Concerned About Unconventional Mental Health Interventions?

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

Wednesday, August 17, 2016

Life's Little Ironies: Arthur Becker-Weidman Instructs ATTACh About Evidence-Based Treatment

I usually avoid looking at the website of ATTACh (Association for the Treatment and Training of Attachment in Children), the parent-professional organization that pushes the belief that emotional attachment is behind most unwanted behavior--  also, that they know how to “fix” this. However, my attention was called to the brochure for ATTACh’s September 2016 conference by a prospective adoptive parent who is being strong-armed to attend. I had a look at it to see what speakers were scheduled. There were some goodies:

Lark Eshleman-- was the therapist for the family of Nathaniel Craver, a Russian adoptee who died, apparently as the result of abuse.

Terry Levy-- one of the old school of holding therapists. He edited a book that included advice to limit quantity and variety of food as part of treatment for Reactive Attachment Disorder.

Michael Trout-- according to lectures he gave for the Association for Pre- and Perinatal Psychology and Health (APPPAH), he believes that attachment occurs before birth and that the fetus is conscious of what the mother says, does, and thinks about. (Yes, just what Scientologists think.)

But the cream of the brochure is that Arthur Becker-Weidman is presenting about evidence-based treatments! This is really quite unbelievable, because B-W has repeatedly published the claim that Dyadic Developmental Psychotherapy is an evidence-based treatment when it is quite clearly not eligible for that category. I won’t get into the whole story here, but it is recounted in detail at http://www.springer.com/psychology/personality+%26+social+psychology/journal/10560/PS2.  (This is free to readers and is the last article in the table of contents you will see.)  I don’t know whether the problem between them was this tendency to make unfounded claims, or what, but it is clear that Daniel Hughes, the originator of Dyadic Developmental Psychotherapy, has cut his former colleague B-W adrift and no longer even mentions their co-authored publications about DDP. I am not sure Hughes ever mentioned B-W’s retracted papers.

 I’ve never completely understood why B-W has made and repeated his unfounded statements about the evidence basis of DDP. Does he actually not know what is required before a treatment can be said to be evidence-based? Or can it be that (not unlike some others) he simply regards the evidence-based designation as a marketing tool that can be used to sell a treatment—and to sell himself as a lecturer and trainer?

 In either case, what on earth is ATTACh doing, allowing him to further entrench himself as a therapist and adviser to adoptive families?  Well… I suppose the answer is obvious. ATTACh is using its annual conference to attract parents and quasiprofessionals and to make them more willing to purchase the organization’s services and publications. ATTACh used to do this by talking about attachment all the time; now they do it might repeating current buzzwords like “trauma” and “evidence-based treatment” (EBT). The connection between EBT and treatment funding /insurance coverage is a value-added factor for ATTACh’s sponsorship of a presentation on EBT—especially one whose past approaches to the issue have been highly problematic.

Is it important for people attending the ATTACh conference to understand what an EBT is? It would be good in a general way if they knew this, of course, but I find it difficult to imagine taking a mixed audience of people who just want to know how to raise adopted children, and trying to convey to them the nature of random assignment to groups, the problem of confounded variables, statistical significance and effect size, and quite a few other things that are involved in deciding whether a treatment should be called evidence-based—in an hour or two. (I make this statement as one who spent some 30 years teaching psychological research methods.) Most people are quite willing to accept testimonials and anecdotes as “evidence” and become bored very soon with any argument saying there is evidence that is more important than personal experience. Also, they don’t like math, and to teach this properly there has to be some math.

If I were running the ATTACh conference—an idea that no doubt would draw gasps of horror from the ATTACh board--  I would organize a presentation about the use of Internet sources to look up evaluations of the evidence for a treatment. Although they are far from perfect, the California Evidence Based Clearinghouse for Child Welfare, the National Registry of Evidence-based Programs and Practices, and Effective Child Therapy all provide extensive resources for checking into whether a child mental health intervention has been strongly supported by empirical work. Adoptive parents who know how to use these websites can spare themselves and their children some regrettable tangles with ineffective or even harmful treatments.

But if ATTACh simply must get EBT into the discussion, let them get a presenter whose history shows that he or she can do the job properly.  




5 comments:

  1. Years ago I attended an open adoption conference where Trout presented the following video, speaking as the unborn baby! It was unsettling for many reasons, not the least being Trout, a fat, bearded middle-aged man voicing the supposed thoughts of an unborn child about to surrendered for adoption. It had to be seen to be believed, evidently he thinks that prenatal humans see, hear, know, and understand all. What a shame we lose all that at birth. Here is the description but it must be seen to get the full weird impact.

    Gentle Transitions: A Newborn Baby’s Point of View About Adoption

    Suggestions on what we grown-ups should think about — and do – to make the adoption experience work best for a baby. Presented as if written by an infant, this ten-minute video may be useful for birthparents, adoptive parents and adoption training. Covered are issues ranging from the importance of the adoptive family having a chance to be pregnant for their adopted baby to the importance of some sort of ritual to mark the transition from one family to the other. Explanations are offered from some of the adopted baby’s subsequent behavior and a plea is made (by the baby, of course) for us to remember that he is watching us. (Color, 10 minutes)

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    1. This is fascinating-- I've heard tapes of his presentations but never thought what it would look like!

      It's a shame, really. He used to be a much-respected clinician working with children, but something seems to have gone wrong.

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    2. It might be one of the hallmarks of mental health pseudoscience when practitioners so readily assume what the child, infant, or fetus is thinking.

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    3. Just the title of this essay had me laughing. Yes, what an irony!

      This is yet another reason to refer to ATTACh as a trade organization rather than a professional association.

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  2. I especially like the ominous tone of "remember, the baby is watching us." Even the very young fetus evidently is watching some say the zygotes are watching at conception! A lot of this stuff comes from Pre and perinatal psychology folks who were very big in the early open adoption movement.

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