Empirically supported psychotherapies: comment on Westen, Novotny, and Thompson-Brenner (2004)

D. Westen, C. M. Novotny, and H. Thompson-Brenner (2004; see record 2004-15935-005) suggested that efforts to identify empirically supported treatments are misguided because they are based on assumptions that are not appropriate for some types of treatment and patients. The authors of this comment argue that Westen and colleagues are simply incorrect when they assert that empirically supported treatments require that psychopathology must be highly malleable, that treatments must be brief, or that the samples studied are unrepresentative of the kinds of patients typically encountered in clinical practice--comorbidity is common in many clinical trials. Randomized controlled trials remain the most powerful way to test notions of causal agency.     

Psychotherapy process: the missing link: comment on Westen, Novotny, and Thompson-Brenner (2004)

In this comment, J. S. Ablon and C. Marci argue that focusing on the empirical validation of manualized treatment packages misses important information about what is efficacious about a given treatment. Psychotherapy process has demonstrated that treatments may promote change in ways other than their underlying theories claim. Manualized therapies may appear distinct despite important similarities in dyadic interaction. These functional similarities in the emergent transactional process between therapist and patient may help explain the difficulty demonstrating differential outcomes across brands of brief therapy. Rather than focus on treatment packages targeting patient symptomatology, the authors recommend a shift in focus to the empirical validation of change processes coconstructed by therapist and patient in naturalistic settings.     

Jousting with straw men: comment on Westen, Novotny, and Thompson-Brenner (2004)

Empirically supported treatments (ESTs) do not cure every patient, and the randomized trial is not a flawless methodology. Upon these often-noted and widely accepted points, D. Westen, C. M. Novotny, and H. Thompson-Brenner (2004a; see record 2004-15935-005) built a critique of ESTs and EST research. However, important work developing effective, clinically relevant treatments for serious problems was omitted from the Westen et al. (2004a) review. Little documentation was offered for the purported "assumptions" of EST methodology that Westen et al. (2004a) criticized; and different review standards were applied to studies supporting versus those disagreeing with Westen et al.'s (2004a) views. Finally, the correlational research designs proposed as a remedy by Westen et al. (2004a) have far more serious weaknesses than randomized trials, thoughtfully applied to real-world clinical care.     

A healthy dose of criticism for randomized trials: comment on Westen, Novotny, and Thompson-Brenner (2004)

D. Westen, C. M. Novotny, and H. Thompson-Brenner identified many important concerns in their critique of methods typically used in randomized controlled trials (RCTs) of psychotherapy outcome and by extension in methods of identifying empirically supported therapies (ESTs). Some of the concerns would be mitigated if empirical support of treatments were assessed multidimensionally (separating favorability of results from definitiveness of research methods used) and continuously rather than categorically. Other concerns can and should be addressed within the existing framework of RCTs and ESTs, including consideration of inclusion criteria other than a single Axis I condition, experimental evaluation of some of the procedural assumptions codified in psychotherapy manuals, and far more detailed reporting of RCT results.     

The benefits of a "sidelong" approach to self-esteem need satisfaction: comment on Crocker and Park (2004)

J. Crocker and L. E. Park (2004) have achieved an admirable integration of the self-esteem literature with their claim that self-esteem is better conceived of as a dynamic human striving, rather than as a passive state or personality characteristic. However, the costs of self-esteem striving may be overstated--these costs may arise only in certain constrained cases. Also, although Crocker and Park suggested that self-esteem is not a true psychological need, there is evidence that humans in all cultures need to feel a positive sense of self-worth (K. M. Sheldon, in press). Problems may arise only when people strive too directly for this feeling, rather than deriving it as a natural concomitant of non-self-focused goals. A "sidelong" approach to self-esteem need satisfaction is advocated in this commentary.     

The research agenda: the vital need for empirical research in child psychotherapy

In this paper I shall describe how work discussion groups offered to staff on-site as part of a mental health in schools outreach project can have a significant impact on the thinking, attitudes and culture within a school. Through the use of some detailed examples of these work discussion groups in action, I hope to illustrate the way these groups can enable staff to enhance their observational skills, develop a deeper understanding of the factors that impact on learning, behaviour and teaching, and reduce staff stress. Finally, I hope to highlight the ways in which such groups not only extend staff skills in engaging with pupils at risk of emotional breakdown and school exclusion, but can also promote a learning environment for all, in which development and growth is promoted at a personal, professional and whole-school level.     

Conditioning, expectancy, and the placebo effect: comment on Stewart-Williams and Podd (2004)

Classical conditioning is included as a component in the response expectancy model of placebo responding. Though introspectable when attention is drawn to them, expectancies need not be in awareness while guiding behavior. Most placebo effects are linked to expectancies, and classical conditioning is one factor (but not the only factor) by which these expectancies can be produced and altered. Conditioned placebo effects without expectancies exist but are relatively rare in humans. The adaptive advantage of cognition is increased response flexibility. For it to convey that benefit, however, it must be capable of overriding the influence of simpler automatic processes. Thus, the higher up the phylogenetic scale, the smaller the role of nonconscious conditioning processes and the larger the role of cognition.     

Unconscious perception: the need for a paradigm shift

According to Snodgrass, Bernat, and Shevrin (2004), unconscious perception can be demonstrated convincingly only at the objective detection threshold, provided that the conditions of their objective detection/strategic model are met, whereas both the subjective threshold model of Cheesman and Merikle (1984, 1986) and the objective threshold/rapid decay model of Greenwald, Draine, and Abrams (1996) are inconclusive. We argue on theoretical, metatheoretical, and empirical grounds that all three dual-process models, which are based on both conscious and unconscious perception, should be rejected in favor of the single-process conscious perception model.     

Active masks and active inhibition: a comment on Lleras and Enns (2004) and on Verleger, Jaskowski, Aydemir, van der Lubbe, and Groen (2004)

Verleger, Jaskowski, Aydemir, van der Lubbe, and Groen and Lleras and Enns have argued that negative compatibility effects (NCEs) obtained with masked primes do not reflect self-inhibition processes in motor control. Instead, NCEs are assumed to reflect activation of the response opposite to the prime, triggered by the presence of prime/targetlike features in the mask. Thus, no NCEs should be elicited when masks do not contain such task-relevant features. In Experiments 1 and 3, the authors demonstrate that NCEs can be obtained when masks contain only irrelevant features. Experiment 2 demonstrates that positive compatibility effects (PCEs) will occur with such masks when masked primes are presented peripherally. These results are inconsistent with the mask-induced activation accounts but are in line with the self-inhibition hypothesis of the NCE. Although perceptual interactions and mask-induced motor activations may contribute to NCEs under certain conditions, they cannot provide a full explanation for these effects.     

Why g is not an adaptation: a comment on Kanazawa (2004)

In S. Kanazawa's evolutionary theory of general intelligence (g), g is presented as a species-typical information-processing mechanism. This conceptualization of g departs radically from the accepted conceptualization of g as a source of individual differences that is manifest in the positive manifold. Kanazawa's theory is thus problematic in the sense that it concerns a purely hypothetical, and empirically unsupported, conceptualization of g. The authors argue that an evolutionary account of g should address it as a source of individual differences--that is, in a manner that is consistent with the empirical support for g.     

Decision-making models of remember-know judgments: comment on Rotello, Macmillan, and Reeder (2004)

The sum-difference theory of remembering and knowing (STREAK) provides a sophisticated account of many interactions in the remember-know (R-K) area (C. M. Rotello, N. A. Macmillan, & J. A. Reeder, 2004). It assumes 2 orthogonal strength dimensions and oblique criterion planes. Another dual-process model (J. T. Wixted & V. Stretch, 2004) with one decision axis has also been applied to R-K judgments with considerable success and provides new insights into the processes involved. An analysis of the 4 major R-K interactions can also be explained by a simpler one-dimensional signal detection theory (J. C. Dunn, 2004a). However these models do not make contact with standard work on recognition memory, so their scope is limited. To bridge this gap, a global-matching model (a theory of distributed associative memory [TODAM]) for R-K judgments is proposed. This model can produce good fits to the data, and there are established experimental manipulations with which to test it. It provides further support for the idea that R judgments are based on associative information, whereas K judgments are based on item information.     

Relations among categorization, induction, recognition, and similarity: comment on Sloutsky and Fisher (2004)

V. M. Sloutsky and A. V. Fisher reported 5 experiments documenting relations among categorization, induction, recognition, and similarity in children as well as adults and proposed a new model of induction, SINC (similarity, induction, categorization). Those authors concluded that induction depends on perceptual similarity rather than conceptual knowledge. Despite the useful contributions of this work, there are some important limitations. The experimental designs examined a limited range of phenomena that are not the most revealing about the use of nonperceptual information. The main results involved a simple triad task, for which the SINC model's predictions are equivalent to the predictions of previous models of inductive reasoning. It is also unclear whether the SINC model can account for the observed relations between similarity and recognition. Implications for future work on induction and related cognitive activities are discussed.     

Constructing desirable identities--self-presentation in psychotherapy and daily life: comment on Kelly (2000)

A. E. Kelly's (2000) thesis that psychotherapy clients benefit from withholding negative information is considered in light of current social-psychological theory and research. Positive illusions about oneself are associated with indexes of mental health; this is consistent with treating therapy as positive identity development. Self-presentation can shape self-concept, even apart from the feedback that an audience might provide; the social construction of identity is a powerful process, suggesting that withholding negative and presenting only positive information is adaptive. However, evidence concerning the level of identification of one's actions suggests complexities in understanding ways clients might deal with disclosing negative information; the authors argue that the impact on self-concept is probably more complex than A. E. Kelly's characterization and that the implications are of a broader scope than indicated so far.     

On the need for structurally competent counselling and psychotherapy: Neoliberal ideology,disability and the psy disciplines

This article highlights and problematises the psy disciplines' articulations with neoliberalism, with a particular focus upon disability and upon counselling and psychotherapy. Recent years have witnessed burgeoning scholarly interest in the potential complicities of the psy professions in a neoliberal agenda of individualisation, pathologisation and responsibilisation of human suffering. Such complicities are, in state therapy settings, driven by a growing need for these professions to offer cost-effective, evidence-based interventions to secure funding in an increasingly competitive market. Whilst the entwining of neoliberal ideology with therapy practices may be innocuous for some, it is contended that disabled people may be at particular risk of harm. A case is then made for training and practice to foreground structural competency, an awareness of how therapy encounters and client concerns are shaped by socio-structural factors, including, but not limited to, politics and political ideology. This would require not only an appreciation of the sociopolitical context in which therapy unfolds and its indubitable shaping of subjectivities, but also greater recognition of disability as a source of social inequity and oppression, as opposed to an individual phenomenon. Moreover, structural competency would require theoretical and demographic diversity in training and practice, which, in turn, would necessitate identifying and addressing barriers to inclusion for disabled people. Points raised are deemed of particular importance given the emergence of long COVID.     

Two versions of the negative compatibility effect: comment on Lleras and Enns (2004)

A. Lleras and J. T. Enns demonstrated a negative influence of a masked arrow that is attributable to the perceptual interaction between the arrow and the mask when these have properties in common (in this case diagonal lines). Although the present analysis is in agreement that this type of perceptual interaction can occur, it also demonstrates that this is not the only way a masked arrow can produce a negative influence. The most critical finding is that a negative influence occurred even when the arrow and mask did not share the common properties that would be needed for this type of perceptual interaction. This illustrates the version of the negative compatibility effect that was studied by S. T. Klapp and L. B. Hinkley (2002) and others.