I consider myself to be a skilled, experienced, and perceptive counselor; however, I am humble enough to know when I need to refer clients to more experienced/focused counselors in other areas/fields.

However, I have also counseled clients that have gone to see some of the “Ivy Psychologists” on staff first, and then have journeyed to see me because of the sheer unprofessionalism and uncaring nature they encounter with said psychologist within just a few minutes of the introductory session.

These are also the same psychologists that consider advancement and power to be their primary focus (I guess counseling is in there somewhere), and any resentment they have towards me being a flag officer/administrator/CLINICAL SOCIAL WORKER is amplified when I have to have a “conversation” with them (some do not last very long here, as I consider counseling to be my passion and purpose, and I have little tolerance for political BS and resentment). One of my best friends, a high school adjustment/general counselor (with an M.A. in Educational Psychology), has experienced the same level of “nose in the air” antics from various albeit very few school psychologists, without any regard to her proven fifteen year successful track record.

In closing, let’s stop pointing fingers, and do what we’re meant to do. A great counselor is a great counselor, regardless of the degree and/or college/university attended.

Just my two cents….

Actually, there is a far more serious issue. Namely, psychologists are not taking the vital signs of therapy. There is a vast literature on the importance of the therapeutic alliance. In fact, it is the single most important variable in determining the client’s progress in therapy. If the alliance is poor, the client is far less likely to improve. If the alliance is strong, the client is far more likely to recover. The real problem is that psychologists are not frequently measuring the strength of the alliance. We are not picking up on ruptures in the alliance and repairing them.
So, psychology should be like medicine in routinely and objectively measuring the vital signs of the person we are helping. We should be unlike medicine in thinking that there is only one way to help a client. A burst appendix can only be helped by surgery. A depression can be helped by whatever bona-fide treatment that fits with what the client thinks will be helpful. If we impose a treatment that does not fit with the client’s theory of change, (even if it has been validated in a journal) then we will rupture the alliance, and lose the client.

A fuller discussion of this issue is on my blog at http://revolutioninpsychotherapy.blogspot.com/

Thanks for uncovering the conflict of interest in the article about psychologists being poorly trained. Could you write a letter to the editor of the LA Times informing them of this? Otherwise, it is an undeservedly negative article about psychologists, of which I am one. They should have looked into it before publishing the article.

I also failed to note the authors’ mention of the APCS credential, which according to the authors recognizes 52 doctoral programs and 10 internships. Guess how many people know of, heard of, or care about APCS? Even I wouldn’t recommend a person seek out a clinician who’s gone to one of these programs, because it’s a meaningless credential.

I tend to admire the Association for Psychological Science (APS), the organization behind the publication of this article. But with the publication of this article, they demonstrated how clearly they are promoting a political agenda over a scientific one. And because of that, they’ve lost my admiration for their devotion to science. So much for that.

Samuel Lopez De Victoria, Ph.D.
http://www.DrSam.tv

That was a very interesting comment, Dr. Grohol. I’d like to expand upon that and point out that my T-Doc spent years in psychoanalysis himself and sometimes links his respective experience to my active therapy. I have found this adds to his keen insight.

In my opinion, the manualization of therapy infers exclusion of the therapist’s autonomy, and it seems to undermine the art that encompasses insight, methods, and solutions that should be tailored with the uniqueness of the individual in mind. Patients all have different histories and personality constructs, and it seems odd to lump us all together with the facilitation of one standardized method.

However, I can’t dismiss CBT. While CBT did not help me one bit, other patients have said CBT has been effective for their situation.

Hi Carlos,

Like many others, I was adding my opinion in response to the article and to some of the comments, so I didn’t feel it was necessary to find definitive surveys that measure the compassion levels of researchers. However, I recently came across this study and thought you might be interested:

Abstract

“Preserving and promoting empathy are ethical imperatives in medical education. The authors of this commentary propose that the hidden curriculum and mixed messages learners frequently receive during clinical rotations may erode humanistic traits essential to high-quality care. Three articles in this issue focus on assessing attitude towards empathy in the health care setting using the Jefferson Scale of Physician Empathy. The authors discuss salient points from these reports, reinforce the concept of empathy as a cognitive attribute, and offer recommendations for teaching and nurturing empathy in health professionals. In the reports, construct validity and reliability of the instrument were confirmed and were comparable with previous results, thus providing medical educators with a sound instrument to measure empathic attitudes in the context of patient care. The authors agree with the distinctions made in the three studies between empathy (described as a cognitive attribute) and sympathy (described as an emotional attribute) and believe that empathy as a cognitive skill can be role modeled, taught, and assessed. Barriers to empathic practice (lack of sufficient role models, failing to teach empathy as a cognitive skill, negative experiences, time pressures, overreliance on technology) can be remedied in medical education through interprofessional education and practice and institutional promotion of relationship-centered care, which maintains the centrality of the patient-clinician relationship while recognizing the importance of relationships with self and others.”

http://journals.lww.com/academicmedicine/Fulltext/2009/09000/Commentary__Identifying_Attitudes_Towards_Empathy_.8.aspx

Although the article does not reference researchers, it does touch upon some of the concepts discussed here.

I have also seen studies that indicate the therapeutic alliance may be more important for positive patient outcomes rather than the type of therapy provided. If one is interested enough, I would guess that anyone here is capable of googling to find relevant articles.

I think perhaps also CBT therapists tend to be less disturbed and neurotic than ‘the other type’.

About 25 years ago, I was hospitalized on the psychiatric unit of our local hospital, and before HMO’s and all the ‘bad’ stuff started taking over. There was this one Social Worker who mostly did referrals and paper work. Another Social Worker did the group therapy. This man practiced there for 20 plus years and was never once observed by another therapist, or supervisor of any kind. He was not only ‘worthless’ but totally destructive…horrible, but nobody listened to me, of course. Then there was this art thing, and for all these affairs your psychiatrist decided if you were to go or not.

I was on that same unit again some seven years ago, and now in a time when the moment you arrive your discharge planning begins.

But there was this really, really great change that I saw, and I had absolutely zero experience with CBT.

There were a few of them, and all day long, every hour, a different therapy for patients took place, all CBT. It was no longer your psychiatrist who decided if you were to go or not, but the patient. You could attend as few or as many as you wished although it was greatly encouraged. The therapist would walk around to the rooms and everywhere and encourage you to go.

And they were absolutely fantastic. the therapists, and I don’t know what their education was, were not only nice and kind, but really normal. There was no ‘hidden agenda’, and no ‘bullshit’. These sessions were so effective and even fun, and I totally could use them. example: maybe there were eight of us patients, and the assignment was to organize what we would do if we were lost as a group on some island, or whatever, after our plane or boat, or whatever, crashed. We had just so much food, and so much shelter stuff, and other things. how would we decide what we needed most to take with us on our journey to get back to civilization? (that type of thing)

Then also, another person came to tell us exactly what to do if we had problems or complaints with any staff, and what number to call, and that someone would immediately show up without first telling any staff person.

Every session we had to do an evaluation as well, etc, etc…really great changes to make the stay more effective than it used to be.

(not edited) KAT

Manualization, to many psychologists and therapists, is the exact opposite of what they view as what makes therapy work. Even medicine rarely adheres to any kind of rigid manualized treatment for disease treatment. While there are certainly practice guidelines, they don’t boil down to a step-by-step how-to guide.

And that’s what I think you find clinical psychologists (and therapists) objecting to — the idea that you could train an educated high school student following a manual to do the same work they do. (And why couldn’t you, if manualized treatment was the supposed gold standard? Who can’t follow a manual??)

“Although I understand the importance of research, I have to agree that too many researchers forget the difference between humans and lab rats.”

I hope you aren’t implying that human beings aren’t animals.

Samuel Lopez De Victoria, Ph.D.
http://www.DrSam.tv

After nearly decade of treatment, I have come to be extremely thankful and appreciative of my “T-Doc”, Dr. S., who I was lucky to have found after all these years. Now I see what I’ve been missing. My regret is not finding this type of clinical practitioner sooner, as neither general practioners nor psychiatrists have recommended this type of treatment to me. I did not know they existed.

I also appreciate the thoughtful comment from patient and future clinician Pt. # 5678 (8:07 pm on October 5th, 2009):

“I agree with Dr. Sam and some others here who find the disconnect between the academic mentality and the actual human.

One thing that I find startling as a patient is the lack of compassion from some of the practitioners I have met. It means a great deal, as a patient to have someone acknowledge one’s pain.

Although I understand the importance of research, I have to agree that too many researchers forget the difference between humans and lab rats.

I will as a clinician, never forget that the person in front of me has a spirit that is ill. That is trying to heal and that my job is to help in that process.”

I cannot forget that one of the most compassionate, dedicated, and skilled therapists I’ve had over the years was a clinician who had a LCSW degree. I’m not sure how the training/education is today in this field (he was in his 60s when he passed away a few years ago), but he sure was a star who shined admist the plentiful faded and dull ones in the therapeutic sky…

Thanks to all the dedicated therapists out there who are truly compassionate and empathetic to those of us who suffer from mental illness.