Evidenced-based Treatment

In the mental health industry there are as many treatments and philosophies to helping people as there are options at Wal-mart for chip types or Tyson meat options. What happens in psychotherapy (and even psychiatrists) of all levels have their own philosophies and methods of treating patients. You get your Christian counselors, your counselors who focus on black, transgendered, women counseling, and those who appeal to new agey type of therapies etc. etc. This is all fine in my opinion. The problem is when a therapist rejects evidence-based treatment no matter what their specialization is.

To recap (or educate):

Psychotherapists (PhDs) are usually people who get PhDs. To practice therapy as a licensed psychologist you go to school in clinical psychology, which is different than counseling. You do not prescribe medication. You have done formalized research most likely on a therapy technique related to mental disorders. You typically use them for their psychotherapy services which last anywhere from 45 minutes to 90 minutes. They teach you evidence-based coping skills and are well versed on their specialization (a good one is anyway).

Psychiatrists (MDs) are people who prescribe medication. They have an MD. This is really all they are trained to do. If they try to do therapy on you they are typically just talking about their free ideas which they shouldn’t be and I often get annoyed and tell them when they are wasting my time and not respecting the field of psychotherapy. In the mental health world psychiatrists often are kind of snobby about psychotherapists even though they secretly probably want to be them. That’s just my take. Most psychiatrists are imprecise with their communication abilities in my opinion, and they often neglect to treat you like a human being beyond their medical ability to write prescriptions. It took me ten years to find one that actually supplies well-being coaching from a neuroscientific standpoint. If they talk about stuff like that from neuroscience, I consider that to be okay because neuroscience is their field, but not psychological therapy.

Under all of this you have Licensed Clinical Social Workers (LCSW) and Masters in Social Work (MSW), to which you will see these abbreviations on their cards. I stay away from these people because I’ve had bad experiences with them, but I’ve heard many success stories with them. I’ve found the ones I’ve seen to have many limitations in their abilities to think and adjust to nuances in a person’s development. Since their education is less than the above two, I also have found them to be unable to keep up with my own knowledge since psychology and neuroscience is also my field. These degrees if I were to continue on with my psychology degree in therapy post-bac I would only get because I was too uninterested or lazy to get a research degree. That’s the main difference–whether or not these people want to do research. In my opinion, research is incredibly important, especially in a field that is constantly evolving and changing due to how young the field is. These people CANNOT prescribe medication.

So you see, the only power given to anyone to prescribe medication is a psychiatrist.

Evidenced-based treatment are therapies that are recognized by established institutions and their lists. There is a Society for Clinical Psychology that provides information on the treatments and disorders.  The American Psychological Association provides the most recognized list of therapies and what constitutes an evidence-based practice. The Substance Abuse and Mental Health Services Administration (SAMHSA) also runs a list.

So, you have to earn this recognition by these qualified institutions in order to be practicing evidence-based therapy. This doesn’t go without issues, though, especially when you’re trying to find a therapist.

Problems

The Freedom of the Therapist
Therapists who choose their deg

Industry Issues in Research and Experts
The user of these industries, in my opinion, should be keeping in mind that this industry is still young and still wrought with flaws. Every industry is. Combine that with the added stigma of mental health and you have general society members not trusting the industry and adding some bullshit pseudo-mental health science on top of it and it really can get quite messy. I myself am an evidence-based user. I trust evidence-based therapies and consult those first but like my skepticism, if the treatment isn’t working I allow for room to test out innovative therapies and techniques that have shown preliminary promise within science or anecdotally from an open minded skeptic usually from a social worker friend or lay person who has been reading Scientific Mind or something like that. Because within this industry, it is true that the therapies are primitive, and since humans are so diverse and individualistic not everything will work.

Being a psychology student myself and doing a psychology research project myself I am extra aware of how studies to reveal the validity of any human or medical data can often go awry due to laziness, misinterpretation, or the pressures to publish or perish on scientific results among other things.

I have seen some therapies be listed to some lists because of one simple study that has had a high sample size but the sample demographic was seemingly entirely unrelated to the therapy in which it would be used to treat individuals. For example, the study that I completed this past year for my undergraduate psychology project was among the first to actually use associative data (you use associative data first typically) to verify that the therapy had some empirical evidence on healthy populations that it was in fact even related at all to individuals when asked about their relationship to psychiatric symptoms.

The study this therapy used to assert their evidence-based practice was testing the therapy on arthritis patients. That is not the sample demographic that this therapy is used on (which is disordered people) but due to the limitations of studies researchers and promoters of this therapy typically count this evidence early on until they receive more empirical data to verify as to what extent is this therapy effective on the psychiatrically ill population. In fact, this was recognized by one of the lists I mentioned above.  The psychology industry is filled with political desires in addition to all the other sciences. But while some people view this as an indication to dismiss academia all together, I view this merely as a flaw and insist that academic background and standing are still the most efficient methods of collecting and recording data there is.

The fact that there are flaws and if people notice them indicates that those people should be speaking up and consulting professionals within the field to assert change. If people don’t like something, I think an individual as a right to complain but also a responsibility to voice that complaint to accurate and willing professionals, because they do exist. Experts and the public need to be more engaged with the industry in order to foster a better relationship of knowledge of health to the people that it treats the most.

 

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