As presented to a field where a slew of people strive to quantify actions, predict behaviors, and quantify emotions, Chambless & Hollon (1998) and Hunsley & Di Giulio (2002) do a decent job of outlining the need to be critical in the assessment of effective therapies. However, while it is imperative that there is well-tested empirical support for therapies, for the sake of patients as well as for the reputation of psychology as a respected science, the two articles do not really resolve anything. Hunsley & Di Giulio’s statistical reassessment of review articles does give weight to the claim that not all psychotherapies are equivalent, yet their fight against fire with fire leads me to be skeptical of their argument just as they are asking us to be skeptical of the articles they review. If they use statistics to beat the statistics of others, how are they gaining any ground other than to stomp their feet and claim that their analysis is better? It’s like claiming blue is just better than red because, well, I said so. Additionally, while the Chambless & Hollon article is useful as a reference for someone designing an empirically supported treatment study, the only concrete guideline they call for is that a treatment be successful in two different studies by independent research teams. Their argument strives toward abstraction with phrases like “evaluators are urged to carefully examine data graphs” (p.13), and the arbitrary requirement that three of everything exist (e.g., three participants should benefit from treatment, p. 13). That said, Chambless & Hollon’s call for intense self-critique is vital if the field is to gain and retain any sort of scientific respect.
Tuesday, September 11, 2007
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Good points all around. I wonder whether the issue of equivalence is even statistical, though. Really, it is about how groups are selected before the stats, which are, after all, totally impartial mathematical observers. The group selection is rather more subjective. That said, there do appear (to me) to be differences at least with some forms of grouping. Nevertheless your points are definitely taken, especially about the Chambless paper. It is tough to figure out how to come up with the proper criteria for an "empirically supported treatment." How does medicine do it, I wonder?
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