Sharon Begley’s article,“Ignoring the Evidence; Why do psychologists reject science?” in the October 12 edition of Newsweek concerns a new report soon to be published in Psychological Science in the Public Interest that argues for a more “scientifically principled approach” to mental and behavioral health care. In her article, she echoes the authors’ lambaste of clinical psychologists, providing a familiar litany of their “ascientific” practices (principally the common refusal to follow evidence-based treatments) and essentially branding them witch doctors.
While the authors of the report (Baker, McFall,&Shoham) do a better job than Begley of delineating and stratifying practitioners of clinical Psychology (e.g. matriculates in Psy.D. programs often lacking a rigorous science curriculum are singled out), Begley, Baker and colleagues largely ignore the most asinine segments of the profession crowding under this much maligned rubric in favor of generalizing the dire straits of mental health care. Psychologists operating within the “scientist-practitioner” model, including those who commonly utilize biopsychology, genetics and neuroscience, were somewhat marginalized.
This report is not the first major criticism of the discipline, but reflects an ongoing debate (for instance, see Psychological Clinical Science: Papers in honor of Richard M. McFall). It is widely acknowledged by serious thinkers within the community that while there are many excellent research-oriented clinical psychology programs, the field is brimming with science-anemic non-PhD programs and even “university-based PhD programs vary markedly in the quality of science training offered to their students.” All of this is in addition to individual differences in practitioner adherence to empirically supported treatments. This comes as no surprise to anyone.
I was actually most interested in reading the online comments regarding the article. A quick (unscientific) survey of the comments seemed to indicate readers fell into one of the two usual camps: one camp of individuals holding a clear distrust and malevolent attitude toward the science of Psychology in general and clinicians in particular; and another camp, mostly consisting of clinical psychologists, defending both the quality of their scientific training and the necessity of what they see as the practical implementation of treatments. I support the Association for Psychological Science’s efforts to establish an alternative accreditation system requiring more rigorous scientific training. However, Begley should have more tactfully and less facetiously asked, “Why do SOME psychologists reject science?”
Edit: After writing this, I came across a scientificblogging report by News Staff on the same study. You can check it out here
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continue reading my follow-up entry: Part
II
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Doctors and Psychologists Don’t Hate Science—They Treat Real Patients:
A Reply to Sharon Begley and Newsweek
Sharon Begley is wrong when she compares the medical profession to “hysterical conservatives” who “seem to hate science,” as she did in her Newsweek column on May 4, 2009 in “Why Doctors Hate Science.” She is wrong when she claims that “psychologists reject science” as she did in her column on October 2, 2009 in “Ignoring the Evidence.” While she finds a few legitimate examples of problems, she is pushing a narrow interpretation of science that is not in the best interest of patients. When it comes to good science, good treatment, and good use of scientific evidence, medical doctors and psychologists are a lot closer to the mark than Begley and the critics she embraces.
In “Doctors Hate Science,” Begley decides that science shows that hypertension patients should be treated with inexpensive diuretics rather than medications that have fewer side effects because both lower blood pressure. Not if you ask the patient who knows that the diuretic causes frequent urination. Who would want to pee more than a dozen times a day, wake twice at night to go to the bathroom, fear getting stuck in a traffic jam without access to a toilet, avoid long meetings, get fatigued during exercise, and lose sexual function? There are good reasons that doctors prescribe more expensive anti-hypertensive medications that have fewer side effects than diuretics.