Dr. Phil and accuracy

I am writing to take exception to Dr. Phil McGraw's comments about his TV show in the article by Laurie Meyers (October Monitor, "Behind the scenes of the 'Dr. Phil' show") as well as to his receiving an APA presidential citation. Dr. Phil claims to provide useful advice to people who are suffering in silence and that his research team conducts "exhaustive literature searches to make sure the content is cutting edge and sound" but this was far from the case in his program on ADHD. That program was a travesty of [accurate] information and likely set the public view of ADHD back decades....The advice included testing for food allergies that he believes contribute significantly to causing ADHD and using EEGs as part of both diagnosis and treatment (EEG biofeedback). Dr. Phil went on to blame some of [a guest's]...ADHD symptoms on bad mothering. All of this grossly conflicts with the substantial body of science in this field. Research shows that within the family, influences such as parenting make no significant contribution to ADHD symptoms, that genetic factors account for 78 to 91 percent of the variance in its traits, that nongenetic unique events such as brain injuries and prenatal hazards such as prematurity and maternal smoking account for 15 to 20 percent of the variance, that EEGs should not be recommended for diagnosis, that EEG biofeedback has yet to produce significant treatment effects in randomized, rigorously conducted studies, and that medications are among the most effective treatments for the disorder, especially if combined with psychosocial (behavioral) and educational accommodations.

Russell A. Barkley, PhD
Medical University of South Carolina
SUNY Upstate Medical University

Prescribing pioneers

I would like to applaud Zak Stambor's article "Psychology's prescribing pioneers" (July/August Monitor) for including examples of how current prescribing psychologists are being affected by their new prescription privileges. In particular, it was encouraging to read the interview with E. Mario Marquez, who according to the New Mexico Psychological Association, is their legislative chair and one of the first two psychologists in the state to receive a conditional prescribing certificate.

Many opponents of the APA's policy on prescription privileges fear that this policy will inevitably lead to the medicalization of the field of psychology. Hearing Marquez frame the policy in terms of it giving psychologists the authority to refrain from prescribing medications, or to help wean patients off unnecessary medications, is refreshing. There seems to be an assumption that with the power to prescribe medication is the intent to use it first and frequently. While psychotropic medications are certainly vital for some patients, practicing therapists are faced with the realization that many clients are medicated gratuitously or in excess. Psychologists like Marquez can now make certain that clients receive a complete psychological evaluation with the level of detail that many general practitioners currently prescribing simply do not perform.

Lisa S. Lively
Auburn University

More on interrogations

I have been following with interest and some concern the discussions between some psychologists about the role of psychologists in the area of interrogation of prisoners.I am saddened to note the "mealy mouthed" and "fence-sitting" attitude of many psychologists in dealing with such individuals who are out to destroy as many people as possible or to cause indiscriminate serious injuries. I feel that 9/11 could well have been prevented if active steps had been taken to interrogate certain individuals as to the plans of terrorists and suicide bombers. For those poor victims it is now too late, and I am sorry to say that psychologists did little to help in this area.

Those who are likely to know when or how merciless destruction of life is likely to occur are individuals who suffer from a combination of mental disturbance and evil. I would not like to consider the components of each in such individuals. It is vital, however, to know the information they carry. What is also vital is for psychologists to support those who are attempting to obtain information by any means possible, in order to prevent future outrages of the 9/11 kind.

I, as many other psychologists, have a strong element of compassion and desire to heal psychological problems and deal sensitively with others. There is, however, a limit to this with certain individuals who are bent on the annihilation of others and their own lives in so doing.

L.F. Lowenstein, PhD
Fair Oak, East Leigh
Hampshire, England