Tuesday, October 16, 2012
At the end of Part I of this post of September 12, 2012, I mentioned that doing psychotherapy outcome studies is diabolically difficult, and promised to discuss the reasons why in this post. In fact, because of the literally infinite numbers of uncontrolled variables in studies of human beings both individually and in relationship to other human beings, psychotherapy outcome research can never be the only standard by which the "science" of human behavior-change technology should be measured. In fact, it's not even the gold standard.
In order to better understand ourselves and what leads us to change our behavior, we must use ALL available sources of information. We have to look at the widespread clinical experience of psychotherapists who use a variety of techniques and theories with a variety of clinical populations. We have to look for potential biases in both clinical studies and within an individual therapist's anecdotes and the conclusions that we draw from them. In forming conclusions about both anecdotal and controlled-trials data, we have to look at a wide variety of possible explanations, as well as for any information and experiences that would seem to contradict those explanations.
We also have to look at the experience of marketers who have been able to induce a large numbers of people to buy a product or vote for a politician (many of whose very powerful techniques have been discussed in previous posts on this blog). We have to look at the social psychology literature, which shows that people behave very differently when interacting with different groups of people and with different individuals than they might do in a therapist's office.
We have to look at historical and sociological trends. We have to look at new knowledge from the neurosciences that might account for findings that are difficult to explain or reconcile with other beliefs. We must look at evolutionary biology. We must examine our own beliefs for logical inconsistencies. We have to be honest about thinking about ourselves what makes us tick personally.
What follows is a list of some of the difficulties psychotherapy outcome researchers encounter, as well as the reasons they may overstate their results. A fuller discussion of each of them can be found in my book, How Dysfunctional Families Spur Mental Disorders.
1. The Problem of the “False Self”