Customer Reviews

House of Cards - Psychology and Psychotherapy Built on Myth

5 star:		(8)
4 star:		(4)
3 star:		(1)
2 star:		(1)
1 star:		(1)

 

 

I am a therapist myself, so I naturally began reading this book with trepidation. But instead of the blanket attack I expected, I found instead a very carefully written book that exposes that deeply flawed foundations to much of current psychotherapy, pop psychology, and professional reputation. I read this book at a time in my own career when a respect for science and the need for verifiable information were re-emerging, and House of Cards has provided me with a number of insights and tools that have helped me to provide therapy that is more effective and that avoids pie-in-the-sky promises or beliefs. Dawes is right: although therapy is not a science itself, it should be founded on scientific knowledge.

House of Cards: Psychology and Psychotherapy Built on Myth by Robyn M. Dawes, critically examines Clinical Psychology and exposes facts that many psychologists would rather have hidden. The author is an Experimental Psychologist and the 1990 winner of the APA William James Award. He is very bold in trying to uphold the truth and convincingly demonstrates what the title suggests.

Perhaps the most striking issue covered in this book is the discussion on studies that evaluate the efficacy of psychotherapy. In 1977, Mary Smith and Gene Glass published an article in American Psychologist which found that on a statistical level, psychotherapy works. Not that everyone improved, or no one got worse from treatment, but on a statistical level people were better off on the measure examined than someone chosen at random. Smith and Glass also found that the therapists' credentials (Ph.D., M.D., or no advanced degree), the therapists' experience, the type of therapy given (with the possible exception of behavioral techniques for well circumscribed behavioral problems), and the length of therapy were unrelated to the effectiveness/success of the therapy.

As Dawes states:

"In the years after the Smith and Glass article was published, many attempts were made to disprove their finding that the training, credentials, and experience of therapists are irrelevant. These attempts failed. (p.55)"

Very few books written by psychologists try to realistically look at psychology's flaws. Although psychology pays lip service to the concept of critically examining its tenants, it is seldom done. Mainstream psychology often dismisses books such as this one in passing as "harsh criticism" and ignores the message they offer.

Robyn Dawes, in the House of Cards, takes great pains to carefully document the most common and dangerous myths that underlie the fields of mental health treatment. The author's writings are firmly grounded in research, and the conceptual integrations are presented in a manner that is easy to understand for both the students of mental health related disciplines, consumers of mental health, and the seasoned mental health professional. In this book, Dawes models one of the central goals of college education; the value of critical analysis. Further, she sets the stage for mental health professionals to behave in a manner that is consistent with the research, and thus finally hold themselves accountable for the work they do with clients. A magnificent book with wide ranging implications for mental health professionals and their consumers. Pay attention, this book is the real truth about the approaches used to alleviate the suffering of clients of mental health professionals. Be accountable!!!

Robin Dawes is a genius and one of the most original thinkers in any field. His work was a primary source for my own Ph.D. dissertation. Unfortunately, clinical psychology has morphed into a hodgepodge of political leftism and Oprah-style "feelings" that has barely any resemblance to science. Compounding all of this is the competition for money as (far too many) psych grads look for a way to earn a living. Completely normal human responses to everyday living are defined as pathological and needing "professional intervention." Meanwhile, criminal and evil behavior is also considered for "therapy" when, in fact, jail is the only reasonable "treatment" needed. Finally, political correctness pervades the whole, especially the care of children. So instead of getting the pot-smoking 30-year-old mother of 5 children by 5 different men to see that her behavior is hurting her kids, the kids are given labels (ADHD, ODD, Bipolar, etc.) and drugs, including antipsychotics, as early as age 2 years. Meanwhile, the therapy train steams right along...

Perhaps things have changed remarkably in the ten years since Dawes had written this book. In my studies of the practice of therapy I have become familiar with a preponderance of the research that has been cited in this text. However, in my opinion, this is a very narrow spectrum of the research availiable on the effectiveness of therapy.

Mr. Dawes, in his text, forgets to mention a number of empirical findings that support the effectiveness of psychotherapy. I wonder at this. It is not as if he had to look these up individually, they are standard course work in any graduate program of psychology. Further, although Mr. Dawes frequently discusses research methodology, he fails to acknowledge that individuals with more severe pathology are less likely to be served by the lay person. In other words, modern psychology has been shown to be more effective than your wise aunts advice, even when you are comparing problems that differ in magnitude.

I am troubled by many of the conclusions that Mr. Dawes has made based on research performed on professions other than psychology. For example, Mr. Dawes contends medical school interviews are similar in nature to therapy - I can't see how he could possibly hope to support this. I feel the same about parol hearings or the many examples he gives from psychiatry. While psychiatrists may work in mental health settings, they obtain little or no formal training in psychotherapy and certainly constitute an experimental confound. Further, Mr. Dawes goes as far to say all psychotherapy is about building self esteem and that all therapists are more motivated by their clinical judgement than by research findings. Considering that Dawes argues for utilizing empirical findings in psychotherapy - you would hope he was insightful enough to avoid these types of sweeping, emotive arguments.

In general, some forms of therapy have been shown to be less effective than others. Some therapists still cling to these and to their professional judgement. However, a modern curriculum in psychology will include several advanced statistics courses as well as numerous research and methodology classes. Many modern psychologists line their bookshelves with empirically proven treatments - and use them. Further, there is a growing movement to keep data to show the effectiveness of interventions within individual treatment. Modern psychologists are sophisticated researchers and possess the requisite tools to both analyze and implement new interventions to track, assess, and encourage change. Mr. Dawes would do well to consider the arsenal of tools available to the average psychologist and then consider the assessment, nosologic, and diagnostic ineptitude common in the medical sciences before again making these comparisions.

That Mr. Dawes has raised some valid points is not an issue. Most of these are points that are frequently discussed within the field of psychology to monitor strengths and weaknesses. However, many of the claims Mr. Dawes makes are more a factor of popular culture than the actual practice of psychology, are based on dated publications, or are unsupported opinions that fly in the face of his very thesis of objective empirical reasoning. As a result of this, I find Mr. Dawes arguments to be one sided, his research to be incomplete, and some of his conclusions to be rather naive.

In this very important book, Dawes affirms the power and effectiveness of psychotherapy, and the fact that your wise aunt is probably better at it than any certificate encrusted psychotherapist. But since your wise aunt doesn't charge you any fees, and has a vested interest in seeing that you get your psychological act together, it makes the psychotherapy industry a veritable house of cards. Dawes assembles an impressive amount of empirical evidence demonstrating that minimally trained paraprofessionals can generally make better psychotherapists than their over credentialed peers. His findings are important in more ways than one, since if psychotherapists are no more effective than an empathetic paraprofessional, then the counseling techniques they use don't actually give a great vote of confidence to the humanistic 'New Age' blather that mandates happiness at whatever cost to our ability to realisticallly perceive the world. But again, in this whiny, self indulgent world, why shouldn't psychologists have a lot in common with another group of much beloved professionals who specialize in making common sense hard: namely lawyers!

Overall, Dawes doesn't offer much as an antidote to the rampant silliness that is modern psychology except for an appeal to common sense. A shame then that it took a book like this to reaffirm that common sense and a healthy skepticism are pretty good things to have, in spite of all those talking heads on TV who tell us otherwise!

Robyn Dawes has critically examined a variety of commonly-held myths in clinical psychology. In doing so, he debunks these myths through citing strong research evidence that contradict their basic tenets. The field of clinical psychology largely seems guided by a variety of pop-culture notions (e.g. that self-esteem is a necessary precursor to every form of "psychological health") fundamentally based in Western ideologies of hedonism. Dawes reviews this myth, as well as several others (e.g. psychologists possess "special abilities" beyond those of minimally trained people, most who suffer from traumatic childhood events are destined to live a psychopathology-ridden life, etc.) and presents the accumulating evidence that goes against popular notions of psychology. This book is the book for the social scientist who feels that psychology should be the "science" of human behavior, as well as a gem of a read for those in the general public who want a more accurate impression of the field, including what it can and cannot offer.

The book was very well researched and enlightening. It helps people to realize that psychology is not science, but actually nothing more than a lose collection of fads. Paul Lutus put it aptly when he noted that "it is only a small simplification to say that clinical psychology is meant for people who are too smart for religion but not smart enough for science".

Robyn Dawe's book is an insightful piece of work that should be in a psychotherapist's library. The book covers a number of important topics. While I did not agree with all of Dr. Dawe's assertions, his comments about psychological tests and psychotherapy were thought-provoking. It is unfortunate that Dr. Dawes recently passed away, as we have lost a great mind.

Dawes clearly has an ax to grind with clinical psychology. Ego and status are what motivate this book. As an academic psychologist Dawes doesn't want to be associated with "those psychologists". Real psychologists do science and those practitioner-psychologists employ pseudo-science. With this as his jumping off point Dawes goes on to a select reading and interpretation of the scientific literature to prove his point. While some of his points are well founded his partisanship flattens out the complexity of the issues being discussed. In service of proving his point he cites the USA Today and other such sources. To get a more balanced and nuanced reading of psychology and psychotherapy I would recommend The Great Psychotherapy Debate: Models, Methods, and Findings (Counseling and Psychotherapy: Investigating Practice from Scientific, Historical, and Cultural Perspectives). Don't be confused by his neutrality ploy he is anything but. Above all this is a book about the politics within psychology today.