Mr. Blankenhorn repeatedly uses "psychiatrist" when he means "psychologist" in the above article. These are completely different professions, with the former requiring an M.D. and the latter a Ph.D. or Psy.D.
Note that the PCSAS quote says nothing about how psychology should be practiced. It instead says that students from PCSAS programs should "contribute significantly to advancing scientific knowledge." This means ?conduct research.? That's the irony. PCSAS programs are not interested in training clinicians--only researchers. Many of these programs explicitly say in their admissions materials that applicants interested in being clinicians should not apply.
There is much more to the debate going on in professional psychology than is portrayed here. This article is a vast oversimplification.
It is hard to see psychology as a regular part of medical care when it’s more art than science.
Maybe what it needs is a little science-based competition.
That’s starting to come from the Psychological Clinical Science Accreditation System (PCSAS), which began looking at psychiatric training last year with an aim to making the accreditation of psychiatrists more scientific.
Here’s an example of what they are trying to do. It is well known that Cognitive Behavior Therapy holds real promise in treating Post Traumatic Stress Disorder (PTSD), but only one PTSD patient in seven is getting it.
This isn’t just because word has not gotten out. It’s because many psychiatrists are thoroughly devoted to their chosen techniques, science be damned.
I’ve been to many shrinks over the years and they all start their pitch with the same line. “This is what I do.” It’s all about them.
I have another approach to suggest. I tell you my problem, and you do what works best in treating it. How about we make this about me? What a concept.
Imagine if your doctor worked that way. “Here’s what I do. I use leeches.” (Bad example. Leeches are making a comeback.) But if the doctor used leeches for everything?
That’s what is happening. Psychiatrists are generally process-centered. Most are one trick ponies. They don’t act like doctors, they don’t go through re-training like doctors.
But they should. If I am going to pay doctor prices for treatment, is it too much to ask that you train, re-train, read the literature, and do what is shown to work best like doctors do? As opposed to witch doctors?
PCSAS’s principles are pretty clear:
An applicant program must provide clear evidence of a consistent record of graduating clinical scientists…Outcome evidence is the sine qua non of PCSAS accreditation…the programs judged to be of highest quality will be those that demonstrate convincingly that the majority of their students contribute significantly to advancing scientific knowledge.
Scientific knowledge, not psychiatric knowledge.
PCSAS’ competitor is the American Psychological Association, which has accredited hundreds of programs, while making a point of noting on its Web sites those whose accreditation has been withdrawn.
The head of the APA’s accreditation program recently sniffed to Scienceline she does not believe there is a need for practicing psychologists to be able to produce science.
Oh, really? Let the competition start.
