Tuesday, July 8, 2014

The Scientist Practitioner Model

I'm not the only psychologist here at Universidad San Francisco de Quito, but I'm probably the only scientist-psychologist. There is a tendency here to focus heavily on therapy, which is fine. I´m sure good therapists do good work. My concern is that psychology has to be empirically based. A solid factual basis is needed so that what works is applied to clinical practice and what is merely psycho-babble is rightly kept out of the clinic. This is why all psychologists need to be trained as both scientists and practitioners.

This isn't anything new, the scientist-practitioner model in clinical psychology training has been highly influential in Europe and North America for decades. The basis of it is simply that any psychological practitioner must also be a capable scientist. There are many benefits to such an approach.

Firstly, psychologists who research keep themselves at the vanguard of the discipline. A professional career in psychology can last more than 40 years. Forty plus years of change and development. A psychologist who rests on their laurels will ultimately become an anachronism.

Secondly, psychologists need to be able to judge if their own practice is effective. Scientific training equips practitioners with a nuanced understanding of expectations, spontaneous recovery, placebo and nocebo effects. The history of medicine is replete with cases of ineffective, or even harmful treatments being continued because doctors lacked the clarity of observation to see what was really happening (think leaches, blood letting etc.).

Thirdly, even if psychologists don´t research or audit their own performance, they need to be evidence-based. Without real evidence to support practice, psychologists risk becoming merely psychological quacks, with their own versions of blood-letting and leaches. Being evidence based means being able to understand empirical research. Research published in reputable peer-reviewed journals. This means understanding research methodology, understanding statistics, and being information literate. An excellent book on this topic, written for medical doctors, but still relevant to psychologists is ´How to Read a Paper´ written by Trisha Greenhalgh (free PDF version here).

In fact, the list could go on and on. The scientist-practitioner model is a no-brainer.

Consequently I am trying to inject as much science as I can into the training of psychologists here in Ecuador. The irony of it all is that I am not a scientist practitioner myself. This is because I am an academic psychologist. I've never treated a patient, my training is all in research. A bachelors degree, PhD and several postdoctoral research positions. Nevertheless, my research has always been in clinical fields, mainly psychiatry and neurology.

As a first step I have introduced research projects as a key part of the assessment all of my courses. Again this has multiple benefits, researched projects have a significant validity that promotes deep learning, and simultaneously students are learning academic research skills. To facilitate this I have produced a detailed guide to writing psychology lab reports. This can be downloaded here.

But it's more than just lab reports. The internet revolution has thrown up more misinformation than information, people all over the world are being bombarded with nonsense dressed as fact. Students too often lack the skills to separate the wheat from the chaff, the nonsense from the fact. As scientist-practitioners we need to primarily rely on material published in peer reviewed journals, and this is something that I´m also emphasizing across my courses.  This skill is often called ´information literacy´. That can be a topic for a future blog post.