Warfare has changed
In response to its "open letter" in the September Monitor, I believe the APA Board of Directors has no business trying to define and regulate what citizens may do through military, police or intelligence agencies authorized by the U.S. government.
President Bush is mentioned twice in the "open letter." Does the board really believe that psychologists and psychiatrists just started consulting in PsyOps and interrogation strategies with the Bush administration? It is well documented that prominent mental health practitioners have consulted to the military and intelligence services for over four decades.
The conduct of warfare and culture of our enemies have changed. Women, children and elders are viable, if not preferred targets of our enemies. While I do not condone inhumane treatment of anyone, I am not in a position to define appropriate behavior for a psychologist in a command structure, in a theater I know little or nothing about. A simple example of the folly of the APA board's line of thinking and direction might next involve psychologists working for police departments (and there are many). Arrested and detained men and women are lit up with electricity (Tasered), sprayed with violently aggravating chemicals and strip searched (with body cavity inspection). Police psychologists are perfectly aware that this is routine in metropolitan law enforcement organizations and jails. How one perceives this is often determined by the point of reference.
To the APA board member, a video showing these practices would be seen as "inhumane, cruel and certainly degrading." To the line officer or police psychological consultant, these are methods that are necessary, humane and protecting of the life of all concerned. Should the police psychologist be charged with ethical violations for accepting these practices or working for an organization that performs them routinely? For the psychologist who is called to war as a combat infantryman or in a special ops unit...will the APA board need to define what type of killing is ethical? I doubt if any member of the APA Board of Directors has any knowledge of military, police or intelligence operations in the real world today.
The APA board may meet and discuss these issues. They may wish to make their collective philosophy known. I do not appreciate the board's attempt to define their philosophy as actuality and then attempt to regulate APA members with it.
Carl A. Ward, PhD
Keeping clients in the forefront
I applaud the seriousness and breadth of the 2009 Presidential Summit on the Future of Psychology Practice as reported in the July/August article "A new day for practice." I would like to caution us all, however, that the actions that will be called "necessary for psychology's future" will almost certainly move us further away from understanding in depth the individuals who need our help and away from providing individualized care for them.
I have always believed that to best help a person, I needed to understand that person's background, needs, emotions, worldview and motives, but throughout the course of my 31-year career as a therapist, there has been consistent change in the field toward dealing with clients en masse. The term "intervention," which came into use after my training, is not just a convenient noun for what we do; it connotes something we do to the client, rather than for or with the client. The belief has become more prevalent that diagnosis implies the form of help that is needed by the client (while we all know that diagnosis tells us almost nothing about the person in front of us).
The EST movement believes this, in general, and is comfortable generalizing from small groups of research clients to every client on the globe (since they must and do admit that the necessary research to test an EST on every different client group is impossible). We are urged to "adapt" to "the busy style of primary-care medicine," which will certainly guarantee very brief treatment for clients. Many of us appear to still want to be like physicians in our practice modes and status, and gaining prescription privileges will guarantee that many such psychologists will start seeing clients only for 15 minutes, just like psychiatrists (despite the current reassurances that psychologists will be different). On every front, less and less time and attention goes to the individual.
My point is that if psychology is a profession with integrity, we should determine what is needed by clients rather than continually "adapting" to "practice trends" and "the marketplace." Those trained more recently may not even understand the value of client insight and of learning to take responsibility for and manage one's life. I'm sure that many support the changes I decry, believing that they are still serving clients well, but I think adapting to economic issues has made it impossible to look objectively at what we truly believe would benefit our clients.
One can certainly view the above as the complaint of someone whose views are out of date, but those still practicing should reflect on whether what they have been taught is the best that we could do for clients or simply what "the system" (the population's beliefs and preferences; the insurance system) will allow us to do. It may be well to keep this caution in mind as you gain more perspective on the ruling forces shaping your career.
Christopher Ebbe, PhD
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