Letters

Let's support our impaired colleagues

The June article, "When a colleague is impaired," confirms that psychologists are lagging behind other health-care professions in the recognition and assistance to impaired colleagues. The article notes that only 11 of the 50 state professional associations appear to have colleague assistance programs, and other states, like Minnesota, have multi-professional assistance programs. These programs are vital in assisting professionals with impairments, as well as supporting them to find the services they need.

In the area of chemical dependency, these kinds of programs already in place for physicians and nurses in most, if not all, states provide a vital service in assisting the professional, maintaining awareness of patient safety, and providing support for that professional to maintain their hard-earned profession. It is disappointing that we, as a profession, have left the leadership in this area to other professions. I urge APA, the ASPPB and the state professional associations to formally develop colleague assistance programs as soon as possible.

Cheryl Buechner, PhD
Cumberland, Wis.

Bloodletting and psychotherapy

Nancy Moore, PhD, APA's executive director of governance affairs, addressed the possible impact of neurobiological advances for the practice of psychology and was quoted in the May Monitor article "It's Time to Shake Up Psychology," as follows: "Within 10 years, what we understand about the brain is going to make our current understanding look like we didn't know anything …. I could see that if we are not careful, talk therapy could look like bloodletting in terms of effective intervention."

We appreciate the exciting advances in the neurosciences, but the thousands of scientific studies showing psychotherapy to be robustly effective are also impressive. The superstitious practice of bloodletting fails as an appropriate comparison to scientifically supported psychotherapy. In contrast, much of the data supporting the effectiveness of psychiatric drugs has come under scrutiny in recent years. We know that psychiatric drug studies can be and have been biased at times by self-interested pharmaceutical companies and the researchers they hire. We know that overprescribing of psychiatric drugs, including powerful antipsychotics, for children and the elderly has become a national problem. We know that psychiatric drugs can have serious side effects including death. When compared to psychiatric drugs, psychotherapy begins to look quite attractive. Psychotherapy is often as effective as psychiatric drugs for an array of emotional problems—without the deleterious side effects of drugs. Therefore, we see no reason, scientific or otherwise, to anticipate that in 10 years psychotherapy will be replaced by neuroscience and designer drugs. Instead, we may look back and be shocked at the rampant abuse and overuse of psychiatric drugs in our day. Perhaps what needs to be shaken up is not the future prospects for psychotherapy, but our current overreliance on biological interventions for emotional problems that are amenable to psychological solutions.

David N. Elkins, PhD
Jennifer C. Franklin, PhD
Harris L. Friedman, PhD
Thomas Greening, PhD
Steven J. Hendlin, PhD
Brent D. Robbins, PhD

Corrections

The June In Brief item, "Judicial decisions could hinge on whether the judge has recently taken a break," incorrectly suggested Jonathan Levav, PhD, was the sole author of the study described. This was not a single-author study; Shai Danziger, PhD, and Liora Avnaim-Pesso, both of Ben Gurion University of the Negev in Beer Sheva, Israel, also contributed to the study.

Also, the June article "Taking on the Military Establishment" erred when it reported that the ECRI Institute report concluded the evidence supporting cognitive rehabilitation for people suffering from traumatic brain injury was too inconclusive to justify its coverage. The article should have said that ECRI's systematic review of the research to date found evidence of benefit for only two outcomes. The ECRI report did not make any coverage recommendations. However, TRICARE used the report in its decision to not cover cognitive rehabilitation.


Please send letters to Sara Martin, Monitor editor. Letters should be no more than 250 words and may be edited for space and clarity.