Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
Alternative Psychotherapies: Evaluating Unconventional Mental Health Treatments

Friday, June 13, 2014

Having a Look at Love and Logic

A reader suggested that having written a post about the plausibility of alternative psychotherapies, I might examine the available facts about the program Love and Logic ®. The website www.loveandlogic.com is informative when looked at carefully, although other sources add much to an understanding of this program.

A quick look at materials describing Love and Logic gives the impression that the program is intended to improve parenting practices and therefore to lead to better developmental and educational outcomes for children. However, this does not seem to be exactly the case, according to the website. This describes Love and Logic as “a philosophy of raising and teaching children which allows adults to be happier, empowered, and more skilled in the interactions with children. Love allows children to grow through their mistakes. Logic allows children to live with the consequences of their choices. Love and Logic is a way of working with children that puts parents and teachers back in control, teaches children to be responsible, and prepares young people to live in the real world, with its many choices and consequences.”

I see in this paragraph two types of outcomes predicted for Love and Logic users. The first is that parents and teachers are happier and have more success in controlling children. The second is that children become responsible (without further definition of how this responsibility is displayed behaviorally) and will eventually be prepared to live in the “real world” (where have they been living up to that point, I wonder, and how does their preparation play out behaviorally now or later?). The statements about Love and about Logic are difficult to relate to specific outcomes. I am not sure how children can be prevented from growing (i.e., learning) from their mistakes, nor whether an absence of love would be considered a cause of such a notional outcome. Neither do I see how Logic lets children live with consequences or whether illogic would prevent them from doing so. Semantically, these two statements would seem to have the same meaning, or lack thereof, if we were to reverse the tasks of Love and of Logic. But let’s drop these side issues and focus on the clearly predicted outcomes: happier parents and teachers who successfully make children do what the adults want. A later paragraph on the website says that Love and Logic “products help parents and teachers enjoy working with children”, and this predicted effect on adults is described more clearly than any statements about the effects on children.

I’m trying to figure out the outcome wanted by users of Love and Logic , because I see that various other websites (e.g., www.colorado.edu/content/fsap-workshops-parenting-love-and-logic(R)-course-starts-july-18 )  refer to this approach as “research based”. (I haven’t found this on www.loveandlogic.com yet.) Research, as the term is usually used, would involve an assessment of whether the predicted outcomes resulted from use of Love and Logic. However, the expression “research based” is a vague one without a common or clear definition, and it may not be intended to communicate the same evaluation of effectiveness as “evidence-based” does.  I note that the California Clearinghouse for Evidence Based Programs (www.cebc4cw.org/program/love-and-logic/detailed) does not give a ranking for scientific evidence to Love and Logic because of the absence of research information. A critique of parent education programs done by Christina Collins (www.joe.org/joe/2012august/a8.php) ranked Love and Logic as an “additional” program, rather than as “top” or “promising”. Love and Logic is described as “innovative” but without an evidentiary foundation in a document developed by Prevent Child Abuse Iowa in 2011; the Iowa document points out that Love and Logic is not listed in SAMHSA’s National Registry of Evidence-Based Practices and Programs (NREPP).

At www.loveandlogic.com/t-research.aspx, a graph representing how parenting stress went down after parents attended a Love and Logic program also shows a reduction in child misbehavior, suggesting that this outcome is also a goal of Love and Logic and may be an operational definition of “responsibility” and “preparation for the real world”.  The same page provides a link to an unpublished article by Charles Fay, a member of the Love and Logic group along with his father Jim Fay and the holding therapy proponent Foster Cline. Fay’s 2012 paper is entitled “Effects of the Becoming a Love and Logic Parent  training program on parents’ perceptions of their children’s behavior and their own parental stress”. As the title suggests, Fay asked for responses from parents who were about to begin the training program and compared those to post-training responses for 2431 of them. There was no comparison group receiving treatment as usual or no treatment, and Fay did not report how many parents failed to complete the program, were lost to follow-up, or showed negative changes following the program. As Fay himself seemed to be aware in the discussion of this study, this evidence is at a very weak level, and there are obvious alternative explanations for the results.

In addition to these research weaknesses, an examination of the evidentiary foundation for Love and Logic requires attention to the fact that Love and Logic® is a highly commercialized, for-profit program, with the ® indicating a registered name. This situation makes it very difficult to have the valuable replication of a study by an independent researcher. That Fay, Fay, and Cline have not been eager to have independent examination of relevant evidence is shown by a copyright infringement suit  (www.plainsite.org/dockets/ic5dk1os/colorado-district-court/love-and-logic-institute-inc-et-al-v-slattengren-et-al).

Is Love and Logic a plausible program? Is it congruent with established information about child development and learning? Its basic ideas about the role of reward in learning have long been supported by clear evidence, although I am not sure why a citation of the work of Edward Thorndike in the 1920s is needed, and I am sure that a citation of John B. Watson is not relevant. There are also elements of William Glasser’s “reality therapy” as used in some schools in the ‘60s and ‘70s, and a plausible approach on the face of it but without much research support. Certainly the advice given to parents and teachers about relaxation and avoidance of anger and punishment is congruent with most established thinking about early relationships, although the suggestion that one simply repeat over and over “I love you too much to argue with you” seems questionable in terms of the transactional view of development.   Love and Logic is said to be easy to learn and to have “immediate results”; these statements appear to be at odds with the experiences of most evidence-based parenting programs that are successful in bringing about changes in parent-child interactions (Parent-Child Interaction Therapy, for instance). It is notable, of course, that specific methods of Love and Logic are available only upon purchase of proprietary books and CDs, so a complete analysis of plausibility is difficult.

It is not usually desirable to pursue an examination of this kind ad hominem, because even the most unpleasant characteristics of individuals (if they existed) would not be relevant to the plausibility or effectiveness of a treatment they advocated. However, as Love and Logic provides little to discuss ad rem, it seems appropriate to look at aspects of the website and of its founders. Once again, a high degree of commercialism is shown by the website. Testimonials and anecdotes abound, and there is no indication that Love and Logic may be inappropriate or even potentially harmful in some cases. “Parenting products” are for sale, and one may join an “Insider’s Club” (the position of the apostrophe suggests that there is only one insider).

Much of the Love and Logic website is devoted to selling training and to attracting trainers, who when they have completed their studies, can take advantage of a “facilitator map” and national referral list. Purchasing a book “gives you the ability to offer an unlimited number of parenting classes… No additional training is required.”   This statement seems to confirm what I was told several years ago by a Love and Logic trainer--  that there was no quality control after a course was taken.

What about the three founders of Love and Logic? Little is available about Jim Fay, except from his short bio on the website. He appears to have been a high school teacher. Charles Fay has a Ph.D. in psychology (possibly with a specialty in school psychology, although it is hard to tell). His dissertation had the title “Factors affecting teachers’ impressions and judgments of students: Individual differences, social-contextual factors, and underlying cognitive processes” (University of South Carolina, 1997). This title does not suggest any formal study of developmental principles or of parenting processes, although Fay may certainly have studied these topics post-doctorate.

A source of concern about Love and Logic comes from the involvement of Foster Cline. Cline’s associations with holding therapy, a physically-intrusive, potentially harmful treatment without an acceptable evidence basis, are undeniable. Cline surrendered his Colorado medical license following a 1995 letter of admonition in connection with the accidental or suicidal death of a child.  His books in the early 1990s stressed his belief that “all bonding is trauma bonding”, suggesting that the relationship between a parent and an infant is parallel to the relationship between a kidnapper and his victim who develops Stockholm syndrome. His long-term mentoring relationship with Connell Watkins, one of the therapists under whose treatment Candace Newmaker died, is well-known, as are his involvements with the defense of parents who killed their children.

Cline’s books have supported the idea that powerful adult authority is essential for the rearing of psychologically-healthy children. Like his colleague and mentor, Robert Zaslow, Cline has stressed the ideas that obedience is evidence of attachment and that adult attachment figures must be seen as powerful by children. Although Cline’s version of holding therapy had strong physical components, there seems to be no reason to think that physical coercion is a part of Love and Logic, which concentrates instead on psychological control. Whether children who “fail” in Love and Logic are then recommended for holding therapy is an unanswered question, but this suggestion was made to me by an individual who had received Love and Logic training.

In the past, Cline was willing to state that holding therapy was not abusive. He was one of several holding therapy-oriented expert witnesses in an investigation of an Arizona man who taught a mother to use unsupervised holding with her daughter (www.azbbhe.us/pdfs/BoardOrder/1994-0002.pdf). Cline’s position has been countered by a multitude of arguments, including the report of a task force of the American Professional Society on Abuse of Children and of Division 37 of the American Psychological Association. Given this history, it is perhaps not surprising that he presses Love and Logic without any evidence that it is an effective treatment, either for parent education or for working with mild childhood behavior problems.

If there are all these problems related to the effectiveness of Love and Logic, why do school systems purchase its training for their teachers? There are some simple answers, I think. One is that K-12 educators are rarely skilled at assessing the evidence for a treatment. Instead, as a group, they tend to be “faddy” and to clutch at attractive proposals, especially if they do not involve much cognitive effort. (Does anyone remember “Paddlin’ Madeline home” T-shirts for teachers?) In addition, Love and Logic is beautifully marketed, with repeated claims of “easy to learn” and “instant results”. The Love and Logic website even suggests ways to create enthusiasm for its trainings--  administrators are not to offer training to all teachers, but to make the opportunity a reward for some.

Conclusion: Love and Logic is a business like any other. Caveat emptor.





6 comments:

  1. Very interesting, Jean! I especially appreciate the clearinghouse link you provided. I'm definitely going to take a look at which programs have research to back their claims.

    It seems to me that perhaps Love and Logic is partially about finding a nice way to control your children. But it's still control and, in my non-expert opinion, that's not really helpful in the development of a child, except to enforce the idea that they can be overpowered. I have a 3.5 year old and trust me, my life would be so much easier if he would just listen and obey. But to what end? My life would be easier but what is he gaining? It's tough to be engaged in their development, it takes much more time but I'm hoping that taking the time to encourage him in developmentally appropriate ways will give him more confidence and self-control later on. I always appreciate your posts!

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    1. Thanks for the kind words-- and do keep in mind that there's a difference between saying that there is supporting research and actually having some. For example,L & L has some unpublished research showing that the parents liked it, but that's quite a bit different from peer-reviewed publications showing that the children's moods and behavior improved.

      I agree with you that L & L does not appear to consider the achievement of a sense of autonomy, either during the preschool period or the early teens. The choices offered are not real ones, and it's very easy for parents to equate "consequences" with punishment-- and let's not forget that when you're annoyed with a child, it's pretty gratifying to make them unhappy for a bit-- that's why we don't stop punishing, even though it doesn't work most of the time.

      Before I forget,there are some evidence-based programs that aren't listed on clearinghouses, just because they have never submitted any material-- so don't assume that if something is not on a clearinghouse, it doesn't have an evidence basis. I recently queried the California clearinghouse about their statements on Circle of Security, and they said OOPS and took the material down to re-work it.

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  2. Dear Jean,
    Thank you for this blog post about L&L; my daughter's elementary school has suddenly decided to implement it for all the 3-5th grade classrooms and I am horrified. I am trying to find resources to talk to the principal about it which is how I found your blog. The more I read the more unhappy I become, both as a parent and as a developmental psychologist. The involvement of Cline is especially troubling to me, but most of it is terrible, and what is good is hardly new, nor is it unique to their framework.

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  3. Let me know if I can be of any more help. There has been very little published about L&L and it manages to stay "underground" most of the time. There is some discussion in my 2003 book with Larry Sarner and Linda Rosa, "Attachment Therapy on Trial" (Praeger).

    I think your success with this will depend in part on whether the principal and school board think evidence-based methods are desirable... or whether they just respond viscerally to the marvelous name (what could be bad about love or logic) and to the unsupported claims.

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  4. Hi Jean, I just finished the love and logic book I rented from the local library and was researchin more about it when I found this blog post. First, I'd like to mention I am an RN with training that includes evaluating medical research, I also have a two year old girl. Now I have been researching various parenting methods from my pregnancy with my main goal of avoiding the pitfalls of my own childhood.

    While I was reading the book (Love and Logic: teaching children responsibility, 2006 e-book) I noticed they didn't quote research papers or other such material as most other books do. And I found this frustrating as I can't read the papers to see if I agree with the quality of the study and it's out comes. Also I expected a website, maybe even with a forum, we're there were expanded materials and examples for harder issues not covered in the book. Instead like you pointed out it read like a commercial.

    Now I would also like to point out that you were not very objective in your blog post, it is apparent from your comments on the actual live and logic principles that you did not make the effort to read at least the main book (which you could have obtained for free as I) as many of the things you point out about its falability were in fact explained in the book, leading you to make false assumptions about what they actually teach.

    Now I'd like to reiterate that I just now finished the book, I have not used the program, and I have not decided yet if I will, I just felt that while your blog brought light to some concerns with the program it also fell short of objectivity by the lack ofor effort out put into actually knowing what they advocate.

    As a final note, I would like to defend in part one of their practices, this is one I actually already use as a nurse and so am familiar with how to use it and why it works. That is, to give two options (to patient or child) both of which are acceptable to you and the other party. For example, I might ask my patient that is full care, would you like me to wash your face first or brush your teeth first? This give the patient some control over their body that they have lost due to paralysis, it also ensures that I don't loose my license for neglecting my patient. As I already have this habit from work I use it naturally on my daughter, I don't use it with "manipulation" in mind, rather with the spirit of "my child is her own person, she deserves dignity and respect". Anyway when I read their book I saw similarities to a nursing practice that allows us to give as much power to our patients as possible who are suffering from powerlessness, and like toddlers, other persons who have suffered a major loss of control on their life, become bitter, angry and withdrawn if you don't show them respect my relinquishing what control you can.

    And finally, my daughter is very well behaved as a 2 year old, she learned the word yah, months before no, and I rarely have a powerstruggle with her (namely that she must hold my hand in or near the road). And all I do in situations that I learned set off a tantrum is ahead of time think of how I would talk to my patient, namely how can I give her choices that will be acceptable to both of us.

    (Also I'd like to say that offering choices is really the only thing I do that's the same, their method of dicipline and letting consequences fall on a child are not my natural mode and I find their method inappropriate for the first year other than offering children choices that young in the name of teaching them how to make choices.)

    I would love to hear your thoughts after you read the book, as the commercialized it you really don't get the picture unless you do (which if they think their method is so golden I think is socially irresponsible of them as the most in need of parenting advice will also be those who can not pay 99$ for a seminar...)

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    1. Dear Jessica-- my strongest concern about L & L is the claim that it is evidence-based, when it is not. I'm also concerned about the lack of quality control that has been reported to me by people who have received L & L training and then gone out to present seminars without guidance or feedback.

      The good things in L & L, like the offering of choices you mention, are common to almost all popular parenting books and programs. The bad things, like allowing children to suffer sometimes-serious consequences, are not. I notice in looking at Internet discussions these days that quite a few people are using "consequenced" to mean the same thing as "punished"-- whether they get this from L & L or not, I don't know, but if you read any of Foster Cline's work you can see that a heavy emphasis on authoritarianism and punishment is what he's offered since the 1980s. (This is of course welcome to quite a few parents.)

      Your point about the irresponsibility of charging so much, if they really think they can be of so much help, is well-taken-- but whatever they really think, this is a commercial enterprise that has been bought into by many a church and school system-- those organizations do the job of advertising L & L.

      Your public library has many parenting books (all the way back to Haim Ginnott) that give excellent parenting guidance without charge. For cases where children are really difficult to manage, individual treatments like parent-child interaction therapy (PCIT) have been shown to be of enormous help to those who need it (but regrettably are not available everywhere). Children whose behavior is really disturbed will probably not be "fixed" by L & L, and according to a few L & L trainers I have spoken to, may get referred for "holding therapy"-- I have no idea whether what they say is correct, of course.

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