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HereSince1628

(36,063 posts)
3. Let me put it this way, I think clinical psychology has a problem sort of similar to education
Mon Jul 29, 2013, 07:43 PM
Jul 2013

In education it's pretty well established that some learning takes place under almost all education treatments. Psychology seems to have a similar problem. For many illnesses most treatments will make some people 'feel better'.

In this light, when trying to identify the best methods for treating a mental illness, the question really can't be does the treatment relieve some symptom or characteristic one or several mental illnesses. So, then Dr. Doraiswamy finding yoga of possible value for a handful mental illnesses is really not very illuminating...MANY things can do pretty much the same thing. Patients should get what is best for them, not merely what sometimes works and is available through a particular clinic or clinician.

And resolving the search for an effective psychiatric treatment into an indeterminate, perhaps endless, period of trial and error effort that depends more upon patient/therapist capacity to persist within an alliance, while casting about more of less without design for things that work among whatever number is available, seems not very much like a rational strategy to find the best treatment. (I do recognize that pushing for patients to get a best treatment method rather than a method that works for some people or the method(s) the clinician is best or most comfortable with, really isn't a dominant approach to the clinical psychiatric enterprise).

If progress is going to made in getting best treatment to patients, it seems to me that the questions really must be of this form: which treatments work better than others, and for whom do specific treatments work better than others?

In that respect, I recommend, not completely facetiously, using the ameliorative value received from a cup of warm broth as the default comparison...then we could say things like proposed psychological treatment "A" works 'x.x' times better for illness "B" than a cup of warm broth; or for cohorts of patients characterized by multiple traits and symptoms J,K L,M,N, O and P this treatment worked 'x.x' times better than a cup of warm broth.



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