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Understanding Differently
Different Cultures; Different Kinds of Focus
Two Camps of Professionals
Scientific inquiry, at least in principle, offers the promise of making a lot of things better. It is the systematic application of scientific methods that has formed the groundwork for much of the technological progress of humankind.
Then why is the press constantly bombarding us with expensive and lengthy study results that seem to show contradictory or even useless results? Are eggs good or bad for us? Scientific studies seem to be continually at odds with each other. In spite of its central role in modern culture, many people are coming to distrust scientific research, either as irrelevant or dangerous.
Is research really becoming less relevant? Perhaps an alternative is that our world, and especially our knowledge of it, is becoming greater and more complex and we are having more difficulty comprehending it. It seems almost as if we have responded to the challenge, in part, by retreating from it. The rate of sheer scientific illiteracy in our modern technological societies is frighteningly high. One particular example strikes within psychology.
Do the results of scientific methods have any bearing on fields where the outcome seems more dependent on art than science?
Psychotherapy is one such field. The arts of healing the mind and changing behavior have their own history, one that runs parallel to the rise of scientific psychology. Parallel, but not the same. Psychotherapy has long been beset by critics of its methods, some very influential and backed by sound empirical research.
Although both are healers of the mind and research psychologists are students of the human soul and human behavior in some sense, healers and researchers have a long history of mutual distrust and animosity. This difficulty has been well documented in the psychology literature (Barlow, Hayes, & Nelson, 1984).
"Researchers blame therapists for not utilizing research findings and for being biased, irresponsible, or antiscientific. On the other hand, therapists blame researchers for not researching common or clinically relevant treatments or populations, and for being scientistic, boring, or irrelvant." (Elliott & Morrow-Bradley, 1994).
As a result, most clinicians perceive scientific psychology research as hopelessly lagging behind clinical work, or otherwise inapplicable to their daily practice. Up to a point, this is in the nature of scientific research. While there are differing philosophies of science, most observers of science would agree that the practical results of scientific studies are much more to discredit old ideas than to produce new ones. Consequently, psychotherapy research takes on a kind of quality control role, rather than an innovative role, for the most part.
Seeing research as quality control makes it easier to understand why clinicians respond in surveys that they commonly find research reports narrow, tedious, and overly concerned with methodology and statistics. The best a study can generally do is to test some narrowly focused fragment of an existing theory.
Researchers require laborious technical descriptions of measurements and methods from each other, in order to evaluate whether their claims are supported by their data. Most of this is of little interest to the practitioner, who usually wants to know mainly what works for who, and how to best use it. The most a practitioner wants to know in most cases is the conclusion.
Most researchers bemoan the fact that so many clinicians tend to turn a deaf to the latest research findings. They do not find research results hopelessly contradictory. A key part of their professional work is to reconcile different observations in order to test different theories. They fully expect contradictions, and expect further research to clarify them.
People outside the research community, including clinicians, are looking for guidance, even definitive answers. They understandably have less tolerance for the lengthy, tedious process of validating and invalidating general causal theories. By neccessity and often by desire as well, they come up with their own models of cause and effect for their
agendas and goals; are well within their professional sphere of talents.
There are two main ways in which research and therapy intersect. One is the use of research methods to test psychotherapy outcomes in large samples. The other is the use of research methods during psychotherapy to better understand and record what is going on in individual cases. In order for therapists to enhance our knowledge of therapy through research, they need to be able to understand the existing research, so that they can help produce more testable ideas for research.
Some practical suggestions that have been made to help bridge the gap between psychological research and the clinical practice of psychotherapy include:
- Develop clearer methods of constructing case studies and better conceptual strategies for analyzing them.
- Include more clinical vignettes and case studies in research papers to demonstrate the clinical relevance or possible application of the research.
- Investigate what types of research are most helpful to clinicians and why.
- Better understand how to disseminate research information to clinicians.
- In training programs for new clinicians, include instruction in making greater clinical use of research results and methods.
- In training programs for new researchers, include instruction in conducting investigations with emphasis on clinical relevance.
