Clinical Psychology Science Exam 1

Three major units

- Foundations - Assessment - Treatment

what are the major confound that prevent us from drawing clear conclusions from testimonials, anecdotal evidence and uncontrolled case studies?

-fraud -self deception, selection perception, confirmation bias --cognitive dissonance -demand characteristics -selection bias -history -maturation/natural course of the problem/ spontaneous or natural remission -regression to the mean -repeated testing -attrition -misdiagnosis -placebo effect -derivative benefits (hedged bets)

what are the hallmarks or defining features of science?

-open-mindedness -use of systematic empiricism -falsifiability -empirical questions -logic -comprehensiveness -parsimony -honesty -public verifiability - replicability -encouragement of public debate

what are the hallmarks of pseudoscience?

-overuse of ad hoc -absence of self-correction -evasion of critical scrutiny -emphasis on confirmation rather than refutation -reversed burden of proof -absence of connectivity -overeliance on testimonial anecdotal evidence -use of "obscurantist" language -absence of boundary conditions -the mantra of holism -double standards -closed mindedness -conspiracy mindedness -promising the impossible

imagine that dr. roger callahan offered you several uncontrolled case studies as evidence for Thought field therapy efficacy. explain at least two reasons such case studies would not convince you that TFT works

1. the overuse of ad hoc hypotheses designed to immunize a claim from falsification i.e. the evasion of risky tests 2. an absence of self correction and failure to use systematic empirical methods (lack of adequate controls to rule out alternative explanations) 3. evasion of critical scrutiny i.e. peer review. there is a failure to replicate findings under controlled conditions

lets say that i believe aliens are abducting people. you on the other hand believe it is a lot of nonsense and that no abductions are taking place i might say okay ill accept your view but only if you can prove to me that aliens are not abducting people. could you do it ? why or why not?

No because this is an example of reversed burden of proof. Because you are not able to prove that aliens are abducting people, you expect me to prove that are not. Therefore, since I cannot prove that they are not, you ultimately stick to the belief that they are. This is an example of reversed burden of proof.

the boulder model:

Served as the blueprint for clinical training. It combined training in science and psychology. It became known as the scientist-practitioner model.

which of the following statements are falsifiable? a. all swans are white b. not all swans are white c. some people have been abducted by aliens d. nobody has ever been abducted by aliens

a and d

context of verification:

a context that permits us to rule out such alternative explantations This typically required experimental control i.e. 3rd variables

confound:

a factor that has not been controlled for in a study which offers a competing explanation for the findings that therefore cannot be ruled out an alternative explanations for the observed finding that cannot be ruled out and that is simpler (i.e. more parsimonious) than concluding that the treatment was the source of the effect

which hallmark of pseudoscience is this an example of? TFT is portrayed as being effective for most, if not all, mental disorders

absence of boundary conditions claims that one size fits all

how can faulty reasoning and peudoscience in clinical psychology and related fields cause harm to society?

all tax players help to pay for mental health services and even harmful treatments consume a portion of the available financial services. people making claims on individuals that are not supported by evidence or even contrary to existing evidence (this can mean very serious errors resulting in prison for innocent people and guilty people are set free erroneously) i.e. cost of lost productivity when effective treatments exist but aren't used

context of verification

allows us to determine that it is actually true

context of discovery

allows us to discover what MIGHT be true

which hallmark of pseudoscience is Carl Sagan's a dragon in the garage an example of?

an overuse of ad hoc because you can't prove that it actually exists

regression to the mean:

anything measured with margin of error or changes over time odds are people high in populations groups are going to regress to the mean same thing happens with the low end not individual but average

Assessment in clinical psychology

assessment is very common and comes in many forms -evaluating the functioning of an individual client -evaluating a family or social unit of some sort -diagnosis -formal standardized testing (cog, behavioral, or personality) -assessment in psychotherapy --treatment planning, monitoring progress, evaluating efficacy

Why do clinical psychologists need to be trained to think and act like scientists?

bc our interventions and assessments have significant potential to cause harm bc we don't know everything yet... -we need to be able to read the research literature in our field -to do that we need to be prepared to separate sense from nonsense

professional schools for psychology

begun by donald peterson in the 1960s -peterson defended this school by noting that few clinical psychologists were interested in both research and service and the professional degree recognized that most students wanted to be clinical rather than scientists -to do this properly and teach the abundance of knowledge and skills required of thoroughly trained professionals in the 70s, peterson argued the competing activity of research training would have to be sharply cuttable for eliminated -peterson went so far as to complain that students were spending these sevenths of their time doing research and learning foreign languages

pillars of ethics

beneficence and nonmaleficence fidelity and responsibility integrity in professional relationships justice respect for people's rights and dignity

emphasis on confirmation rather than refutation:

biased selection of evidence in favor often ignore or dismiss evidence against -confirmatory bias good science involves bending over backwards to try to disconfirm your hypothesis -science progresses by finding claims wrongs ie we become less wrong by finding out ways in which we are wrong

The other ends of the spectrum: McFall's manifesto for a science of clinical psychology

cardinal principle: scientific clinical psychology is the only legitimate and acceptable from of clinical psychology -psychological services should not be administered to the public until they have met minimal scientific criteria --unless they are administered in a research context

the mantra of holism:

claimants often argue that their idea cannot be tested in isolation -rather they must be evaluated within the context of a vast array of other things -can't falsify can't lay rules out only can infer them insistence that complex individual interactions of a vast array of factors must be considered to truly understand a phenomenon

comprehensiveness:

claims to knowledge must account for all the pertinent data. basically NO squinting is allowed

activities of clinical psychologists

clinical psychologists work with -individuals, couples, families, groups and organization -all across the life span clinical psychologists do a variety of activities including: -psych assessment -psych intervention -research -teaching and clinical training -consulting with other professionals and agencies

which hallmark of pseudoscience is this an example of? term-64 roger callahan inventor of thought find therapy claims that journal editors have conspired to keep evidence of this extraordinarily powerful treatment out of the journals

conspiracy mindedness

Additional activities of clinical psychologists

consultation research teaching clinical supervision research supervision administration

Evidence based practice

current approach emphasized by APA clinicians are to base their practice on: -empirical evidence --both research findings and data gathered systematically on the patient in question -their own clinical experience -client preferences but should these sources be given equal weight?

example of self deception/ selective perception / confirmation bias

date's example of lobotomy studies

The staggering costs of mental d/os

direct costs: cost of treatment: best at $55 bill a year in the US indirect: cost of lost employment or decreased productivity, accidents, and social welfare programs: est at $273 bil a year in the US alone worldwide excess $1 trillion annually

iatrogenic effects

direct harm: harm induced inadvertently through treatment

concerns raised by clinical psychologists who doubt the value of science

each individual is unique - therefore group based research findings are of little value clients have problems now - we can't wait for the research to tell us how to treat them clinical psychology as art rather than science

A middle path

each side of the debate has much to offer the other that is why clinical psych adopted the SP model in the first place but with the reframing of the science aspects of training as irrelevant to most doctoral students since they plan to be practitioners, the field has suffered

Scientist-Practitioner Model

emphasizes science (research) and practice usually associated with PhD degree originated from boulder model history: -call for clinical psychologists to be trained as societies goes back to the earliest days of the field the boulder conference: -reasons for SPM: --so that student could develop interests in both research and practice despite the fact that most would concentrate on one or the other --strong value placed on research training as a means of separating fact from fiction --direct involvement in clinical work by researchers would foster their knowledge of important clinical issues so they would be more likely to study them

what are the main points in the rationale for the boulder model?

emphasizes science research and practice usually associated with PhD degree

use of obscurantist language:

employment of vague and obtuse language serves to mystify evade scrutiny or mislead -may give the outward appearance of science without any substance

organizational consultation:

evaluating a service or providing an option on how an organization is doing

promising the impossible:

examples: communicating with a man in a coma through facilitated communication or callahan claims that TFT yields nearly 100% cure rate for all mental disorders when combined with his voice analysis approach

clinical science model

exclusively phD strong emphasis on training in science and use of research in clinical practice -reflects the view that the only legitimate form of clinical psych is based firmly on psych science

parsimony:

explanations must be parsimonious (no more complex than is necessary for the explanation to be sufficient to cover the known facts)

define the principle of parsimony and demonstrate your understanding of that principle by giving an example in which two explanations for some phenomenon are available and in which one explanation is clearly more parsimonious than the other (be sure to indicate which is more parsimonious and why)

explanations should not be NO MORE complex than is necessary for the explanation to be sufficient to cover the known facts an example: alien abductions 1. people are being abducted by aliens : there is no evidence 2. dreams or hallucinations: longer explanations however we already know the facts and this is more accepted

absence of connectivity:

failure to consider how the theory fits with what is already known -fails to account for how the theory can violate one more established principles claimants often purport to have created a whole new paradigm that makes everything before it obsolete

absence of self-correction:

failure to use systematic empirical methods -lack of adequate controls to rule out alternative explanations stagnation -the critical evidence is always just about to be found but never is

how can faulty reasoning and pseudoscience in clinical psychology and related fields cause harm to clinical psychology and mental health professions?

false claims raise doubt about all mental health professionals which may lead the public to assume that all mental health processionals are quacks and to avoid seeking services. this is another path to indirect harm to individuals -it may make people LESS likely to see services that would have helped had they sought them

encouragement of public debate

good scientists bend over backwards to find out ways in which they are wrong -we do this by inviting others to scrutinize our work and point out errors

consider the video on facilitated communication (FC) in autism. why is the burden of proof on Dr. Douglas Biklen to provide compelling empirical evidence supporting his claims that FC is an effective means of communicating with individuals with autism? in other words why is it not the job of skeptics to prove that FC doesnt work?

he believes that he is right. even when there is compelling evidence that FC does not actually work in double blind trials. he is using the absence of boundary conditions as well because he is asumming that FC can work on all mental disabilities there is no boundary. it is not the job of the skeptics to prove that FC does not work because he is the one who is promising the impossible as well as conspiracy mindedness

self deception/ selective perception / confirmation bias

human beings are prone to seeing what they expect or wish to see cognitive dissonance

how can faulty reasoning and pseudoscience in clinical psychology and related fields cause harm to individual clients?

iatrogenic effects opportunity cost

closed-mindedness:

ideological thinking -the rigid defense of a position no matter what evidence is offered to the contrary discouragement of debate -denigration and censorship of non believers

evasion of critical scrutiny:

ie avoiding peer review. because this shows a lack of public verifiability and the promotion of ideas through non-scientific outlets i.e. television news programs

is this falsifiable? all swans are white?

ie no swans are not white yes

define falsifiability and provide an example to demonstrate your understanding of the concept. why is it crucial for scientific theories/explanations to be falsifiable?

if a clam to knowledge is wrong it must be possible to prove that by collecting data. i.e. benjamin rush's claim that bleeding cures yellow fever. he said that those who died despite being bled were deemed to have been bled too late so basically saying that it doesn't count. or carl sagas dragon in thae garage you cannot prove that it actually exists

what would convince you that facilitated communication works, at least in some cases?

if there was a double blind case study done where the facilitators and the people were shown different pictures and they successfully typed out the peoples picture and not the facilitators

cognitive dissonance:

imagine that you spend 1000000 to receive training in roger callahans voice analysis system so therefore you are more motivated to believe that it works (selective perception) otherwise you have to admit that you were foolish to spend money on it

opportunity cost

indirect harm: clients may waste their time and money on treatments that are ineffective -that costs them the opportunity to devote those resources to a better alternative (one with empirically demonstrated efficacy)

Of the false statements and unproven methods, some are benign but many, if not most, have serious potential to cause harm to:

individual clients clinical psychology and other related mental health professions society

intervention in clinical psych

intervention is very common as well -psychotherapy: "talk therapy" --diff approaches focus on diff issues --in North america cog behavior therapy is most common, followed by an integrative approach and psychodynamic the prescription privileges debate -serious shortage of psychiatrists -currently only a select few psychologists can prescribe -highly debated

systematic empiricism:

involves collecting data in a fashion designed to eliminate or severely minimize the influence of error or bias (i.e. confirmation bias)

Practitioner-scholar model

less emphasis on research and more on practice -some programs train practitioner scientists --stress imp of research literature but students don't do research themselves -other de-emphasize value of research -both phD and psD programs two types: -university based -free standing professional school (for profit)

open-mindedness:

limited resources mean we must limit the topics getting serious attention to those which have passed an initial threshold. merely suggesting a possibility is insufficient - the ticket of admission is to provide at least preliminary empirical evidence that the possibility should be taken seriously

Treatment (and prevention)

major approaches to treatment how well does psychotherapy work? do all approaches to treatment work equally well? (dodo bird verdict) how can we help the most people given limited resources?

History

many events may have occurred outside the context of treatment that explain any improvement obsessed ex: an unemployed person gets a job, a persons abusive partner dies suddenly

maturation/natural course of the problem/spontaneous or natural remission

many problems have a variable course (time limited) many problems are time limited or context limited (maybe the problem ran its course) children and adults mature and changes may reflect on development rather tag effects of treatment (cognitive development)

context of discovery:

many situations can provide evidence that a treatment approach might be effective -- that is, a persons improvement might be due to some treatment the person experienced but most situations are inadequate to verify that the treatment is really responsible for any apparent improvement following treatment fail to permit potential confounds to be ruled out

absence of boundary conditions:

most well supported theories specify conditions under which they should and should not apply all inclusive systems -many fringe claims take a one size fits all approach

is this falsifiable? some people have been abducted by space aliens

no

is this falsifiable? some swans are not white

no can't prove wrong because we can't be sure there isn't 1 that is not white

why is training to think like a scientist so important?

numerous statements are made by mental health professionals and popular experts regarding the causes of psychopathology as well as methods for its assessments and treatment -some of these assertions are verifiably true but the validity of many other statements is unknown and many are verifiably false similarly, many unproven methods for the assessment and treatment of clinical problems are offered by clinical psychologists and other mental health professionals -some of these may actually be effective but many others are ineffective or even harmful

clinical consultation:

offering advice and info for other professionals

logic:

ones conclusions must follow logically from ones premises (assuming premises are true)

fraud:

outright lie. many people promoting treatments have financial interest that may lead some to make fraudulent claims

What do most practitioners focus on most? a. research b. past experience c. both

past experience

what is the rationale of peterson and others as to why there is a need for psy.d programs?

peterson said that few clinical psychologists were interested in both research and service and the professional degree recognized that most student wanted to be clinicians rather than scientists

prevention in clinical psych

prevention is less common but growing -primary prevention: prevention of a d/o before it occurs -secondary prevention: reducing the recurrence of a d/o -tertiary prevention: reducing the overall disability that results from a d/p prevention usually based on in community settings -psychologist usually has several roles in prevention ---developing programs --implementing programs --evaluating outcomes of programs

what is the difference between psy.d and phd programs, or more accurately freestanding professional schools and university-based programs

professional schools is a 5 year program where as university based programs or phds are 6 years and have more research based while psyds are reading the research.

overreliance on testimonial or anecdotal evidence:

provide a context for discovery but not a context for verification -context of discovery: -context of verification: appeals to authority rather than empirical data reliance on personal experience

Assessment

psychometrics -what is required for clinical utility of our assessment methods? critical evaluation of our most commonly used assessment methods -uses and abuses of psychological tests myths about clinical expertise classification of psychopathology -why DSM 5 is largely a failure

80% of psychologists engage in what activity?

psychotherapy

random assignment:

radom assign to treat or not treat max chances control and treatment differences INTERNAL validity

public verifiability - replicability

replicability is essential -methods used must be described in detail so others may attempt to replicate your findings

random sampling:

sample represents a population generalizes EXTERNAL validity

falsifiability:

scientific claims must be falsifiable -as in, if they are wrong it must be possible to prove that by collecting data

empirical questions:

scientific questions are limited to those that are answerable by applying systematic empirical methods to gather evidence

what are the 3 models of training?

scientist practitioner practitioner-scholar clinical science model

repeated testing

scores may change on measures simply due to completing the test repeatedly

why so much tension bw the two camps?

that tension reflects the fact that each camp often views the other in terms of a caricature these caricatures are an outgrowth of years of debate over the best way to train clinical psychologists what was originally a join science practitioner model has degenerated to the point where many clinical psych doctoral students get little training to think and behave like scientists -in the worst cases, they are taught to devalue science in favor of clinical experience this leaves us with two camps, each seeing the other as misguided

reverse burden of proof:

the burden of proof rests on the person making the claim not on those who are skeptical of that claim -related to the requirement that claims be falsifiable -many dwellers on the fringes of science try to reverse the burden of proof - to shift it to the skeptic. --such claimants often argue that because nobody has proved their claim wrong, it should be taken seriously -argue that the absence of evidence against their claim can be taken as evidence in support of their claim

conspiracy mindedness:

the fact that scientific community rejects a theory or claimed finding is attributed to conspiracies to suppress such theories and evidence

why are the differences for psy.d and phd programs a concern regarding the future of clinical psychology?

the problems of the professional schools were that the view that the body of knowledge and skills was so large as to prevent sufficient time in the curriculum for research training assumes that knowledge and skills are worth knowing.

which is an empirical question: should the insanity defense be abolished? or does the insanity defense lead to people doing less time than if they were convicted?

the second one because it can be answered through the collection of data

selection bias:

the uncontrolled data we are told about may not be representative -the claimant may have cherry picked the cases that did best --often this is done bc one has ad hoc explanations for why other cases didn't do well ---ex: roger callahan's idea of a toxin allows him to only report participants where a toxin wasn't present. but that amounts to only reporting the cases that got better

demand characteristics:

think of a person who is receive TFT there are demand characteristics built into the procedure that may bias clients to report reductions in anxiety ex: if they don't, they have to keep tapping

in lecture and the first chapter of Lilienfeld et al book, emphasis was placed on a "reversed burden of proof" as a hallmark of pseudoscience. consider the following example: some people believe that satanic ritual abuse is widespread in our society. such people might argue that we should take the notion seriously because nobody has proven that such abuse is NOT occurring. in what way is the burden of proof in this example reversed? why is that a problem?

this is a reversed burden of proof because since no one has proven it wrong it is assumed that it should be taken seriously and that the absence of evidence against their claim can be taken as evidence in support of their claim this is a problem because they are shifting the problem to the skeptic. the burden of proof rests on the person making the claim not on those who are skeptical of that claim this is related to the requirement that claims falsifiable

an overuse of ad hoc (post hoc)

this is designed to immunize a claim from falsification. ad hoc means "for this" - ad hoc solutions are designed to explain away a specific problem after the fact (post hoc) -also known as ad hockery or post-hockery evasion of risky tests retreat to unfalsifiable positions

the problem with peterson's view

to view that the body of knowledge and skills was so large as to prevent sufficient time in the curriculum for research training assumes that the knowledge and skills are worth knowing peterson has more recently questioned the wisdom of creating such programs -unintended consequences: ventures and misadventures in the education of professional psychologists -in that article he reviews the probs that such programs have created

double standards:

tolerance of inconsistencies except from critics contrary evidence is rejected on the basis of the slightest flaw whereas supporting evidence is accepted no matter how flawed it is nit picking about trivial problems in the reasoning used or evidence offered by critics while ignoring the often serious problems the critics arguments and data raise

Foundation

what is clinical psychology? the gap bw science and practice taking a scientific approach -evaluating quality of research -evaluating quality of evidence

assume that i own a cigar manufacturing company and i need to replace my cigar rolling machines. there are two machines available the cigars they roll are indistinguishable -but one machine has only 10 moving parts -the other machine has 100 moving parts which machine should i purchase and why?

why buy something that you don't understand. trouble shoot a 100 part or 10 part? 10 part because you can find an explanation easier

is this falsifiable? nobody has been abducted by space aliens

yes