On being there
I am disheart-ened by Gerald Koocher's column "On being there" (April Monitor). He implies that psychologists offering evidence-based treatments routinely follow treatment manuals, even when it is inappropriate to do so, and that they do not consider empathy and a strong therapeutic alliance essential. Cognitive therapists would have conceptualized how they could best help the cystic fibrosis patient Dr. Koocher described, and most likely would have provided treatment for her that was quite similar to what he did. A sound therapeutic relationship and treatment based on one's conceptualization of the individual patient are two sine qua nons of cognitive therapy.
Judith S. Beck, PhD
Beck Institute for Cognitive Therapy and Research
Bala Cynwyd, Pa.
How ironic to read Gerald Koocher's April column after just finishing reading Terence Campbell's "Beware the Talking Cure" (Upton Books, 1994). The latter opened my eyes to the fallacies of psychotherapy and to question the therapeutic efficacy of counseling. Then I read Dr. Koocher's reminder that not every intervention is evidence-based--nor should it be. But I don't recommend making a practice of it either.
Rick Silen, PsyD
New Albany, Ind.
Thank you, Dr. Koocher, for a brave and eloquent description of what is often most significant for psychologists' work--simply "being there" with another human being. Although accountability in the form of evidence-based treatments and outcome measures is indeed important, most important is not to lose sight of what fundamentally makes a difference--and probably what moved most of us to become psychologists in the first place: the human connection.
Ilene A. Serlin, PhD
APA Div. 32 (Humanistic)
Ethics and PENS
"APA governance news" (April Monitor) notes that the Divisions for Social Justice, a coalition of 10 divisions organized around the promotion of social justice issues in APA, "were pleased with the position taken by the PENS Task Force that psychologists have an ethical responsibility to not engage in, directly support, facilitate or offer training in torture or other cruel or inhuman or degrading treatment." We do support various aspects of the task force report and some of the follow-up activities planned by the APA Ethics Committee, particularly the preparation of a case book.
However, we have a number of reservations about the PENS process and a number of recommendations (at www.scra27.org) to remedy what we perceive as unresolved issues with respect to the participation of psychologists at detention centers, such as the center at Guantanamo Bay.
We believe, for example, that Ethical Principle 1.02 in the APA Code of Ethics needs to be revised in order to make APA's position unambiguous that it is unethical for psychologists to participate in any role, including consultation, in interrogations of detainees involving any form of torture or cruel and inhuman treatment of detainees. We are concerned that little movement has occurred in this direction.
In addition, we believe that APA needs to support an independent investigation of allegations in the press that named and unnamed psychologists have functioned in roles that lent support to the torture or cruel and inhuman treatment of detainees.
Neil Altman, PhD
Chair, Divisions for Social Justice
Note from Olivia Moorehead-Slaughter, PhD, Ethics Committee chair: I thank Dr. Altman for his thoughtful letter. To move forward council's request regarding Standard 1.02, the committee has asked the Divisions for Social Justice to identify what constitute ";basic human rights," since incorporating this phrase into an enforceable ethics standard (vs. an aspirational principle) provides a basis for a licensing board, ethics committee or litigation-based action against a psychologist. The Ethics Committee is eager to receive the divisions' feedback.
We were dismayed to read the Garb, et al. letter (March Monitor) regarding "Assessing assessment" (January Monitor). The authors appear to be so single-minded in their zeal to attack the Rorschach that they criticize an article concerning the expanding role of assessment services in health care and forensic arenas for not including a critique of one particular instrument.
Their justification appears to be a single phrase plucked out of context. It should be noted that despite the contention by Garb et al. that "many psychologists have concluded that the scientific basis for the Comprehensive System is unacceptably weak," their only references for this are to their own publications. While this is not the place to debate the merits of the so-called "Rorschach controversy," we nevertheless feel that Monitor readers would appreciate a more balanced and scientifically justified point of view. We therefore urge interested readers to read "The Status of the Rorschach in Clinical and Forensic Practice: An Official Statement by the Board of Trustees of the Society for Personality Assessment" in the Journal of Personality Assessment (Vol. 85, No. 2, pages 219-237) in 2005. The statement contains tables comparing the efficacy of the Rorschach with other instruments in medicine and psychology, as well as an extensive bibliography. It may also be accessed at www.personality.org.
Bruce L. Smith, PhD, Berkeley, Calif.
Anita L. Boss, PsyD, Alexandria, Va.
Virginia Brabender, PhD, Chester, Pa.
F. Barton Evans, PhD, Bozeman, Mont.
Leonard Handler, PhD, Knoxville, Tenn.
Joni L. Mihura, PhD, Toledo, Ohio
David Nichols, PhD, Portland, Ore.
The power of apologies
One of the main themes in college courses such as "Counseling Techniques," "Conflict Resolution" and others like that is what to do and what not to do with clients. The article, "When should you apologize to your clients?" (March Monitor), gives several refreshing viewpoints on understanding the "ins and outs" of apologizing to clients. Counselors need to be sensitive to their clients' various needs, differences and similarities with others. In so doing, they will be more likely to communicate effectively with them, and with good communication there is rarely a need for apologies. After all, we come out of college with the sincere intent that we want to make a difference, but we shouldn't allow our "poorly chosen words" to interfere with us achieving this end.
Curiously, we all have been taught that "sticks and stones could break my bones, but names will never hurt me." In actuality, a hurtful misspoken word will almost always hurt more and longer. So saying it right and knowing how to properly apologize when we don't are two vital keys we should seek to effectively employ if we want to be good counselors.
Thomas Parish, PhD
Upper Iowa University
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