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Concerned About Unconventional Mental Health Interventions?

Concerned About Unconventional Mental Health Interventions?
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Tuesday, April 10, 2018

Love & Logic (R) and Other Non-evidence-based Programs: How to Argue Against Them


A colleague passed on to me a letter from a person with a MSN degree who is involved with community mental health issues for children. The writer expressed her profound concerns with the program Love & Logic ®, developed and promulgated by Foster Cline, an early advocate of Attachment Therapy/Holding Therapy, and a pediatrician of problematic licensure who declared some years ago that “all bonding is trauma bonding”. No doubt aided by its brilliantly alliterative name, Love & Logic ® has become a great commercial success, earning much public money as school systems buy into this method of group training for parents and teachers, even though it is clear that the program is not an evidence-based treatment.

The author of the letter I mentioned has had years of contact with Love & Logic ®, beginning with a personal experience involving a child she  advocated for, and continuing with discussions with people committed to the method, and awareness of increasing advertising. She checked the level of research evidence for Love & Logic ® with the California Evidence-based Clearinghouse for Child Welfare (www.cebc4cw.org ). CEBC, which is well-known for its descriptions and ratings of treatments for children, lists Love & Logic ® but notes that the program cannot be rated because there is no adequate research evidence for its effectiveness. CEBC lists a 2005 article that reported that parents liked the Love & Logic ® program but did not touch on its effectiveness as a behavioral treatment for children. CEBC notes that there are no standards that trainers for Love & Logic have to meet other than attendance at training workshops (and it is my understanding that there is no follow-up from the organization to insure that trainers are teaching the program correctly).
  
Love & Logic ® is not listed by the National Registry of Evidence-Based Programs and Practices (run, at least until recently, by SAMHSA) or by www.effectivechildtherapy.org, a service of the Society for Clinical Child and Adolescent Psychology. I should also point out that in the opinion of some psychologists, the trademark for Love & Logic ® should prevent its ever being listed as an evidence-based treatment, because commercial considerations mean that evidence may be kept secret rather than being presented transparently as is required by scientific investigations.

I wrote in more detail about Love & Logic ® several years ago (https://childmyths.blogspot.com/2014/06/having-a-look-at-love-and-logic.html ) so I won’t go into more detail about the program. Instead, let me turn to the issue of dissuading school systems from engaging in the selling of this and similar “trainings”.

The argument against Love & Logic ® hinges on the concept of evidence-based treatment. Unfortunately, American public education is coming very late to the idea that evidence-based programs are preferable, and indeed the greater number of educators and school administrators have little training or interest in understanding how safe and effective treatment programs can be identified. A recent wave among psychologists of opposition to the privileging of evidence-based treatments will no doubt be welcomed by many educators.

How, then, to argue against treatments that are unsupported by acceptable research evidence? Surely the key to this argument is to approach the organizations that fund school systems’ activities. State and local governments may also be indifferent to research results in general, but they do not like to spend money, and they do like to get what they pay for. Being revealed as wasters of public funds is a good way not to get re-elected. School officials themselves do not allocate funding--  they simply ask for funds to be spent, so they are not likely to suffer public disapproval for choosing a non-evidence-based program. Neither are they elected and subjected to public scrutiny and possible loss of their positions.

A major point of the movement toward evidence-based treatment is that scarce resources are conserved when programs are chosen on the basis of high levels of evidence of their safety and effectiveness. Are state and local officials prepared to justify expenditures that are based on unsupported commercial claims rather than on evidence of effectiveness? It’s hard to imagine that they could get away for long with giving a school lunch contract to a company whose service did not live up to the standards required in the contract. A heating company that kept schools at 45 degrees F. all winter would not be hired again. It’s a lot harder to decide whether parent and teacher training programs have been effective, so there will probably be few complaints from the recipients—but community members who publicly bring up the lack of existing evidence for a program may well have a political impact on the actions of elected officials.

In addition to suggesting that state and local officials receive public criticism for funding non-evidence-based programs like Love & Logic ®, I’d like to point out that teachers’ unions are a powerful force and indeed are organizing for greater effectiveness just now. Union organizers may be receptive to the argument that ineffective training programs are being funded while money is not made available for a variety of educational necessities, even textbooks in some cities.  Union members may be pleased with parent or teacher training that can make their work more successful, but why should they stand by to see needed funds expended without results? Speaking up on this kind of issue can be a way for teachers’ organizations to work against the increasing deprofessionalization of their jobs and to make clear that collective bargaining can work toward goals other than salary and benefits increases, important as those are.

A point to be brought up when arguing against programs like Love & Logic ® is that the choice is not between these programs and nothing. There are effective programs to help parents and teachers work with children who are at risk for a range of developmental problems, and especially with children who are aggressive, oppositional, and noncompliant. One such program, with many years of evidentiary support behind it, is Parent Child Interaction Therapy (PCIT), which focuses on children of preschool and early school age and works to correct behavior problems before they interfere with school achievement. PCIT uses play but is not a “play therapy” and does not depend on children’s insight or private thoughts. Instead, its stress is on improving relationships between children and adults and training adults to help children comply with adult rules without having to use harsh or constant discipline.

Evidence-based programs like PCIT provide a lot of “bang for the buck”. Money spent for them is not wasted, and authorities who approve this kind of spending can be proud of their fiscal responsibility. Non-evidence-based programs like Love & Logic ® waste money that is much needed for other educational purposes. Now that programs like Love & Logic® have co-opted the public school system for their own commercial advantage, it’s important for concerned people to persuade state and local governments and  teachers’ organizations to re-think past decisions and stop this present and future waste of public funds.



4 comments:

  1. Do you have any recommendations for lay parents (parents with basically "normal" kids) who are simply looking for effective, healthy discipline strategies? My brother and his wife use Love & Logic, but my parenting is informed by the principles of Elaine Mazlish and Adele Faber (How to Talk So Kids Will Listen...) as well as Dr. Laura Markham's Peaceful Parenting. How can a regular parent determine if these parent educators can be trusted?

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    1. Hi Nicole-- sorry to say this, but I think on the whole that determining this is very difficult. Some parenting advice is based on scientific evidence (e.g. how to use reward and punishment effectively), but most has never been tested systematically. I think it is a good idea to focus on issues of "basically normal kids" and to avoid methods that were derived from treatments for serious childhood problems. My beef with Love & Logic is that it was never shown to be effective for serious problems, but the proponents have sequed into using it for ordinary parenting. However, what will "work" for any particular family depends so much on individual and cultural factors that it's impossible to determine that any one method is good across the board. I would suggest avoiding methods that are highly authoritarian, that are dramatically different from anything the parents have done before, or that will not be supported or accepted in the family's social group. The advice that most of the suggestions share is to keep in mind that what the child does or says is generally not "about you", so parents need to avoid any perspective that stresses their dignity and the child's obligations to respect them. (Not that the child does not need to be guided to respect others, but this does not mean that any failure of respect to parents is horrible and must be stamped out.)

      I think the best parenting "manuals" offer their advice as suggestions and do not promise wonderful though unlikely outcomes. Ideas like "peaceful parenting" need to be interpreted as meaning "more peaceful than some parenting" because it would be silly to imagine that living in a family of people of different ages and needs could ever be as peaceful as living alone!

      My advice is, read a book carefully if it appeals to you. Try doing what it says for a couple of weeks just to see if YOU can do it, without regard to whether your kids are responding as you want. If you can't do it, don't fight that-- if you can, and have practiced for a while, ask your kids how they think it's going, and see how the whole family is doing. However, you also need to keep in mind that any change you make is likely to have some effect fairly soon, just because it's a change, and that change may not be a permanent one.

      In my opinion, the very fact that you are trying to think how to act as a parent is very much to your credit and is the factor that is likely to produce a good outcome!

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  2. Thank you for taking the time to respond, Dr. Mercer. Like many parents, I want to raise respectful, capable adults - but I don't want to do it in a way that is also hurtful to them. While I wish there was a way to cross reference the bewildering world of parenting books against some kind of checklist of their effectiveness, it IS comforting to know that love, moderation and a little parental common sense can go a long way.

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