. Why is this so? For many and varied reasons. Research is still in its infancy. It does the best it can and continues to improve research methods and tools, but it cannot and never will account for all the confounding variables (self-reports, personality, beliefs, etc.) that alter research outcomes. For example, being in an experimental or laboratory setting verses a treatment or counseling room is and always will be different, and so go the conclusions.

Further, it is rare for unsuccessful research findings to make its way to publication, thus skewing the information available to clinicians. Ethically, this is an abysmal practice, and lends to some distrust of publishers and publications.

Clinicians and clients alike do not want a purely logical, textbook approach. After all, it is a relationship, and it is the relationship that heals. Knowledge or science, as important as it is, is secondary. Because of the complexities of human life and personality, flexibility in treatment is required. Infrequently will clinicians value research recommendations over honed intuitive skills, clinical judgment and leading of the Spirit when they are in conflict with each other.

The clinician has the final authority and responsibility to use his or her judgment, along with the client, in deciding what is best for the client. This is understood and acceptable for those in leadership positions--the pilot of a plane, not those in the tower, has the final say about what is or is not safe for those under his care.

As in most any career field, there must be some matching between the personality of the worker and the assigned tasks and methods by which he or she accomplishes those tasks. A reserved, shy person is unlikely to apply or feel comfortable with a the job of a salesperson. Likewise in therapy, a clinician who relies almost exclusively on logic and feels more at ease in a structured environment would be more likely to offer a cognitive (changing thinking) or behavioral (changing behaviors) approach to treatment. A clinician who tents to be more philosophically-minded is more likely to be aligned with an insight oriented therapy (more in depth, looking to history to answer why people feel or behave as they do). If all clinicians had to provide the recommended research treatment to each client presenting with a specific problem, most every clinician would be required to learn approaches that don't fit his or her personality, and job interest, passion and fulfillment would be compromised. Clients would sense these things, which would negatively affect treatment outcome.

Further, no research study has or ever will say their results apply to every person and/or under every situation. Therefore, the treatment must be tailored to the individual and not, as the article would expect clinicians to do, simply lump that individual in with the researched population.

As a final comment, but not exhaustive, research is a time-consuming and costly process. Therefore, the majority of psychological studies focus on the more manageable therapies, such as cognitive and/or behavioral. Research of insight or psychodynamic treatment is very limited because it is often even more time-consuming, costly and can be very complex. As one who uses this latter approach, until it has been given equal research consideration with other methods, I will not assume researched recommendations to be the shinning eastern star that all should follow, but a shimmering candle casting a faint light upon a limited study, and always to be used at the discretion of the one who knows his or her client.

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