As a counsellor and psychotherapist also trained in science and in scepticism I have been disappointed in the apparent lack of depth to the sceptical analysis of counselling that seems to be present from time to time in the NZ Skeptic. This lack of rigour in analysis goes back some way. In June 1995, for example, an article appeared in this publication saying counselling was no use. This judgement was based on a single study conducted in 1939.
More recently, in the Summer 1997 NZ Skeptic is an article critical of counselling reprinted from the Times. The article is based on a single report.
I am not claiming that counselling or counsellors should be immune from critical analysis. In fact I think it is essential. However my previous experience of examples of such shallow analysis has been in the form of criticism coming from either:
1: fundamentalist Christians who believe all problems can be solved by consulting the Bible
2: the new right, whose supporters have replaced the Bible by the writings of Ayn Rand and a small group of economists and whose doctrine is that everyone should be able to solve their own problems. I have been surprised to find it in the NZ Skeptic.
Careful critical analysis can only be helpful to psychotherapists, counsellors and their clients. Martin Seligman’s book What you can change and what you can’t (Random House, 1994) is a good example of writing by someone who has believed that most forms of counselling are ineffective and yet has produced a useful survey of what works and what doesn’t. Members of CSICOP genuinely interested in research into the outcomes of counselling and psychotherapy could do worse than read Brett Steenbarger’s study “Toward Science-Practice Integration in Brief Counselling and Therapy” The Counselling Psychologist 20 (3): 403-450.
For a more lengthy discussion of the techniques involved in outcome studies and some of the research findings I would suggest Bergin and Garfield’s Handbook of Psychotherapy and Behavioural Change (4th Ed. John Wiley 1994).
Seligman himself has become more impressed with the outcomes of psychotherapy following his role as clinical advisor for a survey by the American Consumers’ Union (Consumer Reports 1995, November, Mental Health: Does Therapy Help?). This survey found that members who had been to psychotherapists were overwhelmingly of the view that psychotherapy was helpful.
It is true that many studies of counselling and psychotherapy are subject to criticism (as are most studies in astronomy or botany). This is a very difficult field in which to do research.
My own view is that the development of effective techniques in counselling is at an early stage. One study suggested that the variation in the models we use accounts for only 10% of change (Beirman, B.D. et al, Am Jl. Psychiatry 146 (2) 138-147, 1989) (most of the rest seems to be based on the client’s desire to change and the quality of the relationship between the counsellor and client) and this is obviously unsatisfactory.
A recent critic suggested that counselling was only about as effective as giving the client a pill. For those who know about placebos, that isn’t bad in terms of relieving misery. My personal aim is to be as effective as giving an injection (maybe even, one day, as good as a surgical intervention).
In making these criticisms of the quality of the articles above, I am not attacking the NZ Skeptics’ campaign against the excesses of so-called “recovered memory” or “ritual abuse” therapy. While some correspondents to the NZ Skeptic have taken a somewhat extreme stand at times, I think this has been necessary to counter some of the excesses that developed in this area.
Soon after the Skeptical Inquirer started publishing in this area, I talked to people running “ritual abuse” workshops in New Zealand and they frightened me. It seemed to me that they were working with extremely disturbed people and using methods likely to make them even more disturbed. I gave talks on these topics at meetings of both the NZ Association of Counsellors (NZAC) and NZ Association of Psychotherapists (NZAP) expressing my concerns and encouraging my fellow practitioners to be cautious.
Unfortunately most of the extremists involved in these activities were not members of the NZAP or NZAC and therefore not bound by their ethics or accountable through their complaints procedures.
In conclusion I would make a plea for the maintenance of high standards of scholarship in our sceptical endeavours. Lack of rigour in any area damages our credibility in all areas.
