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...or anyone else who's interested.
I was chatting with one of my supervisors about our discussion of if psychotherapy can (or should) be evidence based, and he pointed to a series of articles from the early 1990s that came to be known as the Stone-Klerman debate. It all revolves around a case of a nephrologist who sued a psychoanalytic hospital in the 1970s for not using "evidence based" tx to treat his depression and focusing only on therapy for his narcissistic personality DO.
Dr. Klerman (at Cornell at the time, previously at Mass Mental) wrote an article in favor of the need to adherence of evidence-based treatment over empiric clinical experience.
Dr. Stone (then at McLean, now Professor at Harvard Law - and writing movie reviews for the psychiatric times) wrote a rebuttal which, among other things, emphasized that empiric clinical experience is based on decades of work, while even the best "evidence" in psychiatry can be uncertain.
The initial articles are good reading, but the series of letters to the editor that follow get pretty emphatic (and funny). Even the patient chimes in (perhaps underscoring the dx of narcissistic PDO). if you've got the time, well worth it.
Klerman GL. The psychiatric patient's right to effective treatment: implications of Osheroff v. Chestnut Lodge. Am J Psychiatry. 1990 Apr;147(4):409-18.
Stone AA. Law, science, and psychiatric malpractice: a response to Klerman's indictment of psychoanalytic psychiatry. Am J Psychiatry. 1990 Apr;147(4):419-27.
I was chatting with one of my supervisors about our discussion of if psychotherapy can (or should) be evidence based, and he pointed to a series of articles from the early 1990s that came to be known as the Stone-Klerman debate. It all revolves around a case of a nephrologist who sued a psychoanalytic hospital in the 1970s for not using "evidence based" tx to treat his depression and focusing only on therapy for his narcissistic personality DO.
Dr. Klerman (at Cornell at the time, previously at Mass Mental) wrote an article in favor of the need to adherence of evidence-based treatment over empiric clinical experience.
Dr. Stone (then at McLean, now Professor at Harvard Law - and writing movie reviews for the psychiatric times) wrote a rebuttal which, among other things, emphasized that empiric clinical experience is based on decades of work, while even the best "evidence" in psychiatry can be uncertain.
The initial articles are good reading, but the series of letters to the editor that follow get pretty emphatic (and funny). Even the patient chimes in (perhaps underscoring the dx of narcissistic PDO). if you've got the time, well worth it.
Klerman GL. The psychiatric patient's right to effective treatment: implications of Osheroff v. Chestnut Lodge. Am J Psychiatry. 1990 Apr;147(4):409-18.
Stone AA. Law, science, and psychiatric malpractice: a response to Klerman's indictment of psychoanalytic psychiatry. Am J Psychiatry. 1990 Apr;147(4):419-27.