Posts Tagged ‘evidence-based’
The ability to choose an evidence-based psychotherapy on the base of scientific knowledge has been a negligible factor in the evolution of the human brain. One could argue that empirical science itself fosters a style of thinking that is counter-intuitive for many of us. Personally I believe that the human way of trying to identify causal relations in a chaotic universe is the main reason of the evolution our kind has taken in the last few thousand years. But our susceptibility to see causal relations can also be a big problem. Thus I believe the main reason why fad therapies can book so much success is that the human mind is not made to think empirically. And if people do think the scientific way there are lots of downfalls, because the empirical science we have today is far from perfect and methodological problems lurk around many corners. It is easy to express (warrant) criticism of the scientific method (which currently is strongly connected to positivism) and shake up people’s reality. This can be a good thing, if you want to get people start thinking themselves, but far more often those who condemn the scientific system propose to let go of all empirical science altogether and adopt a system of their own choice. Funny enough these systems often try to build on the credibility of science, but in the end are not provable.
Whereas in the field of medical health, imbalanced can often be cured by the ingestions of medication, the parallel in the mental health would be ingestion of new thoughts in order to resolve psychic imbalance. While the body can react quickly to changes in the system, the plasticity of the neuronal structure is less flexible. Ingestions of new mental processes need to be repeated many times in order to change the underlying biological substrate. While most people understand that the process of loosing weight requires constant attention to food intake and regular exercise, most people do not understand that mental change is comparably slow. When a “quick and easy” fix is offered, people hope to circumvent the long trajectory of psychotherapy.
To sum it up (and two minor new points):
- The human mind is not made to think in a scientific way.
- Problems with the scientific method often lead people to turn to religion/quick’n’easy solutions/fad therapies.
- Normal therapy usually takes time, money and is painful.
People love to fall for the “it’s easy and painless” trick
- Many conditions do not have a real “cure”. Some can not accept that.
- Authority figures support fads and get rich doing so.
Elements of scientific approach violated in fad therapies
If any given theory is considered scientific (within the current paradigm), this usually means that it is objective, testable and replicable. There are different ways in which fads can be non-scientific. Mostly they are scientific in some ways, but not in all. Here are some of the preferred ways of fads for being non-scientific:
- There is no operational definition, no specifications of the processes and how they are related to important constructs and variables.
- There is no theory at all.
- The cause and effect relationship between the characteristics and consequences of environmental events and experiences has not been researched using sound methodology.
- Causal relationships are presumed without any reason or people are made to believe that there is a causal relationship by presenting correlational evidence.
- Alternative explanations are not pursued.
- Effects are generalized without reason to do so.
- Evidence is subject to biases.
- Unwarranted predictions are made.
Effect size is a parametric test, belonging to the GLM family that allows to compare the size of an effect between two groups (or for that matter two conditions in one group). The test can be used in all kinds of research designs (experimental and non-experimental) that employ different kind of measurements or/and manipulations. Given that the study itself is not biased, it offers an easy solution to compare the effect of different manipulations with each other. It also gives an indication of the real-life value of a given intervention (when compared to baseline). The concept of effect size is one of the core paradigms in scientific evidence-based therapy research and has stimulated the development of effective therapies, by giving a “golden” standard on which effect can be compared. Recently Cohen’s system of labelling different effect sizes has been criticized, still I would consider it to be scientific mainstream knowledge and the wide use and acceptance in the scientific community reinforces its use.