Concerned About Unconventional Mental Health Interventions?

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

Wednesday, August 31, 2016

Birds of a Feather: Are Childress and Becker-Weidman Flocking Together?

An interesting remark concerning me has been passed along from someone else’s blog—www.drcraigchildressblog.com. The author of this statement signs himself “Art”. Here is what he says:

Mercer is a founding member of the fringe advocacy group, Advocates for Children in Therapy. See:
http://psychology.wikia.com/wiki/Advocates_for_Children_in_Therapy
It is not worthwhile addressing her “concerns,” as all she wishes to do is have a forum to express her fringe ideas and is never open to a real dialogue, evidence, or support of views other than her own biases.

Now, could it be that this “Art” is Arthur Becker-Weidman, whom I had occasion to mention on this blog a few days ago (http://childmyths.blogspot.com/2016/08/lifes-little-ironies-arthur-becker.html)? Yes, as we used to say in my childhood, it might could be. Of course there are lots of people named Arthur, or even watercolorists who take “Art” as their nom d’Internet. But this one makes an unusual reference to a “wikia” outfit which has allowed Becker-Weidman, often writing as AWeidman, to say whatever he likes about topics like Dyadic Developmental Psychotherapy, which he claims (contrary to all existing evidence) to be an evidence-based treatment. Psychology.wikia is not a part of Wikipedia and does not require the “neutral point of view” (NPOV) that is one of Wikipedia’s characteristics, nor in my experience does it permit editing by all readers.  Interested readers of this blog may like to compare the psychology.wikia articles on Advocates for Children in Therapy and on Dyadic Developmental Psychotherapy with the articles on those topics on Wikipedia.

For the sake of argument, then, let’s assume that the writer “Art” is indeed Arthur Becker-Weidman (curious, though, because he was once quite sniffy when I addressed him as “Art”). What’s he up to? Is he getting into Parental Alienation, like Craig Childress (see http://childmyths.blogspot.com/2015/08/craig-childress-tries-to-drag.html), the advocate of a not-very-plausible connection between parental narcissism and a child’s refusal to visit an estranged parent? Or is he just cross because I called attention to the fact that he is giving a conference continuing education presentation on a topic that all evidence suggests he misunderstands badly?

I don’t know what the story is, nor do I know whether Childress and Becker-Weidman have ever met. It may just be that Becker-Weidman looked around for someone else who objected to criticism from me, and then got on board with what that person was writing on his blog—the basic idea being to answer criticism with a personal counterattack rather than with a factual response. Nevertheless, it’s interesting to think about what these two have in common.

Here are some characteristics shared by these fellows.

1.     1.  Advocacy for treatments that are either little-known or seriously questioned by most professional psychologists.  Childress’ “attachment-based” parental alienation treatment program is not listed either by the National Registry of Evidence-based Programs and Practices (NREPP; www.nrepp.samhsa.gov) or by the California Evidence Based Clearinghouse for Child Welfare (CEBC: www.cebc4cw.org), at least under any name I can think of for it. Dyadic Developmental Psychotherapy, which Becker-Weidman has written about, is not listed by NREPP and received from CEBC a rating of 3 (promising, but not presenting strong scientific evidence).

2.     2.  Publications with problems. Some lack peer review or editorial management and are essentially self-published. Childress’ publisher shares an address with his office. Becker-Weidman’s first publication was with Nova Scientific, an outfit that sends out emails asking people if they would like to edit a book and apparently gets graduate students to do this (I intermittently get mailings from them, usually dealing with topics I know nothing about.) He later went on to the interestingly named “specialty” publisher Wood ‘n’ Barnes. I have to give him credit for finally working his way up to Jason Aronson, though this may be more to do with difficulties of that publishing house than improved material. Becker-Weidman’s history of seriously criticized and indeed retracted journal publications is something I’ve discussed elsewhere. Childress does not appear to have published in professional journals.

3.    3.   Ambiguous backgrounds. Childress’ CV, which he used to have on line but seems to have taken down, shows a lengthy gap in employment and educational enrollment before he emerged as an advocate of Parental Alienation concerns. Becker-Weidman presents or allows himself to be presented as a psychologist, although he is licensed as a clinical social worker. He has a doctorate in human development, a perfectly respectable achievement, but not one that leads to licensure in clinical psychology.  

The two do seem to be birds of a feather, don’t they? I will be watching with interest to see whether Becker-Weidman introduces PA to DDP, or whether Childress gets on the DDP bandwagon.




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.  




Tuesday, August 16, 2016

Nurture, WEIRDness, and Complications: Do We Influence Our Children?

In 1998, Judith Rich Harris published The nurture assumption, a book that argued that parents had
little impact on their children’s development. This position was most annoying to many parents who
 had worked and worried to provide their children with parenting that (they hoped) would assure them
 with later happiness and success. Like most apparently simple positions, of course, Harris’s claim
 worked well only within certain boundaries. She did not argue that abusive parents and kind parents
 created the same outcomes, just that within a normal range of parenting behavior, what the parents did
was not the major factor determining child outcomes. Other important factors were the child’s and the
 parents’ genetic characteristics, school experiences, peer influences, extended-family influences,
religion, and community and national events.  In other words, Harris argued, on the basis of considerable research, not that parents were not important, but that other factors were quite important at all times and became more important as children got older.

It’s a common mistake to assume that whatever is true at one stage of life will necessarily continue to be true at other stages. Some rules of development seem consistent, but others change a good deal with age.

In addition, the term “developmental bias” is sometimes used to describe the assumption that whatever is happening now is based on events that happened early in life.  Later events can be caused by earlier events, of course, but it’s also possible that some experiences that make a lot of difference to a baby’s behavior may have nothing at all to do with later behavior and development. It might be that later experiences are so powerful that they just wipe out the early effects, or that maturational change causes reorganizations of behavior that leave behind any early events or experiences.  An example is the fact that babies who walk early and who walk relatively late (but within the normal range) really can’t be told apart later--  their walking and other movements are similar, and their early development and experience don’t seem to make any difference. Or, for another example, there are the descriptions from years ago of Russian babies who were swaddled a lot of the time until they were a year old and didn’t get much chance to crawl or pull to stand, yet it was reported that they walked at about the same time as babies who were encouraged to move around. 

The idea that it may be a mistake to assume that early experiences determine development is an important one as we argue about whether parents do or don’t influence children’s development. As Harris noted, there is a lot of evidence that events other than parenting are powerful shapers of children’s behavior and abilities. But at the same time we see increasing research reports that show how parenting may influence very young children.

Here’s an example of this kind of research, by Emily Little, Leslie Carver, and Cristine Legare (“Cultural variations in triadic infant-caregiver object exploration”, Child Development, 87, 1130-1145). Little and her colleagues were interested in the ways parents play with babies by using toys and objects—holding a toy for the baby to see, or helping the baby grasp it. Most of the research on this has been on people in the “WEIRD” population (Western, Educated, Industrialized, Rich, and Democratic), and “WEIRD” adults are known to choose to be face-to-face with babies while playing and to use object play as a teaching tool. Western psychologists have focused on this kind of interaction to the point where we look at babies’ use of social referencing (gazing toward an adult for a cue about a strange object) and joint attention as  essential developmental steps. But Little and her colleagues were curious about whether the rest of the world—the non-WEIRD part—behaved in the same way, and how children might be influenced differently.

Little and her colleagues decided to compare caregivers in the United States with caregivers on the island of Tanna in the Melanesian archipelago, a quite non-WEIRD place where subsistence farming and traditional life go on without compulsory schooling. (Other researchers like Barbara Rogoff have shown how children in this kind of society learn by watching adults more than by instruction.) The researchers looked at three ways the caregivers could interact with the children: using their voices, getting face-to-face and using the gaze to signal, or by physical contact (touching or holding the child, moving the child’s whole body and head, moving the body while holding the head still, moving the child’s body parts). As they played with the babies and the toys for three minutes, the U.S. group used their voices at about the same rate as the Tanna caregivers did. But the two groups reversed their use of visual and physical contacts--  the U.S. group used visual interaction more than twice as often as the Tanna group, and the Tanna group used physical interaction more than twice as often as the U.S. group. And what were the effects on the babies? There were not as many differences in infant behavior as Little and her colleagues had predicted, but the U.S. babies did look at the toy more often than the Tanna babies did—perhaps because of their previous experiences with caregivers who used their gaze to give and receive information. 

When Tanna babies and children later behave in ways that seem to reflect their caregivers’ early behavior, does that happen because of their experiences in infancy? Or are those experiences not nearly as important as their many later experiences, which will reflect the culture they live in? Either of these conclusions is possible in light of our limited information… limited because we see only a few people who move from a non-WEIRD infancy to a WEIRD childhood, and almost none who do the reverse. In either case, we need to remember that early experiences could be overwhelmingly important, or completely unimportant, or any point between—and what’s more, how that works could be different for each aspect of development. Like everything else about development, it’s complicated!
   

        

An Article About Dyadic Developmental Psychotherapy-- Read for Free

The editors of Child and Adolescent Social Work Journal have very kindly selected one of my publications to include in a free on line issue of their journal. The paper is about the growth and development of "woozles"--  ideas that we think are supported by evidence, simply because we've heard about them so often. The woozle example I used is Dyadic Developmental Psychotherapy.

Read it here:

http://www.springer.com/psychology/personality+%26+social+psychology/journal/10560/PS2