A provocative new report calls for the reform of clinical psychology training programs, suggesting that clinical psychologists and therapists are using methods that are out of date and not supported by current science.
The issue is salient as the prevalence of mental health disorders in this country has nearly doubled in the past 20 years. Study authors appeal for a new accreditation system to ensure that mental health clinicians are trained to use the most effective and current research to treat their patients.
The report is issued in Psychological Science in the Public Interest, a journal of the Association for Psychological Science.
According to the research psychologists — Timothy Baker (University of Wisconsin-Madison), Richard McFall (Indiana University), and Varda Shoham (University of Arizona) — there are multiple practices in clinical psychology that are grounded in science and proven to work, but in the absence of standardized science-based training, those treatments go unused.
Baker and colleagues cite one study in which only 30 percent of psychologists were trained to perform CBT for PTSD and only half of those psychologists elected to use it. That means that six of every seven sufferers were not getting the best care available from their clinicians.
Furthermore, CBT shows both long-term and immediate benefits as a treatment for PTSD; whereas medications such as Paxil have shown 25 to 50 percent relapse rates.
Critics of the report, including Psych Central’s John Grohol, suggest it is a biased, lopsided look at the efficacy research, promoting a black-and-white view of psychotherapy and clinical psychologists, when a more nuanced and complex approach is needed.
Dr. Grohol noted, “This is a propaganda piece, not an objective study of the problem. Two of the three researchers have a direct conflict of interest with being involved in the new accreditation organization they promote in the article.”
The report suggests that the escalating cost of mental health care treatment has reduced the use of psychological treatments and shifted care to general health care facilities.
The authors also stress the importance of coupling psychosocial interventions with medicine because many behavioral therapies have been shown to reduce costs and provide longer term benefits for the client.
Baker and colleagues conclude that a new accreditation system is the key to reforming training in clinical psychology. This new system is already under development: the Psychological Clinical Science Accreditation System.