Over the weekend, I listened to a very interesting debate on NPR Science Friday. The three guests were psychotherapists discussing whether there should be a scientific basis to clinical psychology.
I’ve summarized the three viewpoints below. I wanted to share this debate with you, because I think we have similar discussions in the music therapy field.
What do you think? After reading the summaries, please leave a comment. Join the debate!
We need to improve the scientific basis for clinical psychology. The public should receive treatment that’s based on the best science available. If a therapist makes a claim that they helped someone, they ought to be able to say what they did and be able to point to the evidence that supports their treatment is effective and not harmful. There is currently no accountability standard in psychotherapy. Practitioners should be held to a standard of evidence.
Many current training programs train practitioners who do not understand science. We want programs that will turn out graduates who advance the field and further our understanding of what works. Several surveys of current practitioners have found that most of them still rely on their own or their colleagues’ experiences when choosing a treatment, instead of the research literature. Psychologists need proper science training, not necessarily to do their own research, but to be able to read and evaluate the research done by others. The science should guide what we do in practice.
View 2: The skill of the therapist is what makes the difference.
The skill of the therapist is what makes the different in treatment, not the particular intervention used. We ought to be accountable for the outcomes we obtain from our patients, not the treatment applied. There’s currently a movement in the field for individual practitioners to collect evidence in their own practice so they can evaluate their effectiveness.
Scientific training is already a part of an American Psychological Association (APA)-approved program. Psychologists are not ignoring the evidence. More science training will only reduce the amount of clinical training and supervision time, which may ultimately decrease the effectiveness of the therapist. The treatments we are giving now are effective. Why change the model?
View 3: We need more science training…for certain situations.
The skill of the therapist is fine for most clients who just need help with basic problems of living and need to talk it out with someone objective whom they trust. But for people with significant psychological disorders, it’s much more important to know the research and whether the treatment we’re going to provide works. Of course we know that the therapeutic relationship is important, but we need to adapt how we evaluate effectiveness based on the disorder.
It’s a great first step to evaluate the results of your own practice. But that may not be enough. How do you really know what is making your client better? It could just be time, relationship changes than occur outside of therapy, medicine, etc. Therefore, we also need more controlled scientific studies.
And we need therapists who understand the science. People in practice need to know when there are treatments that are effective, so they can either get trained in the treatment themselves or refer the client to someone who is. Eventually, students trained in science will begin to infuse their own practice with science. They will read the literature to know what’s out there and what works. They will take care to document the effects of their practice. It doesn’t make sense to say: “This treatment has not yet been tested with this particular group, so I’ll just do what I think is best.” Instead, you should generalize from the best science available and try to determine whether that will work for that particular group. So, yes, it matters for people to know about the science.
What do you think?
So, what do you think? Do you think music therapists should have an understanding of science and be research-savvy? Or do you think it’s more important to focus on clinical (and for us, musical) skills, since that’s what is making the biggest difference for our clients?
If you have thoughts, please leave a comment in the box below. Join the discussion!
And click here if you’re interesting in listening to the debate.
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