PhD/PsyD Multiculturalism's role in psychology? Strengths/weaknesses/critiques/questions

[calimich]

A quick search of this board revealed very few threads devoted to this topic, so I imagine this thread could meander a bit. Some potential starting points:

1. What has your training been like regarding issues of race/racism/power/privilege/oppression as they pertain to an individual's mental health?

2. It has been suggested that some of "these words" are buzzwords without substantive value. How do you understand the topic of multiculturalism and diversity as they relate to psychology? How do you understand the concept of "social justice"?

3. Does psychology have a role/duty to play in addressing endemic racism and inequities within our society? If so, how can we as a profession carry out that role/duty?

or whatever else you want to contribute...

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[WisNeuro]

I think you'll get vastly different answers on training in this area. Here's my background as one. At least didactically, in graduate school we had one required course in multiculturalism that was mostly readings and group discussions. In addition to that, most classes had at least a partial section of the class related to it and the classes specific focus (i.e., ethic/racial issues in neuropsychological assessment, etc). My internship had 1 didactic a month dedicated to it, and my fellowship had 1 didactic a month, 1 journal club a month, and one experiential, half-day outing a month dedicated to it.

Research-wise, I was a research assistant and later project coordinator on a large project looking at correlates of ADHD in a broad sense (genes, neuropsych, familial psych history) requiring testing and structured clinical interviews of family and children. That project had about a 50% AA sample. Later, I was brought on as a psychometrist for a state Alzheimer's Assn specifically to increase AA and hispanic enrollment.

That's the 10,000 ft view of the training. Clinically, way too complex to list as it varied wildly by level of training and geographical location.

 

[LETSGONYR]

I think in general, psychologists do a good job of understanding diversity in the general population and how it might affect barriers to treatment, disorder presentation, or general adjustment.

I'd say that as a field, though, there are areas in which psychologists are sorely lacking. For example- the number of psychologists or Doctoral students with disabilities is extremely low. I personally know someone with a disability who was applying to internship who had interview offers rescinded because they didn't want to pay for accommodations. What would the implications be for a patient with a disability, if PWD aren't good enough to work there?

 

[Ollie123]

From the perspective of a clinical science PhD program:

1. What has your training been like regarding issues of race/racism/power/privilege/oppression as they pertain to an individual's mental health?

Was addressed formally in didactics (i.e. coursework) as well as through clinical supervision (and research if/when relevant depending on the particular area of study). Rather than a required course just in this, we had a 2-course sequence where this and some other related topics were interwoven together. A separate elective course was also offered, but few students seem to take it because I think most find the instructor/instructional method pretty unappealing and potentially inconsistent with a clinical science framework. That obviously isn't endemic to the topic, rather the way this individual went about things. All required courses within the clinical section were obligated to have at least 1 lecture of the class devoted to diversity issues (though many had more). They track our clinical cases and exposure to diverse populations...I can't say for certain if any consequences result if they feel a student isn't getting adequate experience in that area since it wasn't an issue given the populations I worked with and it would have been handled privately, but I imagine there would be concerns. Internship has strengthened that focus further and I actually think excessively so given there are several enormous gaps in other areas that I think they need to fill, but I know they tried to build it up more in recent years so they may still be finding that balance.

2. It has been suggested that some of "these words" are buzzwords without substantive value. How do you understand the topic of multiculturalism and diversity as they relate to psychology? How do you understand the concept of "social justice"?

I think the study of individual and societal differences in general is critical to psychology and indeed nearly everything that we do could be described as such. These topics certainly fall under that umbrella. Broadly, my view of social justice basically boils down to encouraging respect for all persons regardless of the aforementioned differences. Obviously the nuances of that get very complicated and I'm not sure are worth delving into here.

I fully agree they are buzzwords. I actually think it is relatively rare for them to be addressed in a comprehensive, meaningful way. More often they are tacked on to things (course titles, grant applications, etc.) in a half-assed way because its "popular" right now. APA accreditation is about input rather than output, so its easy to change a few syllabi to look good. I see a tremendous amount of very sloppy, if not downright piss-poor science being done in this area, then used inappropriately by politicians on both sides. I view it as relatively similar to neurobiological work (which is my primary area). Throw in pictures of brains and everything looks great and super-scientific even if you don't have a control group, a proper sample size, or really any idea what you are doing. Same thing with many of these issues. Its a shame, particularly given I've seen some evidence that things like tailoring treatments can actually be iatrogenic. So good intentions are not enough.

3. Does psychology have a role/duty to play in addressing endemic racism and inequities within our society? If so, how can we as a profession carry out that role/duty?

Short answer - absolutely. Long answer - A multitude of ways. Given the stigma of mental illness, I think therapy necessarily plays a role in this. Research plays a huge role in this - I'm excited we're finally starting to see some of the traditional barriers between fields broken down. We had a grand rounds talk a few years ago that showed some particular health disparities were partially attributable to differences in allele frequencies across races, with pretty solid effect sizes for genetics research. That topic would have been viewed as completely off-limits just 5-10 years ago, but as discussion as opened up I think we are starting to see better integration of this across fields.

 

[WisNeuro]

. I personally know someone with a disability who was applying to internship who had interview offers rescinded because they didn't want to pay for accommodations. What would the implications be for a patient with a disability, if PWD aren't good enough to work there?

Seems like an issue that could run afoul of the ADA. They should pursue legal action.

 

[LAPsyGuy]

This is a really important topic. My training seems similar to many others'. I've also had great training at prac sites, especially universities and safety net sites like county hospitals.

It's not just cultural differences, but historical power and class differentials that need to be taken into account in order to give appropriate care.

 

[LETSGONYR]

Seems like an issue that could run afoul of the ADA. They should pursue legal action.

I believe they did. It was a few years ago. But that type of thinking/action is more common than you'd think.

 

[futureapppsy2]

Seems like an issue that could run afoul of the ADA. They should pursue legal action.

IMO, anyone who doesn't want their career to fall on the sword for the sacrificial greater good should avoid sueing over disability discrimination, which runs rampant--both covertly and overtly--in professional psychology. This is a tiny field, and people talk--a lot. Not to mention, programs do pretty good jobs of keeping out, pushing out, or kicking out qualified trainees with disabilities out when they want to, for hazy-but-sort-of-barely-legal reasons. It's a huge issue, and one where research is just emerging.

 

[WisNeuro]

Perhaps, but I question the rampantness of it. Perhaps I was fortunate to train with people of various disabilities as fellow students and supervisors (e.g., CP, paraplegia, psychiatric) in graduate school and my training sites. I've seen very supportive attitudes from professionals. I don't doubt that this occurs in our field, I just question whether it's endemic.

 

[futureapppsy2]

Perhaps, but I question the rampantness of it. Perhaps I was fortunate to train with people of various disabilities as fellow students and supervisors (e.g., CP, paraplegia, psychiatric) in graduate school and my training sites. I've seen very supportive attitudes from professionals. I don't doubt that this occurs in our field, I just question whether it's endemic.

Actually, there's now empirical data on this!

Regarding APPIC data:

In 2006, the APPIC survey included a question regarding perceived disability-related discrimination during the internship application process. That year, there were 196 endorsements of disability across all disability categories, and 45 of individuals reported that they had experienced disability related discrimination (APPIC, 2006). Even assuming that no respondents endorsed more than one disability category—which is very unlikely—that still represents a perceived discrimination rate of almost 25%. Although the disability discrimination question was unfortunately eliminated from subsequent surveys, the high rate of reported discrimination, coupled with anecdotal reports of disability-related discrimination, should still be cause for concern.

Regarding original data (n=56)

Participants were asked to rate how supportive they found their faculty and supervisors in general with regard to disability-related issues. A five-point Likert-type scale with the anchors of “1- not all supportive” and “5-extremely supportive” was used. For the 55 participants who answered the question, the mean score was 3.04 with an SD of 1.25. Responses were fairly evenly divided among the bottom two ratings (34.5%), the middle rating (29.1%), and the top two ratings (35.7%).

Participants were also asked to indicate whether or not they had experienced any type of perceived disability-related barriers or discrimination (structural, attitudinal, systemic, etc.) during graduate school and post-doctoral training or the related application processes. The four phases and the total sample size for each phase are as follows: (1) pre-internship graduate training or the graduate school application process (n=49); (2) internship or the internship application process (n=46), (3) post-doctoral training or the post-doc application process (n=38), or (4) the licensure process (n=33). The highest level (67.3%; n=33) of reported discrimination and disability-related barriers occurred during graduate school and the graduate school application process, and the lowest level (36.3%; n=12) occurred during the licensure process. A little less than half of respondents reported that they experienced disability-related barriers or discrimination during the internship (43.4%; n=20) and post-doctoral phases of training (47.4%; n=18).

Citation: Lund, E. M., Andrews, E. E., & Holt, J. M. (2014). How we treat our own: The experiences and characteristics of psychology trainees with disabilities.Rehabilitation psychology, 59(4), 367-375.

So, yeah, pretty pervasive, both when you look at APPIC data, the above study (the first of its kind), as well as the various conceptual pieces out there. Of course, more work needs to be done, but at least someone's started it (I also know a couple of authors, and they are doing more work on this, FWIW).

 

[WisNeuro]

Definitely interesting food for thought. Although, I'd like to see some more done to characterize it. I wonder how the question of supportiveness relates to general feelings of support, and if it differs from non-disabled individuals' ratings of supportiveness in general. I don't have the article, but how did they define discrimination that was structural, etc? Or was it left open to interpretation?

Edit: I could only find the abstract, but from the small n, they also state that "Most participants did not disclose their disability during the graduate school, internship, or postdoctoral application processes." I wonder what effect that had on their ratings. Also, how can we make assertions about the supportiveness of disabilities if they are never disclosed. The "invisible" ones anyway.

 

[futureapppsy2]

Definitely interesting food for thought. Although, I'd like to see some more done to characterize it. I wonder how the question of supportiveness relates to general feelings of support, and if it differs from non-disabled individuals' ratings of supportiveness in general. I don't have the article, but how did they define discrimination that was structural, etc? Or was it left open to interpretation?

The supportiveness item was specific to disability-related issues, although something looking at overall sense of support in disabled and non-disabled trainees would be interesting. FWIW, I talked to one of the authors at a recent conference, and she mentioned that they are currently analyzing the qualitative responses to the discrimination/barriers item, so hopefully, that'll be out at some point. There's a few good conceptual articles discussing barriers, particularly:

Andrews, E. E., Kuemmel, A., Williams, J. L., Pilarski, C., Dunn, M., & Lund, E. M. (2013). Providing culturally competent supervision to trainees with disabilities in rehabilitation settings. Rehabilitation Psychology, 58, 233-244.

Hauser, P.C., Maxwell-McCaw, D. L., Leigh, I.W., & Gutman, V.A. (2000). Internship accessibility for deaf and hard-of-hearing applicants: No cause for complacency. Professional Psychology: Research and Practice, 31, 569-574.

Taube, D. O., & Olkin, R. (2011). When is differential treatment discriminatory? Legal, ethical, and professional considerations for psychology trainees with disabilities. Rehabilitation Psychology, 56, 329-339.

 

[Ollie123]

I imagine the 25% number is also likely to be an underestimate, depending on how they are defining it. A large portion of disabilities are not visible or readily apparent upon meeting someone, mitigating the potential for outright discrimination unless individuals choose to disclose it. I imagine many opt not to do so in an interview/application context, depending on the nature of the disability. If split into obvious vs. not-obvious disabilities (there may be a more sensitive term for what I'm getting at - please pardon my ignorance on this), I imagine the rates of discrimination are even higher among the former. Donn't really have the sample size to look at it in the APPIC data (at least in any given year), but could with other data. Pretty scary stuff.

 

[futureapppsy2]

I imagine the 25% number is also likely to be an underestimate, depending on how they are defining it. A large portion of disabilities are not visible or readily apparent upon meeting someone, mitigating the potential for outright discrimination unless individuals choose to disclose it. I imagine many opt not to do so in an interview/application context, depending on the nature of the disability. If split into obvious vs. not-obvious disabilities (there may be a more sensitive term for what I'm getting at - please pardon my ignorance on this), I imagine the rates of discrimination are even higher among the former. Donn't really have the sample size to look at it in the APPIC data (at least in any given year), but could with other data. Pretty scary stuff.

I know the Lund et al study did ask if disabilities were visible/readily apparent, but they didn't break down the discrimination data by that in the article. Maybe they will when they publish the discrimination data qualitative analyses?

On the disclosure piece, they did report this (%/n reporting disclosing at that time/stage):

Graduate school application process (n=49)1,2


Pre-interview

34.7% (17)

During interviews

26.5% (13)

Graduate school (n=49)1


Disability services office

44.9% (22)

Program faculty

77.6% (38)

Practicum supervisor

63.3% (31)

Internship (n=35)


Application (pre-interview)

45.7% (14)

Application (during interview)

60% (21)

Internship supervisors (after matching)

74.3% (26)

Post-doctoral application (n=31)


Pre-interview

22.6% (7)

During interviews

32.3% (10)

Post-doctoral training (n=32)


Post-doctoral supervisors

53.1% (17)

All stages of training (n=56)

Fellow students or colleagues

60.7% (37)

 

[473912]

Just my $.02...

1. What has your training been like regarding issues of race/racism/power/privilege/oppression as they pertain to an individual's mental health?

I can only speak for undergrad, but they never touched racism/power/privilege/oppression. I'm glad we didn't because those are too complex for the classes I took and they should be a RESEARCH study program by itself. The only thing we talked about was in Individual Differences when we talked about how races and sexes differ in IQ, WAIS, MMPI, etc.... It was so hard for people to swallow that people are different and every demographic isn't the same as another with a completely equivalent bell curve. I thought my teacher did very well to try to drive that point home using BioPsychoSocial reasoning.

While I'm on the soapbox, at the same time, for my multicultural credit, I took a senior-level ethnic studies course based on interracial portrayals in the media. You know what it consisted of? Watch a movie, write a one page OPINION paper. We repeated that every week for 10 weeks. It was a joke. No analysis on numbers of interracial characters or relationships in movies over the years, no longitudinal study on beliefs throughout a lifetime, no case study on portrayal or evolution of interracial characterization in a movie... nothing even vaguely scientific... which is sad because this is research that would be interesting to know. This lack of any factual depth is echoed by friends I've made in that program. "Ethnic/gender studies is where you go for an easy degree" is something I've heard more than once. ...and it shows because they cannot argue their point beyond strawmanning, and appealing to emotions. If that's the level of study in a multicultural education, that is really sad. I don't want anyone with that poor of an ability to analyze to tell me if I have "privilege" or not.


2. It has been suggested that some of "these words" are buzzwords without substantive value. How do you understand the topic of multiculturalism and diversity as they relate to psychology? How do you understand the concept of "social justice"?

I think these are buzz words without substantive value. I understand that certain demographics come with a different culture, diathesis, and stressors. Knowing about them can help in both assessing and treatment. There isn't a one size fits all assessment standard or treatment method. I think we all know this. If we keep that in mind and be wise about it, and work within our knowledge and limitations, I think good things can be done in the profession.

But going back to "those words" as quoted in the question, I find that they are too often used improperly and emotionally only (as opposed to factually) by those overly concerned with "social justice" (again, quoted in the question). Privilege in one sex or race will be blown out of proportion and will be mentioned all the while ignoring the corresponding disadvantages, or the privilege or disadvantages of the entity it's compared to. It's a complex interweaving of issues based on a lot of factors. That's called a society. It might not always be fair, but it's how it is. We are all not under the same bell curve and wanting to run the world as if we are, is a terrible, terrible practice. This overblown, oversimplified "privilege" is used to prove "power"... Garbage in, garbage out is all I have to say there.

It's not racist or sexist to say that men and women are different. Or blacks and white are different. Or different cultures are different. It's true. You move into racism to say that a negro or a skirt can't do _______ because of that status. Again, that bell curve is not the same. That's soooo hard for people comprehend it seems.

Most people I've talked to who labelled themselves "social justice warriors" have a terrible allergy to using appropriate statistics and analyzing data critically. The 23% wage gap study is so flawed and long since discredited (By a report by the labor department, despite being brought up by politicians including the president), yet when I bring up why, I'm simply told I'm a sexist and the conversation is shut down. I bring up how stereotype threats are damaging and counterproductive in some cases, all the while showing the research, I'm told I'm a closet racist and the conversation is shut down. I'd love to talk about these things intelligently, and I'm totally open to being wrong. But, I want to be incorrect for the right reasons. They just did not know how to argue.

3. Does psychology have a role/duty to play in addressing endemic racism and inequities within our society? If so, how can we as a profession carry out that role/duty?

"Address endemic racism and inequalities"? I didn't study psychology to go into social engineering in a major way, so no.... Psychology has no "duty" to address these issues. The preconceptions and racism and sexism that does exist in the world didn't happen overnight, and it won't be cured by people purposely manipulating society for some level of "fairness". We can educate, we can live and teach by example... we can correct misconceptions with facts and again by example. Ultimately that's how it's done. You don't make lasting social change in societal kinks by using a hammer on it. You'll only get an equal backlash from it. It's a SLOWWWWWWWW process, but it does happen.

Maybe I'm naive, but I think as clinical psychologists, our first priority is to the patient, not to get into correcting injustices in society. I'm betting that can sometimes be in direct conflict with each other. Maybe social psychs or sociologists might get into the best ways to move forward towards a goal of "equality or fairness" (which are two extremely vague terms that can vary wildly depending on the metric), but I'd raise an eyebrow at anyone acting towards that goal unless they understand that you can't bludgeon or even argue fairness in a population. You'll only get a backlash that would cause you to power up... then they power up... and it turns into a battle of wills. And using "thought police" statistics to make policy or making public policy with the express purpose to change thoughts is a big, big mistake. No one should be in the business of policing someone's thoughts. "Fairness" and "equality" (depending on how they are measured) is a great goal. Your heart's in the right place... but that's just not how it works, not in any lasting way.

...phew!

 

[PsyOpt]

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[PsyOpt]

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[Fan_of_Meehl]

From above:

"Most people I've talked to who labelled themselves "social justice warriors" have a terrible allergy to using appropriate statistics and analyzing data critically. The 23% wage gap study is so flawed and long since discredited (By a report by the labor department, despite being brought up by politicians including the president), yet when I bring up why, I'm simply told I'm a sexist and the conversation is shut down. I bring up how stereotype threats are damaging and counterproductive in some cases, all the while showing the research, I'm told I'm a closet racist and the conversation is shut down. I'd love to talk about these things intelligently, and I'm totally open to being wrong. But, I want to be incorrect for the right reasons. They just did not know how to argue."

Yup...I'd have to agree with you wholeheartedly there. The biggest concern I have is people arbitrarily focusing on gender/race in a situation to the exclusion of other contextually relevant factors and the 'you're racist/ you're sexist' 'rebuttal' being utilized as a trump card that means 'I win / you lose' the debate/discussion because, when ad hominem attacks (i.e., 'you're a racist') by 'social justice warriors' this is a special case where ad hominem is...well 'social justice.'

 

[MCParent]

The biggest concern I have is people arbitrarily focusing on gender/race in a situation to the exclusion of other contextually relevant factors and the 'you're racist/ you're sexist' 'rebuttal' being utilized as a trump card that means 'I win / you lose' the debate/discussion because, when ad hominem attacks (i.e., 'you're a racist') by 'social justice warriors' this is a special case where ad hominem is...well 'social justice.'

It used to be "that's racist," but evolved into "that's offensive" (so that no justification need be provided) and then "check your privilege" (even less justification needed).

M/C is of course vital, but the state of it in psych, compared to some other fields, is insanely primitive. I have psych textbooks that literally say, "Asian people like therapy like this:" and "Black people like therapy like this" (sometimes a helpful little table is provided). I have another theories textbook, purporting to focus on M/C issues, in which in the multicultural chapter a vignette using a Black patient focuses on his challenges in "rapping with sistas." This was published in 2012.

 

[erg923]

M/C is of course vital, but the state of it in psych, compared to some other fields, is insanely primitive. I have psych textbooks that literally say, "Asian people like therapy like this:" and "Black people like therapy like this" (sometimes a helpful little table is provided). I have another theories textbook, purporting to focus on M/C issues, in which in the multicultural chapter a vignette using a Black patient focuses on his challenges in "rapping with sistas." This was published in 2012.

This was very much the focus of my "multicultural training" in the mid-2000s. Patently useless.

 

[MCParent]

This was very much the focus of my "multicultural training" in the mid-2000s. Patently useless.

Still is at many programs. I teach theories & interventions and M/C at the graduate level, and I encourage students to question the zeitgeist.

 

[smalltownpsych]

Just my $.02...

3. Does psychology have a role/duty to play in addressing endemic racism and inequities within our society? If so, how can we as a profession carry out that role/duty?

Yes. I think that we do have a role to play. I tend to address it one patient at a time. My patients are the victims of sexual abuse, poverty, substance abuse, mental illness, racism, sexism, etc. Every time I help someone recover from their victimization and help empower them to fight back in an adaptive manner, I feel that I am helping. I tend to see it as social work being focused more on the system and clinical psychology focused more on the individual, but either perspective necessitates advocating to an extent.

On the other hand, I don't think that as a profession we should give our "scientific opinions" on political issues and we should stick to reporting the science as accurately as possible. Racism is a good example, we have a lot of science about aspects of it, but I think making a moral judgement about it being good or bad is beyond the scope of science. Sure, almost all psychologists would probably agree with the opinion that racism is bad, but that is not a scientific finding.

 

[calimich]

I really appreciate the dialogue so far, the sharing of opinions, and the asking of questions. It's nice to hear how different folks understand these ideas and thoughts re: how much/little these issues fall within the scope of professional psychology.

some of my thoughts...

In my research and experience I've found it common for people to focus on definitions/terms/numbers as a sort of defense against addressing the perhaps more uncomfortable reality of lived experiences and searching for answers to and reasons for societal imbalances. It's also interesting to notice who stays silent in these types of conversations.

I've also found it common for folks to debate individual prejudices/racism vs. systemic inequalities and get bogged down by the semantics of "systemic racism". As a field, we've been historically trained to focus on individuals, so it's not surprising that it may be difficult for psychologists to embrace a wider view. I am not a clinical psychologist (to be), I am a counseling psychologist (to be). Our discipline purports to be preventative, focused more on the promotion of wellness then on the treatment of illness, and dedicated to helping individuals cope with normal lifespan developments. Thus, we take a view that "isms" hurt ALL people and that, as a prof of mine says "we're all cooked in the same soup." Working to reduce systemic discrimination (e.g., uneven job call backs -- http://www.nber.org/digest/sep03/w9873.html) is one way to address systemic inequalities which likely affect individuals' mental & physical health and overall well being. Realizing organizations are composed of individuals allows for the development of interventions at both a micro and macro level, and complicates the matter.

My specific area of research is focused on training methods of new teachers. A substantive body of research exists showing White teachers tend to hold lower expectations for students of color and that they communicate their expectations in a variety of consistent, subtle ways (e.g., body language, tone of voice, comments on papers). Another body of research has shown expectancy effects (self fulfilling prophecies) operate within school systems. Most teachers (I was one before making the career shift) get into the profession to help kids, not to discriminate. They are largely unaware of messages they've internalized and unconscious to the ways in which they pass along those messages (individual biases). Helping new teachers become aware of their implicit biases is a first step in reducing the disproportionate negative effects of their unintended actions. BTW, the K-12 public teaching force is ~80% White while students of color are ~52% of the student body, iirc.

Just one example of systemic intervention aiming to affect individuals, promote well being, and prevent future pathology.

 

[calimich]

Still is at many programs. I teach theories & interventions and M/C at the graduate level, and I encourage students to question the zeitgeist.

Agreed that early M/C education focused on "the other" (e.g., How to work with X diverse population/individual), however, contemporary methods used within many counseling psych programs have moved toward a more introspective model (e.g., Who am I as a cultural being and what beliefs/prejudices/biases do I bring to my counseling/consulting/research?). The latter approach moves away from ideas such as "people of color 'need' something different" and rather encourages clinicians to examine their own role in perpetuating (perhaps unknowingly) unequal treatment.

Given your institutional power it seems you might have an opportunity to influence training for the better.

 

[LAPsyGuy]

Yes. I think that we do have a role to play. I tend to address it one patient at a time. My patients are the victims of sexual abuse, poverty, substance abuse, mental illness, racism, sexism, etc. Every time I help someone recover from their victimization and help empower them to fight back in an adaptive manner, I feel that I am helping. I tend to see it as social work being focused more on the system and clinical psychology focused more on the individual, but either perspective necessitates advocating to an extent.

On the other hand, I don't think that as a profession we should give our "scientific opinions" on political issues and we should stick to reporting the science as accurately as possible. Racism is a good example, we have a lot of science about aspects of it, but I think making a moral judgement about it being good or bad is beyond the scope of science. Sure, almost all psychologists would probably agree with the opinion that racism is bad, but that is not a scientific finding.

Are you waiting for science to determine what is right and wrong? You've got a long wait ahead of you. Your argument is flawed in a few ways. Ethics and morality cannot be scientifically determined. The APA has an ethics code. Should it be scientifically "proved" before being put into place? Does all common sense need substantiation? Racism is evil on its face, and it's very clear it's not particularly good for our mental health. Do we really have to figure out how bad it is, and the mechanism behind its dangers before trying to stamp it out?

Also, how do you delineate political from the personal. Doesnt racism add to, if not cause in many cases, the stress and shame and depression we as clinicians try to help our clients heal. Psychology has, and must have public health elements, and we should be embracing those elements. I'm not saying that we should be warriors, but we know things that can help the general public, and we should be disseminating them from various scales if intervention.

We seem to be in a profoundly antiscientific period in our society, and everything has become political. It would be a mistake to back away from what we know is true for fear of it being called political. Please stop calling racism political. Yes, it's a political hot button issue, but that doesn't make it only political.

 

[MCParent]

Agreed that early M/C education focused on "the other" (e.g., How to work with X diverse population/individual), however, contemporary methods used within many counseling psych programs have moved toward a more introspective model (e.g., Who am I as a cultural being and what beliefs/prejudices/biases do I bring to my counseling/consulting/research?). The latter approach moves away from ideas such as "people of color 'need' something different" and rather encourages clinicians to examine their own role in perpetuating (perhaps unknowingly) unequal treatment.

Given your institutional power it seems you might have an opportunity to influence training for the better.

Does it? What textbook does this? I don't see it in the Sueian M/C approach. It appears to me to still be the dominant paradigm, including in Counseling Psych.

I think I do do it differently. But I use no textbook and only primary sources for the M/C class, and I'll probably move to that for my theories and interventions class too.

 

[LAPsyGuy]

Does it? What textbook does this? I don't see it in the Sueian M/C approach. It appears to me to still be the dominant paradigm, including in Counseling Psych.

I think I do do it differently. But I use no textbook and only primary sources for the M/C class, and I'll probably move to that for my theories and interventions class too.

There have been books that use this sort of approach, but they tend to be dated and no longer respected. It should be all about meeting client where they are; culture, gender, religion, disability, sexuality, etc included.

 

[smalltownpsych]

Are you waiting for science to determine what is right and wrong? You've got a long wait ahead of you. Your argument is flawed in a few ways. Ethics and morality cannot be scientifically determined. The APA has an ethics code. Should it be scientifically "proved" before being put into place? Does all common sense need substantiation? Racism is evil on its face, and it's very clear it's not particularly good for our mental health. Do we really have to figure out how bad it is, and the mechanism behind its dangers before trying to stamp it out?

Also, how do you delineate political from the personal. Doesnt racism add to, if not cause in many cases, the stress and shame and depression we as clinicians try to help our clients heal. Psychology has, and must have public health elements, and we should be embracing those elements. I'm not saying that we should be warriors, but we know things that can help the general public, and we should be disseminating them from various scales if intervention.

We seem to be in a profoundly antiscientific period in our society, and everything has become political. It would be a mistake to back away from what we know is true for fear of it being called political. Please stop calling racism political. Yes, it's a political hot button issue, but that doesn't make it only political.

I said very clearly that science cannot determine morality. I also said that I fight racism and many other destructive (in my opinion) forces. My point was that we should not conflate science with either morality or politics. I have my own personal morality that is informed by my own socio-cultural perspective and background and profession (e.g., APA ethics code). Part of my own moral code and the APA ethics code is that prejudice and bias is something for me to be aware of and work to mitigate. I also believe that it is healthier for the field of psychology to focus on science as opposed to social justice, but that is my belief and it is shaped by personal experience, biases, and reasoning. It is not a testable hypothesis.

 

[Ollie123]

In my research and experience I've found it common for people to focus on definitions/terms/numbers as a sort of defense against addressing the perhaps more uncomfortable reality of lived experiences and searching for answers to and reasons for societal imbalances. It's also interesting to notice who stays silent in these types of conversations.

This is an area where I would urge caution. I hold no doubt whatsoever that this happens. When it happens and whether it is manifesting at a given time is typically going to be an assumption on your part that may or may not hold true and the very sort we should be trying to avoid in such discussions. Encouraging introspection is necessary in these discussions and also something I think we all need to do more of when having them. However, I have often seen folks on this board cross the line into essentially telling others that disagreement (or even discussion rather than blind acceptance) is "racism." Any further denial/defense is more evidence of racism. Having the discussion itself is "privilege", etc.. Things spiral out of control quickly. No idea if you yourself were involved in any of those discussions so please don't take this personally, but this struck a chord since its something I've seen unfold with some regularity here.

I think this is critical because there are few better ways to make sure an idea won't be taken seriously by a scientific/educated community than to defend an idea in that way (again - not saying you have - just that I've seen others here do so). We've had what I felt were some interesting discussions regarding the terminology itself and pros/cons of the word "privilege" itself in a context where many posters were readily admitting many advantages they carried. The conversation got shut down because several folks came in and essentially said that discussing the topic made everyone a racist(/sexist/etc. - think we've had a few such conversations in different context). All it really resulted in was those folks and their views no longer being taken seriously or respected...which likely wasn't their goal. I know for me personally, anytime someone defends a concept in that manner - my immediate reaction is "Wow, this idea really must be flawed if circular reasoning wherein they presume to know my mental state is the best defense they have." Oftentimes, they do still have good points despite that, but it takes immense effort to overcome that reaction and continue to look for meaning in what they are saying...something I will readily admit, I often don't manage to do.

 

[LAPsyGuy]

I said very clearly that science cannot determine morality. I also said that I fight racism and many other destructive (in my opinion) forces. My point was that we should not conflate science with either morality or politics. I have my own personal morality that is informed by my own socio-cultural perspective and background and profession (e.g., APA ethics code). Part of my own moral code and the APA ethics code is that prejudice and bias is something for me to be aware of and work to mitigate. I also believe that it is healthier for the field of psychology to focus on science as opposed to social justice, but that is my belief and it is shaped by personal experience, biases, and reasoning. It is not a testable hypothesis.

Sorry, I think I'm missing your point. How do you separate out the personal from the political? Science is the means to a society's goals. It doesn't stand monolithically alone. The questions science asks are socially laden. You've made an impossible distinction.

 

[calimich]

Does it? What textbook does this? I don't see it in the Sueian M/C approach. It appears to me to still be the dominant paradigm, including in Counseling Psych.

I think I do do it differently. But I use no textbook and only primary sources for the M/C class, and I'll probably move to that for my theories and interventions class too.

Glad to hear you do things differently! One text that comes to mind is Pedersen, P. B. (2004). 110 experiences for multicultural learning. Washington, DC: American Psychological Association. Of course there are some not-so-great activities, and some profoundly simple and powerful ones that have potential for starting rich dialogues, imo.

 

[futureapppsy2]

Edit: I could only find the abstract, but from the small n, they also state that "Most participants did not disclose their disability during the graduate school, internship, or postdoctoral application processes." I wonder what effect that had on their ratings. Also, how can we make assertions about the supportiveness of disabilities if they are never disclosed. The "invisible" ones anyway.

Note that the abstract says, "during the application process." If you look at the disclosure data I posted in response to Ollie, the majority *did* disclose DURING training, just not during the application process.

Also, it's entirely possible for supervisors and faculty to say bigoted things about disability/trainees with disabilities without knowing someone has a disability, just as people can say homophobic things without knowing that someone is not straight. Doesn't mean it isn't hurtful or doesn't have an impact on the trainee's experience.

I'm not denying that there are trainees with disabilities in this field who have a wholly positive experience or most positive one, but the limited data we have as whole seems to suggest that there are significant barriers to to trainees with disabilities in professional psychology.

 

[smalltownpsych]

Sorry, I think I'm missing your point. How do you separate out the personal from the political? Science is the means to a society's goals. It doesn't stand monolithically alone. The questions science asks are socially laden. You've made an impossible distinction.

It's kind of like the separation of church and state in government. An elected official will have their own personal beliefs but they are not allowed (in theory) to legislate those. As a person, I have my own personal beliefs but those should not be given greater weight because I am a psychologist. I can talk pretty confidently as a psychologist about the effects of combat exposure and trauma responses and the neurobiological underpinnings and also treatment of PTSD, but if I say that I am anti-war, that comes from a personal belief. Another personal belief that I have is that it is better for our field to try to maintain this separation, as much as possible, and to avoid getting embroiled in politics. I would be very saddened if the APA came out publicly in favor of or against the ACA, for example.

 

[LAPsyGuy]

It's kind of like the separation of church and state in government. An elected official will have their own personal beliefs but they are not allowed (in theory) to legislate those. As a person, I have my own personal beliefs but those should not be given greater weight because I am a psychologist. I can talk pretty confidently as a psychologist about the effects of combat exposure and trauma responses and the neurobiological underpinnings and also treatment of PTSD, but if I say that I am anti-war, that comes from a personal belief. Another personal belief that I have is that it is better for our field to try to maintain this separation, as much as possible, and to avoid getting embroiled in politics. I would be very saddened if the APA came out publicly in favor of or against the ACA, for example.

I think we may be addressing different levels. Your example of being anti-war and working with a vet is a good one. Divulging that would be of no use and would be demaging. But I'm not talking about that distinction, we both agree with it. I'm talking about things like advocating against physical punishment because science has shown that rewards are stronger and more effective, don't lead to PTSD or propagate further violence, etc. people would find that political. Another example is the research done on gay couples raising kids. That research was driven by politics and diverging systems of morality. Or not supporting torture? How do we manage those intersections as a profession?

 

[LAPsyGuy]

Another set of examples is that it's good to divulge one's own cultural difference to a client, and one's ignorance of their culture to further rapport and trust.

 

[QAsPsych]

M/C is of course vital, but the state of it in psych, compared to some other fields, is insanely primitive. I have psych textbooks that literally say, "Asian people like therapy like this:" and "Black people like therapy like this" (sometimes a helpful little table is provided). I have another theories textbook, purporting to focus on M/C issues, in which in the multicultural chapter a vignette using a Black patient focuses on his challenges in "rapping with sistas." This was published in 2012.

I can't speak for anyone else, but in my own program this is what everyone is asking for, like, "yeah sure culture is important and blah blah blah but what do I DO with an Asian client." My training does not approach the question from this perspective, but everyone who does not operate within the world of cultural research seems to want advice for working with "diverse" clients (where the hoped-for advice is in essence, "Asian people like therapy like this:"). They don't really like answers that are complicated or want to hear what M/C researchers have to say on the topic. If multicultural considerations mean they have to move beyond what they currently believe, my experience says most people in the heavy research side of things are not interested in hearing it. Which is unfortunate because I actually think multicultural perspectives are hugely important for mental health (based on the large body of research I have read).

It's also unfortunate what Tumblr, SJW stuff, & the abuse of the word "privilege" have done to public perception of actual issues of social justice, systemic inequalities, etc.

 

[473912]

It used to be "that's racist," but evolved into "that's offensive" (so that no justification need be provided) and then "check your privilege" (even less justification needed).

M/C is of course vital, but the state of it in psych, compared to some other fields, is insanely primitive. I have psych textbooks that literally say, "Asian people like therapy like this:" and "Black people like therapy like this" (sometimes a helpful little table is provided). I have another theories textbook, purporting to focus on M/C issues, in which in the multicultural chapter a vignette using a Black patient focuses on his challenges in "rapping with sistas." This was published in 2012.

I was told in one class the professor pointed someone out (the only black student from what I'm told) to demonstrate ebonics for the class. Not only is that ridiculous, it's stupid.

Are you kidding me? I just imagined the scene from Airplane. "Oh, I speak jive."

But it's Oregon. I know their heart was in the right place, but there's about 3 black people in the state. They don't know. I keep hearing how the program is so "diverse" and all, when the cohorts are about 95% white and 85% female and the number of genderqueer cohorts outnumbers men. lol.

Having said that, I'm not in any way in favor of quotas or diversity for diversity's sake. That's also counterproductive and illogical. I'm just saying those demographics don't scream "diverse" to me. That's why "diverse" is often a meaningless buzzword, also.

 

[smalltownpsych]

I think we may be addressing different levels. Your example of being anti-war and working with a vet is a good one. Divulging that would be of no use and would be demaging. But I'm not talking about that distinction, we both agree with it. I'm talking about things like advocating against physical punishment because science has shown that rewards are stronger and more effective, don't lead to PTSD or propagate further violence, etc. people would find that political. Another example is the research done on gay couples raising kids. That research was driven by politics and diverging systems of morality. Or not supporting torture? How do we manage those intersections as a profession?

I think the best way to manage it is stick to reporting the research as clearly and objectively as we can as psychologists and leave the advocacy for other organizations. If I want to be involved in advocacy (which I do), then I can choose to as an individual. I try to make it clear when speaking or teaching whether I am giving my opinion as a person, a psychologist with clinical experience, or citing research.

Also, I think you are combining a couple of types of research about physical punishment. Yes, reinforcement is more effective than punishment, whether it is physical or not. Punishment is used to rapidly extinguish an undesired behavior and is effective short term. Punishment includes time-out or taking away desired objects. Yes, physical punishment teaches kids to be more aggressive, as well. We do what we see. Physical punishment does not lead to PTSD, child abuse can cause PTSD. All of the kids in my family and most in the extended family, received spankings and none of them have PTSD. In fact, some of the punishment was excessive and fairly abusive, and still no PTSD. I work with families and their kids and from personal clinical experience know that there are no easy answers to parenting and what I see is that ineffective or neglectful parenting appears more damaging to kids than the occasional swat on the butt. In fact, some of my parents get so frustrated with their ineffective parenting that it leads to increased violence with kicking and biting from the kid and an escalation from parents. In other words, I believe (personally) that "violence is the last refuge of the incompetent" (Isaac Asimov)

 

[smalltownpsych]

Does it? What textbook does this? I don't see it in the Sueian M/C approach. It appears to me to still be the dominant paradigm, including in Counseling Psych.

I think I do do it differently. But I use no textbook and only primary sources for the M/C class, and I'll probably move to that for my theories and interventions class too.

Those were the types of classes I liked and the style that I use for much of my teaching.

 

[Ollie123]

They don't really like answers that are complicated or want to hear what M/C researchers have to say on the topic. If multicultural considerations mean they have to move beyond what they currently believe, my experience says most people in the heavy research side of things are not interested in hearing it. Which is unfortunate because I actually think multicultural perspectives are hugely important for mental health (based on the large body of research I have read).
.

As someone who has raised that issue - let me share that I think there are two camps. One is exactly as you describe. However, I also think a number of us (myself included) who ask that question are genuinely looking for substantive implications, regardless of complexity. There is no denying the MC literature is fraught with studies essentially concluding "Diversity is good, discrimination is bad, hurray for everyone" without offering anything meaningful (see my aforementioned post about it being a "buzzword" to get things funded, resulting in a lot of sloppy work). Raising the issue of your own background and ignorance of theirs is a good example of a practical recommendation that is far from "black clients want you to say Z" or something ridiculous like that. Though I question how well validated the former even is (does disclosing ignorance of someone's culture actually build rapport? Does that overwhelm any potential loss of confidence in the therapist in terms of engagement/outcome?).

Fully agree with everything else you said, just wanted to address this particular point. I'm just severely disillusioned with the "cultural competence" movement at present. Jumping off some of the points MCParent made, I think it is very much a "cart before the horse" in the literature at present. We know its good, we want to do it. I genuinely believe most folks in the field have the best of intentions but I frequently see it pushed WAY beyond what we can say with any remote confidence. I think (I admit, this isn't my area so others certainly will know the literature better). Its a work in progress, an admirable goal and one we absolutely should be striving towards. I worry about it because: 1) Good intentions can well end up still being harmful and 2) It may heighten therapist confidence at times when skepticism is still warranted.

Basically, I think we could be doing MUCH more than has typically been done to translate multicultural research into actionable plans to improve clinical outcomes with diverse populations. We need more people doing good work in that area.

 

[WisNeuro]

Just to piggyback on smalltownpsych, I am against corporal punishment in most forms, but also agree that the research is commonly misstated. How and when punishment is administered is the most important factor. I agree with some of his points that we should be a little better at both sticking to the data, and also disavowing misinterpretations of our data. Much too often, media sources take a study, have someone with no science training or background interpret and report on it, and then we get a generation of dearly held myths. I'm all for advocacy of our data and science first and foremost.

 

[smalltownpsych]

Just to piggyback on smalltownpsych, I am against corporal punishment in most forms, but also agree that the research is commonly misstated. How and when punishment is administered is the most important factor. I agree with some of his points that we should be a little better at both sticking to the data, and also disavowing misinterpretations of our data. Much too often, media sources take a study, have someone with no science training or background interpret and report on it, and then we get a generation of dearly held myths. I'm all for advocacy of our data and science first and foremost.

Exactly the point that I was making, couldn't have said it better myself. I think that is the reason for some of my own frustration with M/C (not Parent, each time I saw that I kept thinking they were referring to MCParent ) . The frustration being that the science gets muddled with opinions and beliefs. I love other cultures and relish meeting a new patient from a new culture because I know that they are going to open up a whole new world of perspective to me. Is it helpful to know a few things about a culture going in, maybe, maybe not. On the one hand it can help me to see something that I might miss or misinterpret, on the other hand i might see something that isn't there. I work with a lot of multicultural clients (some from identified minorities, some not) and sometimes culture plays a big role in what is going on and sometimes less of a role.

Much of my clinical work is guided first and foremost by how the brain works which seems to be similar across cultures. but I don't know how solid that statement is since I haven't seen a lot of research in this area. The second aspect of my work is guided by the patient's interpretation and perspective of their experiences and helping them to make sense of it. That second part clearly relies on culture, background, beliefs, temperament, upbringing, education, SES, religion, gender, sexual orientation, and the individual themselves. This second part is very real but less scientific because you can't really quantify or measure it.

 

[deleted343839]

Another personal belief that I have is that it is better for our field to try to maintain this separation, as much as possible, and to avoid getting embroiled in politics. I would be very saddened if the APA came out publicly in favor of or against the ACA, for example.

You realize that APA issues policy statements and amicus briefs and lobbies Congress on a regular basis, right? That is a major function of APA's Public Interest Directorate.

Politicians are fond of citing all manner of "science" to back up their legislative agendas. Where social and behavioral sciences are concerned, there should be an authoritative voice that can help policymakers choose a reasonable course of action. That doesn't mean APA should always endorse or oppose a specific piece of legislation (though I can think of many hypothetical examples where that would be perfectly reasonable). But as an organization that has a mission to "benefit society," APA has a mandate to step in where it can to influence policy in the direction most consistent with our science. The alternative is allowing pseudoscience to fill the vacuum.

So of course APA issues public statements on legislation that is relevant to psychology and, yes, many of the issues revolve around minority and disadvantaged populations. When some self-aggrandizing pastor testifies before Congress that you can "pray away the gay," I expect nothing less than for APA to show up with reams of data to indicate the contrary. Or we can just slink in the corner, hand the agenda over to the quacks and zealots (or to our medical colleagues who will dive right in), and become completely obsolete in the public sphere lest we get our hands dirty.

 

[WisNeuro]

That may be where I differ from smalltown, I think we should be more political as a profession, but also more beholden to the data.

 

[QAsPsych]

As someone who has raised that issue - let me share that I think there are two camps. One is exactly as you describe. However, I also think a number of us (myself included) who ask that question are genuinely looking for substantive implications, regardless of complexity. There is no denying the MC literature is fraught with studies essentially concluding "Diversity is good, discrimination is bad, hurray for everyone" without offering anything meaningful (see my aforementioned post about it being a "buzzword" to get things funded, resulting in a lot of sloppy work). Raising the issue of your own background and ignorance of theirs is a good example of a practical recommendation that is far from "black clients want you to say Z" or something ridiculous like that. Though I question how well validated the former even is (does disclosing ignorance of someone's culture actually build rapport? Does that overwhelm any potential loss of confidence in the therapist in terms of engagement/outcome?).

I see a lot more accusations of fuzzy thinking and buzzwords towards the MC literature than I see fuzzy thinking and buzzwords in the MC literature, and in return I see a lot of buzzwords around EBP with no clear directions, fuzzy thinking, and poorly done science.

And, yes, I think there is pretty clearly evidence for disclosing one's cultural perspective and expressing humility on the topic, and how to do so without challenging the client's confidence in the therapist. I'm in the middle of trying to publish something on this topic which I hope will clarify and offer actual advice.

Let me know who in mental health is funding studies that say "diversity is good" though, as far as I'm concerned the well is pretty dry.

 

[WisNeuro]

Let me know who in mental health is funding studies that say "diversity is good" though, as far as I'm concerned the well is pretty dry.

One reason I'd never go full on academic. The water in the mental health research well shrinks every year. Talk about advocacy, we need to be advocating as a profession for publicly funded research in general.

 

[Ollie123]

I see a lot more accusations of fuzzy thinking and buzzwords towards the MC literature than I see fuzzy thinking and buzzwords in the MC literature, and in return I see a lot of buzzwords around EBP with no clear directions, fuzzy thinking, and poorly done science.

And, yes, I think there is pretty clearly evidence for disclosing one's cultural perspective and expressing humility on the topic, and how to do so without challenging the client's confidence in the therapist. I'm in the middle of trying to publish something on this topic which I hope will clarify and offer actual advice.

Let me know who in mental health is funding studies that say "diversity is good" though, as far as I'm concerned the well is pretty dry.

I see it in both. Sloppy, lazy science is a huge problem for the field as a whole (hence the need for things like the replication project). I see slightly more of it in the MC literature, but acknowledge there is a wide confidence interval for both. The problems seem to be different, with EBP literature often ignoring alternative explanations/confounds and the MC literature ignoring basic experimental methods (my main complaint). Will look forward to seeing the paper - that's precisely what we need more of. I fully admit it may be out there - if you've seen a study that actually manipulated that in the context of a trial and looked at outcomes and mediators, I'd love to see it. Heck, I'd even take a laboratory analogue. Frankly, I haven't even seen studies where it was manipulated, which is why I drew that conclusion. Would be genuinely thrilled to be proven wrong.

As far as funding goes, I don't see many bodies funding conclusions outside the political arena Rather, I see a lot of medical centers where people submit grant after grant doing various iterations of the the same damn thing with various subpopulations they know nothing about, in my view seemingly take advantage of a community of people to get their data and then churn out awful papers without ever actually working with the community, etc. Papers where the only conclusion they can draw regarding MC is "Yay diversity" because they didn't actually manipulate the things they were interested in (for example, one I see all the time is tailored treatment vs. inactive control instead of tailored vs. untailored). I'm not sure if the issue is it being highly fundable or if the issue is just that changing the population is a very easy way to tweak a grant application and people are just looking ways to get more applications out quicker and this is an easy way to do that. Either way, I don't see enough of the folks doing good work getting the funding. Again the same with the neurobio - how many dead salmon are out there?

 

[smalltownpsych]

You realize that APA issues policy statements and amicus briefs and lobbies Congress on a regular basis, right? That is a major function of APA's Public Interest Directorate.

Politicians are fond of citing all manner of "science" to back up their legislative agendas. Where social and behavioral sciences are concerned, there should be an authoritative voice that can help policymakers choose a reasonable course of action. That doesn't mean APA should always endorse or oppose a specific piece of legislation (though I can think of many hypothetical examples where that would be perfectly reasonable). But as an organization that has a mission to "benefit society," APA has a mandate to step in where it can to influence policy in the direction most consistent with our science. The alternative is allowing pseudoscience to fill the vacuum.

So of course APA issues public statements on legislation that is relevant to psychology and, yes, many of the issues revolve around minority and disadvantaged populations. When some self-aggrandizing pastor testifies before Congress that you can "pray away the gay," I expect nothing less than for APA to show up with reams of data to indicate the contrary. Or we can just slink in the corner, hand the agenda over to the quacks and zealots (or to our medical colleagues who will dive right in), and become completely obsolete in the public sphere lest we get our hands dirty.

I was aware of that and have seen instances of that in the APA Monitor that seemed appropriate to me by citing the relevant science. I guess I was referring more to taking stances on endorsing or opposing legislation and my fears of the organization becoming too politicized. I would actually rather we were more willing to get our hands dirty so long as it is sound scientific data that is driving it. Some of my fears were caused by an issue of the APA Monitor that was titled the Psychology of Climate Change or something to that effect. I don't want this to turn into a debate about climate change either, I cite this example because it makes me question whether we should be involved in that at all. I would rather have the APA battling United Health and how they are unilaterally determining how long our sessions should be or how many a patient should have based on United's own practice guidelines. Our compensation has been static for about 18 years and now is being threatened further and the APA is saying....... *crickets*

 

[QAsPsych]

You certainly point to one of the challenges/divides, which is about the value placed on certain methods. Not about to solve that one in this thread, but I think it is a cause of a great deal of the back and forth. Anyway there's plenty of EBP literature where the basic design of the comparison group is problematic to say the least. I think we're in agreement about the poor quality of research on tailored treatments, though.

 

[LAPsyGuy]

I think the best way to manage it is stick to reporting the research as clearly and objectively as we can as psychologists and leave the advocacy for other organizations. If I want to be involved in advocacy (which I do), then I can choose to as an individual. I try to make it clear when speaking or teaching whether I am giving my opinion as a person, a psychologist with clinical experience, or citing research.

Also, I think you are combining a couple of types of research about physical punishment. Yes, reinforcement is more effective than punishment, whether it is physical or not. Punishment is used to rapidly extinguish an undesired behavior and is effective short term. Punishment includes time-out or taking away desired objects. Yes, physical punishment teaches kids to be more aggressive, as well. We do what we see. Physical punishment does not lead to PTSD, child abuse can cause PTSD. All of the kids in my family and most in the extended family, received spankings and none of them have PTSD. In fact, some of the punishment was excessive and fairly abusive, and still no PTSD. I work with families and their kids and from personal clinical experience know that there are no easy answers to parenting and what I see is that ineffective or neglectful parenting appears more damaging to kids than the occasional swat on the butt. In fact, some of my parents get so frustrated with their ineffective parenting that it leads to increased violence with kicking and biting from the kid and an escalation from parents. In other words, I believe (personally) that "violence is the last refuge of the incompetent" (Isaac Asimov)

When I trained in PCIT, it was repeated over and over that time out was not a punishment within the operant system.