One Flew Over the Cuckoo's Nest...

In reading the articles for this week, I was intrigued by the concepts discussed by Hunsley and DiGiulio in the Dodo Bird text, as well as through the extremely dense work of Chambless and Hollon in Defining EST. I would like to focus a bit more on the Hunsley work, especially because they were able to fit in three birds within their title.

The Dodo Bird theory was easily struck down throughout several meta-analytical studies presented in the work. What is most interesting to me is the initial theory of all psychological treatments having equivalent effects. I can only think to compare that to the educational system, in noting that regardless of the teacher, curriculum, and child within the classroom, all results are going to appear to be the same. I can assure you that that is hardly the case, as a former teacher, because so many variables affect the outcome of quality teaching and instruction. If this can be seen in areas of expertise ranging from the classroom to the emergency room, why would my clinic be any different? How could one even postulate that these various treatments would yield the same result?

If in fact equivalence was the end result of all clinician and treatment procedures, I find it highly unlikely that we (future clinicians) would be fighting so diligently for a spot to practice this art. Additionally, I believe that less trained professionals would be able to administer treatments to patients, considering our training would be irrelevant to their outcome. There has been a push in recent years over this (especially Masters level therapy in some states to reduce costs of mental health care), but a large pushback from professionals who can show through empirical evidence that the quality of the training of the clinician, paired with empirically relevant training models, yields better patient outcomes than the alternative.

I would agree hardily, therefore, that we must strive for results that benefit the patients and are replicable between and within treatments in order to solidify the effectiveness of highly-trained therapists and various treatments. Working towards this goal will keep our profession intact, and any potential clinicians from flying the coop…