Quality control and the practice of clinical psychology

Because of current health care reforms, quality control, accountability, and cost-effectiveness have become important issues in the practice of clinical psychology. It is imperative that practicing clinicians begin to evaluate their services to assess whether they demonstrate high quality and cost-effectiveness, as well as a continued commitment to qualify improvement. Deming's (1986) approach to quality control is discussed as a useful strategy for improving effectiveness in the practice of clinical psychology. This approach emphasizes the process of identification of the client population, improvements through incremental processes, and evaluation of outcomes. Organizational Behavior Management (OBM) techniques are also reviewed as useful ways in which to supplement and improve on Deming's approach to quality control. Science and quality control are discussed as being inherently coherent. The scientist—practitioner model dictates that services provided to clients should be rigorously evaluated. Various procedures for evaluating the quality of services provided in clinical practice are discussed.     

Skinner on cognition

One of the most controversial, if not the most controversial, aspect of behaviorism is its claims (actual and putative) concerning cognition. Part of this controversy is caused by egregious exegetical errors on the part of Skinner's critics. Critics can then easily refute behaviorism by attributing these problematic claims to Skinner. This paper attempts to faithfully describe Skinner's claims regarding cognition. Skinner advances several arguments regarding the role of cognitions in human behavior and in the science of human behavior. We suggest that there are two distinct kinds of claims in this web: 1) claims regarding the proper relation between science and cognitions and 2) claims regarding the status of cognitions as natural events. Due to the multiplicity and interdependence of many of these arguments, it is best to view Skinner's position on cognition as consisting of a web of interdependent claims.     

The potential role of state-dependent learning in cognitive therapy with spider phobics

Investigated the potential role of state-dependent learning in cognitive therapy with spider phobics. It was hypothesized that one strategy for increasing the effectiveness of cognitive therapy for anxiety would be to induce anxiety in subjects while they were learning the cognitive restructuring principles (i.e., during treatment). Thirty-two undergraduate volunteers were randomly assigned to one of six experimental conditions. Subjects in the five treatment conditions (the sixth was a no-treatment control condition) met for three sessions of cognitive restructuring,in vivo exposure, or a facts lecture (i.e., the placebo group). Results indicated that when working with spider phobics, three sessions of cognitive restructuring,in vivo exposure, or a facts lecture resulted in equal effectiveness immediately following treatment, but are more effective than no-treatment at all.     

The credibility of sexual abuse allegations: Child sexual abuse, adult rape, and sexual harassment

Allegations and denials of sexual abuse often occur in a context in which there is rarely decisive evidence. The present study investigated the credibility of allegations of three kinds of sexual abuse—child sexual abuse, adult rape, and sexual harassment—that also contained a denial by the alleged perpetrator. Perceptions of fair punishment were investigated for the perpetrator if he did actually commit these acts and for the accuser if she was lying. Results indicated that allegations were generally rated in the credible direction. Allegations of child sexual abuse were rated more credible than allegations of rape or sexual harassment. Females found all allegations more credible than males. Males were more likely to believe allegations in the child sexual abuse condition than either the rape or sexual harassment conditions. Females were more likely to believe sexual harassment allegations. Punishments were generally the most severe for child sexual abuse, and psychotherapy was a popular disposition for both perpetrators and those making false allegations.     

The Ethics of Enhanced Interrogations and Torture: A Reappraisal of the Argument

This article critically reviews what is known about the ethical status of psychologists’ putative involvement with enhanced interrogations and torture (EITs). We examine three major normative ethical accounts (utilitarian, deontic, and virtue ethics) of EITs and conclude, contra the American Psychological Association, that reasonable arguments can be made that in certain cases the use of EITs is ethical and even, in certain circumstances, morally obligatory. We suggest that this moral question is complex as it has competing moral values involved, that is, the humane treatment of detainee competes with the ethical value/duty/virtue of protecting innocent third parties. We also suggest that there is an ethical duty to minimize harm by making only judicious and morally responsible allegations against the psychologists alleged to be involved in EITs. Finally, we make recommendations regarding completing the historical record, improvements in the professional ethics code, and the moral treatment of individuals accused in this controversy.     

Is gerontology a branch of astrology? The role of advanced age in scientific explanation

Although gerontologists have been troubled by meta-scientific problems such as the proper definition of their discipline, the nature of time and age, and the lack of a nonarbitrary distinction between the old and the not old [e.g., Baltes & Goulet (1970) In Life-span developmental psychology (pp. 4–23). New York: Academic Press; Birren (1959) In Handbook of aging and theindividual (pp. 3–42). Chicago, IL: University of Chicago Press; McKee (1982) Philosophical foundations of gerontology. New York: Human Sciences Press; Reese & Overton (1970) In Life-span developmental psychology (pp. 116–149). New York: Academic Press; Wohlwill (1970) Psychological Review, 77, 49–647], philosophers of science have paid little attention to the meta-scientific problems of gerontology. In this paper some philosophical problems in gerontology are examined through an analysis of the nature of scientific explanation. An argument is presented that claims that gerontology avoids many of the meta-scientific problems associated with time and advanced chronological age because these terms will tend to be obviated or “screened off” in scientific explanations in gerontology.     

What is a delusion? Epistemological dimensions

Although the Diagnostic and Statistical Manual of Mental Disorders (American Psychiatric Association, 1994) clearly indicates delusions have an epistemic dimension, it fails to accurately identify the epistemic properties of delusions. The authors explicate the regulative causes of belief revision for rational agents and argue that delusions are unresponsive to these. They argue that delusions are (a) protected beliefs made unfalsifiable either in principle or because the agent refuses to admit anything as a potential falsifier; (b) the protected belief is not typically considered a "properly basic" belief; (c) the belief is not of the variety of protected scientific beliefs; (d) in response to an apparent falsification, the subject posits not a simple, testable explanation for the inconsistency but one that is more complicated, less testable, and provides no new corroborations; (e) the subject has a strong emotional attachment to the belief; and (f) the belief is typically supported by (or originates from) trivial occurrences that are interpreted by the subject as highly unusual, significant, having personal reference, or some combination of these.     

Homophobia: Conceptual,definitional, and value issues

The construct of homophobia and the psychometric properties of instruments purporting to measure homophobia are critically evaluated. The history of the term and its various definitions are briefly reviewed. We conclude that existing measures of homophobia have been inadequately psychometrically evaluated and therefore it is not clear whether currently this construct can be accurately measured. It is also concluded that the construct of homophobia, as it is usually used, makes an illegitimately pejorative evaluation of certain open and debatable value positions, much like the former disease construct of homosexuality. Finally, proposals for theory development and construct definition in the domain of reactions to homosexuals and homosexuality are provided.     

The (even) bolder model. The clinical psychologist as metaphysician-scientist-practitioner

Is the clinical psychologist best characterized as a scientist-practitioner? Or does the practice of science and psychotherapy involve metaphysics to such an extent that the clinical psychologist ought to be considered a metaphysician-scientist-practitioner? To answer these questions, the roles, if any, of metaphysics in science and psychotherapy are examined. This article investigates this question by examining the views of the logical positivists, Karl Popper and Imre Lakatos, and concludes that the practice of science and psychotherapy involves metaphysics in (a) problem choice, (b) research and therapy design, (c) observation statements, (d) resolving the Duhemian problem, and (e) modifying hypotheses to encompass anomalous results.     

The structure of the cognitive revolution: an examination from the philosophy of science

The received view is that psychology has undergone several scientific revolutions similar to those that occurred in the physical sciences. Of these, this paper will consider the cognitive revolution. Because the arguments in favor of the existence of a cognitive revolution are cast using the concepts and terms of revolutionary science, we will examine the cognitive revolution using accounts of revolutionary science advanced by five influential philosophers of science. Specifically, we will draw from the philosophical positions of Popper, Kuhn, Lakatos, Laudan, and Gross for the purpose of discussion. We conclude that no substantive revolution took place according to these accounts. This conclusion is based on data gathered from some of the major participants in the "cognitive revolution" and on a general scholarly survey of the literature. We argue that the so-called cognitive revolution is best characterized as a socio-rhetorical phenomenon.