Pseudoscience in Clinical Pseudoscience in Clinical PsychologyPsychology

By Elise SimondsBy Elise Simonds

Clinical Psychology:Clinical Psychology:

• Concerned with the nature, diagnosis, Concerned with the nature, diagnosis, classification, treatment, and prevention classification, treatment, and prevention of mental disorder and disabilitiesof mental disorder and disabilities

Psychology is a SciencePsychology is a Science (or should be one)(or should be one)

• Just like any other science, they Just like any other science, they employ the scientific method when employ the scientific method when testing a hypothesis or a theorytesting a hypothesis or a theory– FalsifiableFalsifiable– Replicable Replicable – Testable Testable – Lacking in biasLacking in bias

• But there are a lot of other But there are a lot of other

psychologists who give us a bad namepsychologists who give us a bad name

Deeper look at:Deeper look at:

• Facilitated Communication (FC) for Facilitated Communication (FC) for autistic childrenautistic children

• Questionable Psychological Questionable Psychological Assessment TechniquesAssessment Techniques

• St. John’s Wort and Other Herbal St. John’s Wort and Other Herbal Treatments for Psychological Treatments for Psychological DisordersDisorders

Facilitated Communication Facilitated Communication (FC):(FC):

• Used for individuals Used for individuals with Autism and other with Autism and other disorders that severely disorders that severely effect their ability to effect their ability to communicate with communicate with others.others.

• Autism: Autism: – a disease which causes a disease which causes

verbal, communicative, verbal, communicative, and relational problemsand relational problems

– Onset is 2 years oldOnset is 2 years old– Usually, communication Usually, communication

is completely absent is completely absent

Facilitated Communication Facilitated Communication (FC):(FC):

• To help autistics communicateTo help autistics communicate• Involves initial hand-over-hand Involves initial hand-over-hand

and/or arm support, pulling the and/or arm support, pulling the hand back after each selection, hand back after each selection, slowing down the movements, slowing down the movements, assistance in isolating the index assistance in isolating the index finger, verbal reassurances, and finger, verbal reassurances, and encouragementencouragement

• How do we know the facilitators are How do we know the facilitators are only supporting rather than only supporting rather than influencing what the patient is influencing what the patient is typing? typing?

• Could be conscious or unconscious Could be conscious or unconscious • Regardless of empirical support, Regardless of empirical support,

it became very popular in the 90’s it became very popular in the 90’s and has not subsidedand has not subsided– Last week’s People Magazine ran an Last week’s People Magazine ran an

article supporting its usearticle supporting its use

Facilitated Communication Facilitated Communication (FC):(FC):ResearchResearch

• Studies on FC present pictures, movies, objects, or verbal Studies on FC present pictures, movies, objects, or verbal questions to see if patients can type in correct answersquestions to see if patients can type in correct answers

• Most studies attempt to prevent the facilitator by Most studies attempt to prevent the facilitator by influencing responses by keeping him uninformed of the influencing responses by keeping him uninformed of the stimulus or task’s goal:stimulus or task’s goal:– Ask patient questions, but not the facilitator Ask patient questions, but not the facilitator incorrect answers incorrect answers– Present questions or information in the absence of the facilitator Present questions or information in the absence of the facilitator

no correct responsesno correct responses– Use a table divider to compare trials when the facilitator cannot see Use a table divider to compare trials when the facilitator cannot see

stimulus to trials when he can see stimulus stimulus to trials when he can see stimulus incorrect responses incorrect responses– Compare trials where facilitator provides no help, hand-over-hand Compare trials where facilitator provides no help, hand-over-hand

assistance without prevention of errors, and hand-over-hand assistance without prevention of errors, and hand-over-hand assistance with prevention of errors assistance with prevention of errors correct only when facilitator correct only when facilitator was aware of the stimulus and full support was providedwas aware of the stimulus and full support was provided

• Some cases have even described children who get correct Some cases have even described children who get correct answers without attending to the keyboard or the stimulus!answers without attending to the keyboard or the stimulus!

Facilitated Communication Facilitated Communication (FC):(FC):

Obviously no paying attention to what he’s doing, so Obviously no paying attention to what he’s doing, so how can he possibly independently produce correct how can he possibly independently produce correct

answers?answers?

Facilitated Communication Facilitated Communication (FC):(FC):The Supporters’ Side of the StoryThe Supporters’ Side of the Story

• These studies were done in a lab where performance was These studies were done in a lab where performance was compromised due to the unfamiliar environmentcompromised due to the unfamiliar environment– Studies done at two children’s schools disproved this argumentStudies done at two children’s schools disproved this argument

• The Facilitated Communication Institute at Syracuse University The Facilitated Communication Institute at Syracuse University claims “There is empirical research to support the validity of FC:” claims “There is empirical research to support the validity of FC:” – ““Controlled studiesControlled studies (e.g. Intellectual Disabilities Review Panel, 1989; (e.g. Intellectual Disabilities Review Panel, 1989;

Calculator & Singer, 1992; Vazquez, 1994; Weiss, Wagner & Bauman, Calculator & Singer, 1992; Vazquez, 1994; Weiss, Wagner & Bauman, in press), in press), observational studiesobservational studies (Biklen, 1990 and 1993; Attwood & (Biklen, 1990 and 1993; Attwood & Remington Gurney, 1992; Biklen, Saha & Kliewer, 1995) and Remington Gurney, 1992; Biklen, Saha & Kliewer, 1995) and autobiographical accountsautobiographical accounts (e.g. Eastham, 1992; Oppenheim, 1974; (e.g. Eastham, 1992; Oppenheim, 1974; Nolan, 1987; and Crossley & McDonald, 1980) provide evidence that Nolan, 1987; and Crossley & McDonald, 1980) provide evidence that the method works.” the method works.”

• ““The method The method maymay be useful for any individuals who cannot speak be useful for any individuals who cannot speak or whose speech is highly echoed or in other ways limited and or whose speech is highly echoed or in other ways limited and who cannot point independently *and* reliably. But we have not who cannot point independently *and* reliably. But we have not selected a random group of people classified as autistic or selected a random group of people classified as autistic or developmentally disabled and tried the method with them, so we developmentally disabled and tried the method with them, so we cannot say with what percentage it might work.” (Biklen, 2005)cannot say with what percentage it might work.” (Biklen, 2005)– They can’t even state with confidence that it works!!They can’t even state with confidence that it works!!– They’re openly admitting to a serious lack of empirical data on their They’re openly admitting to a serious lack of empirical data on their

part!!part!!

Conclusion:Conclusion:

Does FC Work?Does FC Work?

NO!NO!

Psychological Assessment Psychological Assessment Tests:Tests:

• Used by psychologists to measure Used by psychologists to measure personality and psychological functioningpersonality and psychological functioning

• Two kinds:Two kinds:– Projective Tests – present an ambiguous stimulus and Projective Tests – present an ambiguous stimulus and

asked a series of open-ended questionsasked a series of open-ended questions– Self-Report Inventories – a statement is made and you Self-Report Inventories – a statement is made and you

must indicate if you agree it is true for youmust indicate if you agree it is true for you

• To gain acceptance as scientifically sound To gain acceptance as scientifically sound assessments, they must meet the following criteria:assessments, they must meet the following criteria:– StandardizationStandardization – of test so results can be replicated by – of test so results can be replicated by

any other assessorany other assessor– ReliabilityReliability – internal consistence, inter-rater reliability, and – internal consistence, inter-rater reliability, and

retest reliabilityretest reliability– ValidityValidity – measures what it claims to measure – measures what it claims to measure– NormsNorms – cutoff scores to determine the meaning of the test – cutoff scores to determine the meaning of the test

resultsresults

Psychological Assessment Psychological Assessment Tests:Tests:TheThe Rorschach Inkblot TestRorschach Inkblot Test

• Projective testProjective test• Shown ten cards and asked what you seeShown ten cards and asked what you see• Assessors focus on: Assessors focus on:

– The nature of what is seenThe nature of what is seen– What aspects of the card are used in the What aspects of the card are used in the

responsesresponses– The sequence of responses given during testingThe sequence of responses given during testing– The examinee's nonverbal reactions to the inkblotThe examinee's nonverbal reactions to the inkblot

Psychological Assessment Psychological Assessment Tests:Tests:TheThe Rorschach Inkblot TestRorschach Inkblot Test

• Does it measure up?Does it measure up?– StandardizationStandardization – Yes & No; Exner developed a – Yes & No; Exner developed a

system (The Comprehensive System) to ensure system (The Comprehensive System) to ensure standardization, but many do not use itstandardization, but many do not use it

– ReliabilityReliability – No; inconclusive results – No; inconclusive results– ValidityValidity – No; some scales may be valid, but overall – No; some scales may be valid, but overall

there is no correlation between it and other more there is no correlation between it and other more supported tests of personality and psychological supported tests of personality and psychological functioningfunctioning

– NormsNorms – No; good norms set for the different age – No; good norms set for the different age groups, but not for minorities who tend to score groups, but not for minorities who tend to score differentlydifferently

• Conclusion: insufficient scientific evidence to Conclusion: insufficient scientific evidence to justify the continued use of the test in clinical justify the continued use of the test in clinical settingssettings

Psychological Assessment Psychological Assessment Tests:Tests:Myers-Briggs Type Indicator (MBTI)Myers-Briggs Type Indicator (MBTI)

• Self-report inventorySelf-report inventory• 126 M.C. questions 126 M.C. questions

based on Jungian based on Jungian personality theorypersonality theory

• Classifies people Classifies people into 16 types which into 16 types which are used to identify are used to identify personalities and personalities and make predictions for make predictions for ideal job placementideal job placement

Psychological Assessment Psychological Assessment Tests:Tests:Myers-Briggs Type Indicator (MBTI)Myers-Briggs Type Indicator (MBTI)• Does it measure up?Does it measure up?

– StandardizationStandardization – Yes; good when administered – Yes; good when administered properly, but there are questions regarding the properly, but there are questions regarding the type cutoffstype cutoffs

– ReliabilityReliability – No; mixed results, more research is – No; mixed results, more research is neededneeded

– ValidityValidity – No; no proof it makes accurate – No; no proof it makes accurate predictionspredictions

– NormsNorms – Yes; good norms set for both sexes, all – Yes; good norms set for both sexes, all ages, all occupations, and across minority groups ages, all occupations, and across minority groups and culturesand cultures

• Conclusion: The MBTI lacks strong empirical Conclusion: The MBTI lacks strong empirical support for its use and should not be heavily support for its use and should not be heavily relied on for its predictive capabilitiesrelied on for its predictive capabilities

Psychological Assessment Psychological Assessment Tests:Tests:Thematic Apperception Test (TAT)Thematic Apperception Test (TAT)• Projective testProjective test• 31 picture cards used to reveal dominant drives, 31 picture cards used to reveal dominant drives,

emotions, and conflicts of the personalityemotions, and conflicts of the personality• Conclusion: There may be a promising future for Conclusion: There may be a promising future for

the TAT, but there is no support for it as it is the TAT, but there is no support for it as it is currently employedcurrently employed

Psychological Assessment Psychological Assessment Tests:Tests:Projective DrawingsProjective Drawings

• Projective testProjective test• Draw a person, a house, a tree Draw a person, a house, a tree

and a person, or a family and a person, or a family engaged in some joint activityengaged in some joint activity

• Among the ten most commonly Among the ten most commonly used assessment strategies by used assessment strategies by cliniciansclinicians

• Measures psychological Measures psychological functioning, emotional functioning, emotional intelligence, and intellectual intelligence, and intellectual functioningfunctioning

• Conclusion: Should not be Conclusion: Should not be heavily relied on due to their heavily relied on due to their vulnerability to many vulnerability to many weaknesses and errors in weaknesses and errors in administration, scoring, and administration, scoring, and interpretation interpretation

Psychological Assessment Psychological Assessment Tests:Tests:Anatomically Detailed Dolls (ADDs)Anatomically Detailed Dolls (ADDs)

• A.K.A. anatomically A.K.A. anatomically correct dolls or correct dolls or anatomically explicit dollsanatomically explicit dolls

• Projective testProjective test

• Primarily used for young Primarily used for young children with restricted children with restricted cognitive and verbal skills cognitive and verbal skills to determine existence of to determine existence of sexual abuse sexual abuse

• Conclusion: lack of Conclusion: lack of support for the use of support for the use of these dolls to screen for these dolls to screen for sexual abusesexual abuse

Herbal Treatments for Herbal Treatments for Psychological Disorders:Psychological Disorders:

• Becoming increasingly popular with the current Becoming increasingly popular with the current trend towards natural, holistic, and ecological trend towards natural, holistic, and ecological approaches to lifeapproaches to life

• Used by about 12 to 42% of AmericansUsed by about 12 to 42% of Americans• Not regulated by the FDANot regulated by the FDA• Puts people at risk because the use of these Puts people at risk because the use of these

treatments may stop seriously ill individuals from treatments may stop seriously ill individuals from seeking medical attentionseeking medical attention

• People assume that everything natural must be People assume that everything natural must be good and harmless, but this is not necessarily good and harmless, but this is not necessarily accurateaccurate

Herbal Treatments for Herbal Treatments for Psychological Disorders:Psychological Disorders:

• St. John’s Wort (hypericum):St. John’s Wort (hypericum):– Used to treat depressionUsed to treat depression– Conclusion: Lacks strong empirical support and should Conclusion: Lacks strong empirical support and should

not be used to replace traditional medicinesnot be used to replace traditional medicines

• Ginkgo Biloba:Ginkgo Biloba:– Claims to slow down aging process and to diminish the Claims to slow down aging process and to diminish the

cognitive deficits of old agecognitive deficits of old age– Conclusion: a look at the research renders mixed results, Conclusion: a look at the research renders mixed results,

leading one author to conclude that although Ginkgo may leading one author to conclude that although Ginkgo may slightly improve your memory, so will a candy barslightly improve your memory, so will a candy bar

• Kava Kava:Kava Kava:– Used in rituals in the islands of the Pacific and as a relaxantUsed in rituals in the islands of the Pacific and as a relaxant– Conclusion: Inadequate research designs with questionable Conclusion: Inadequate research designs with questionable

results has led to close scrutiny of its usefulness. results has led to close scrutiny of its usefulness. Additionally, long term use has been reported to lead to Additionally, long term use has been reported to lead to severe liver damage and liver failures severe liver damage and liver failures

Conclusion:Conclusion:

• Just because a professional psychologist or Just because a professional psychologist or the media supports an idea does not mean the media supports an idea does not mean they are necessarily correctthey are necessarily correct

• Unsupported theories and practices are Unsupported theories and practices are frequently advertised as the newest frequently advertised as the newest answer to your biggest problemsanswer to your biggest problems

• If something sounds questionable or too If something sounds questionable or too good to be true, do your own research; good to be true, do your own research; pop-psychology is all around uspop-psychology is all around us