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Why do we have trained clinicians?

Firstly, let's think about how people become trained clinicians.

People become trained clinicians as a result of their (in brief)

  • completing a specified amount of study across a broad range of topics within the fields of clinical and counselling psychology or other human service field, and across a range of modalities (say, Behavior Therapy, Existential Therapy, use of EMDR, Psychodynamic  Therapy etc -- but usually in a minimum of two different types of therapy. While doing so
  • completing a minimum number of hours of practising a variety of therapies under supervision, especially being cognizant of client's feelings about particular therapies, their expectancies of therapy, and what to do if problems arise with a person's response, or lack thereof, to therapy
  • completing a supervised research study, ideally in a clinically relevant area

It remains an important part of that training that would-be therapists remain scientifically sceptical of any therapies they may call upon. Throughout this training they learn how to develop the ability to ask good questions of a therapy, and of their own practice, and how to try to answer those questions -- what makes good practice, what makes safe and effective practice -- how to compare different therapies against each other. This site attempts to argue for the worth of EFT Emotional Freedom Technique -- but provides detailed discussion of one research study, without highlighting just how poor is the quality of the research done -- what is "talk therapy" against which the approach  is compared -- which one of the hundreds of approaches was used, and then why that one????   http://www.tappingsolutionfoun...cience-and-research/

It is important that the therapies the student wishes to practice are evidence-based -- see here for guides to what is EBP

http://www.samhsa.gov/ebp-web-guide

 https://store.samhsa.gov/shin/...-4205/SMA09-4205.pdf

http://nrepp.samhsa.gov/AllPrograms.aspx

I could not find EFT in any of their lists of evidence-based practices.

As part of this questioning they should remain open to alternative points of view with regards to particular therapies; such as, at least with respect to psychodynamic and behavioral therapies (these are, after all, accepted evidence-based practices), this site http://blogs.plos.org/mindthebrain/

It is important to note that both "behavioral" and "psychodynamic" therapies have been subjected to repeated "component analyses" to try to determine what are the critical components involved in their success -- but this has only been able to happen after the therapies have matured and differentiated -- respectively highlighting the roles of behavioral activation and mentalization, for example. This is what needs to happen for all therapies. In the case of "new" therapies, like EFT, we don't all need to accept that the only effective components are those identified by Church. 

It is not unusual for therapies to gather very positive results early in their development, but when subjected to use by practitioners less accepting of the approaches "message" to later be struggling to convince a broader audience of that therapies effectiveness. Perhaps even more importantly, considerable research now shows, the particular therapy used is much less important than the quality of the relationship between therapist and client.   https://www.centerforclinicalexcellence.com/

It is by the combination of all these skills that one can be assured that the therapies practised will be selected in a stepwise, methodical, safety-focused and thorough process. Further, if problems arise, a trained clinician will be in a position to address both relationship issues and "practice" issues -- those not adequately trained,  who have not had their training and experience accredited, resulting in their not being "registered" (Downunder parlance) or "licenced" (North American context), cannot provide this secure base for their clients. I take part in a number of web forums and recently I was not allowed to say of one technique that it hadn't worked for me, but I did benefit from components of that technique which had been much better refined in a different model. Why was I not allowed? -- the need for reporting such "treatment failures" is now recognised as a crucial part of evaluating therapy alternatives -- see also here   https://www.facebook.com/groups/166671503346266/  Psychiatrist Rob Purssey has written some extremely interesting comments in this area and I encourage readers to obtain his materials.

 

Last edited by Russell Wilson
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