🚀 go-pugleaf

On Wed, 15 Oct 1997 15:21:16 -0700 Anne Dietrich said:
>Dear Ken,
>
>I, too, missed out on this discussion.  In response to your comments,
>viz:
>
>>The research seems to indicate that there is no correlation between
>>experience or advanced training and diagnostic accuracy or therapeutic
>>efficacy.
>
>How was the research conducted?  How was "diagnostic accuracy"
>determined? How was "therapeutic efficacy" defined and measured?  How
>long after treatment was efficacy determined? 2 months? 2 years?

 I have delayed my response in the hope I could dig up relevant citations, but
mid-term grading has put that idea to death effectively for the moment.  On the
 issue of diagnostic accuracy I'd refer you to the literature on actuarial vs
clinical prediction.  I can offer more specific information in the future if
there's interest.  I do believe that the the evidence shows that experience and
 years of training really don't do much in terms of improving the effectivness
 of treatment.  Therefore, the PhD is a bad investment if you intend to do ther
apy.  An MSW or MA is more than sufficient in terms of training and a better
value in terms of the time and energy invested given what the market will suppo
rt in terms of income for people doing therapy as a principle part of their
occupation.

>
>>as scientist-practitioners, shouldn't APA's decisions be based on the
>>research and not on opinion surveys?
>
>Are surveys not considered research?  There are so many difficulties in
>research on therapeutic process and outcome -- I think all methods will
>have inherent difficulties, such that it will be almost impossible to get
>a clear picture.

 Surveys are certainly research, but I don't think that opinion surveys are a g
ood way to decide on the issue of are MA's as effective as PhD's.  We get biase
d feedback on how we are doing as clinicians (particularly on an outpatient bas
is).  Therefore our opinions can't be taken too seriously.  Objective outcome
research should be the standard.  If we decide on the basis of our opinions abo
ut that value of the PhD, cognitive dissonance alone predicts that we will say
the PhD is worth it and necessary.  Never mind the issue of protecting guild in
terests, which gets us back to following the psychiatrists in fighting a rear-g
uard action against the encroachment of "lesser" degrees onto our turf.

>>Second, even if APA declares that PhD's should be paid more,
>>that is up to the payer.
>
>I agree.  If an MA level psychologist does equivalent work to one with a
>PhD, it's only fair they receive the same pay, and the consumer should
>have a say in the matter.

  Furthermore, it might be o.k. to pitch the brand-name product over the generi
c product (Coke vs the store brand) and charge more for it if you are selling s
ugar water or consumer goods.  But as mental health professionals we have a
larger responsibility.

>>We have not demonstrated that we offer any added value in the
>>marketplace over MA or in some cases BA practitioners.
>
>How would we demonstrate this?  How could we know?  Any ideas?
Back to the above points on outcomes - again, I  can dig some stuff up if peopl
e want more specifics.
>
>Anne Dietrich, MA
>University of British Columbia

The bigger issue behind all of this is that unless we can demonstrate that a Ph
D is worth more in doing therapy, no one will pay us more for having it.  Botto
m line: if I wanted to do therapy full-time, I would have gotten my MSW  and be
en done two years ago.

Ken Heard,
URI