Welcome to my blog, Science Matters.
I have long wanted to write a blog, but I had little time to do so during my dozen-year career as an assistant and associate professor of clinical psychology in the United States and Australia. My writing was focused on journal articles, book chapters, and a clinical guidebook. Although I love scientific writing, I've found that for some topics, especially those that are controversial for political and/or ideological reasons, traditional academic writing is an inadequate means of communication.
At the end of 2016, I decided to leave academia (for a while, at least) to pursue "Career 2.0." I am seeing clients in private practice 3 days a week at Life & Mind Psychology in Miranda, NSW, where I focus on using exposure-based cognitive-behavioural therapy to help clients overcome anxiety-related issues. I plan on spending a fourth day providing supervision to recently-graduated psychologists. I now have the time and freedom to write a blog, and I couldn't be more excited about this opportunity!
In the years to come, I expect to write about a host of topics that intersect with my values as a scientifically-oriented clinical psychology practitioner, researcher, supervisor, and educator. I expect two themes to be featured regularly on this blog: (a) the biomedical model of psychological problems, and (b) the quality and scientific credibility of mental health interventions provided to clients and the general public.
Both of these themes were evident in a clinical encounter I had last week*. Parents of a teenager who recently developed problems with obsessions and compulsions described their experience seeing a local psychologist referred by their GP. After several sessions of directionless conversation, the psychologist recommended a referral to a psychiatrist for medication. The parents were told their child's "symptoms" were the product of a "chemical imbalance" that could be "corrected" by an "antidepressant." Not keen on medicating their child or viewing his issues as the product of a diseased brain, yet assuming the credentialed psychologist's advice was credible, the confused parents came to me for a second opinion. They were surprised to know there was no credible scientific evidence to suggest OCD is caused by a chemical imbalance, and that there exists a highly effective psychotherapy for OCD (exposure-based cognitive-behavioural therapy) that works better than psychiatric drugs but was not mentioned by the psychologist. (*identifying information has been changed to protect client confidentiality)
This clinical encounter is a microcosm of our society's exposure to the biomedical model of psychological problems and to the kinds of services often provided by healthcare professionals. The issues involved play out in the clinic, in our schools, in the media, and affect us all whether we're aware of it or not.
Are psychological experiences like anxiety and depression diseases of the brain with known neurobiological and genetic causes that are corrected by psychiatric drugs? What are the effects of promoting this ideology to clients, school children, and the general public? Why do so few clients receive scientifically-supported interventions for their problems? What does scientific research say about our mental health interventions, and how trustworthy is this science? Why, in our current decades-long era of improved "mental health literacy" and dramatically increased use of psychiatric drugs, are societal mental health outcomes markedly worsening? Are there compelling science-based alternatives to the biomedical approach to mental health? How can we as a society make progress on these issues? I look forward to blogging about these topics in the years ahead.
My next post will examine the increasingly popular practice of "mental health literacy" education in our schools. I will present a detailed analysis of a recently published, award-winning study in which Canadian researchers informed hundreds of teenagers that problems with anxiety, depression, hyperactivity, and so on are diseases of the brain caused by chemical imbalances that require professional treatment. A closer look at this study will reveal troubling questions about the accuracy of information disseminated to children about "mental illness" by scientists, the manner in which mental health literacy and stigma are measured, the interpretation of results with small effect sizes, and the behaviour of biomedical researchers when asked to publicly defend the scientific credibility of their work. Each of these questions highlights a recurring theme in contemporary mental health discourse and I hope my posts will make a helpful contribution to this discourse in the years to come.
Analysis of mental health practice, research, theory, and policy from the perspective of an American scientist-practitioner clinical psychologist in Australia.