The Gap Between Scientific and Clinical Practices - Research Paper Example

Running Head: Scientist-Practitioner Ideal Exploring the Scientist-Practitioner Ideal College: Philosophy The discussion about the gap between scientific and clinical practices is a foremost concern of all the psychology professionals and scientists. The evaluation of history of different developments and proposal of training methods, theories, models and criticism of different scholars on the models leads to the relevance of clinical trail methodology in present psychological practice. However, the discussion of drawbacks and narrow understanding of educators and clinicians regarding scientific practitioner model will help in understanding the gap. Exploring Scientist-Practitioner Ideal Generally, the scientist-practitioner model is made known in ways of talking and writing or in a discourse. These ways should position the psychological practitioner as a scientist involved in legitimate epistemic authority. In the study ‘Scientist-Practitioner Model: A Critical Examination’, Ian John (1998) found that the developments in science studies and sociology of scientific knowledge suggested the more intelligible way of explicating the way in which the psychological practice is rendered. He however emphasized the need of epistemic authority for psychologists to reduce the gap between scientist and practitioner and to find the origin for the practices observed by clinical practitioners (Ian John, 1998). While considering the gap between psychology practitioner and scientist, the demand of trained personnel for applied psychological work need emphasis. This recognizes both the need and responsibilities. According to David B, Baker the need for clinical psychologists came to fore after World War II. (David B. Baker, 2000). Narrow Understanding in Training and Internship However, the need of clinical psychologists came to fore after the World War II, the training and internship for clinical psychologists dates back to 1897 and 1908 respectively. According to Routh (1994) J.A.Wallace Wallin, one of the co founders of American Association of Clinical Psychologists got his clinical psychology degree from Yale University. His complaint about the lack of assistance he faced in university authorities reveals the need of a systematic and organized system to produce clinical psychologists at that time. After that in 1926, Morton Prince a Boston Neurologist believed that the psychology is a liberal art than a medicine and again this is a narrow understanding about a science. How can an art cure the impairments through therapies and techniques? He arranged an endowment for clinical psychology in form of Harvard Psychological Clinic in Department of Philosophy of Harvard University. In addition to the above-mentioned endowment, he founded the ‘The Journal for Abnormal Psychology’ in 1906. In the later course of period, Henry A. Murray, a doctor of medicine trained in Freudian psychology is responsible for development of Harvard Psychological Clinic. The foundation formed for training and internship thinking psychology as an art resulted in narrow understanding of the science and did not fill the gap between scientist and practitioner. (Routh, 2000). This resulted in a need of bridge between science and practice. However, the establishment of few schools and clinics regarding clinical psychology did not bridge the gap between science and practice in Psychology. The discussion on the studies published by ‘The Local Clinical Scientist’ will help in bringing out the attitudes and knowledge base of the scientist to meet the problems addressed by clinician during consultation. Most of the problems are due to inadequate generalizability and can be reduced by recognition of the value of local observations. This is possible by taking the feed back from the clinical psychologists for scientific investigations. As it did not happen in many instances, the bridge between scientist and practitioner is absent and educators and clinicians did not recognize its importance for a long time. However, in this context the clinical setting is a scientific laboratory and resulted in shaping scientist-practitioner model. According to Raimy (1950) regarding scientist-practitioner model, the boulder model prefers the training for clinical psychologists as both scientists and practitioners. This model again did not work, as there is basic misunderstanding about the relation between scientist and practitioner. This is because, psychologists who seek academic or research careers found this model valid. However, many clinical practitioners did not contribute for both research and practice. This made the participants at the Boulders Conference to endorse a diversity of training patterns preferring the continued possibility of experimentation. However, the training programs preferred in the conference did not materialize in the course of time and there was little experimentation or diversity in training and education, which in turn increased the gap between scientist and practitioner. The scientific training offered at the expense of practice did not bridge the gap between scientist and practitioner. Moreover, the uniformity is attained at the cost of quality. As a result, the diversity, which leads to new thoughts and methods, did not arise at all. In this context, the understanding of the problem by educators and clinicians comes to the fore and a need of bridging the gap between educators and clinicians arises before narrowing the gap between scientist and practitioner. (George Stricker, 1997) The narrow understanding of diversity by educators and clinicians in boulder model resulted in distortion and damage of the development of clinical psychology. The existence of gap between scientist and practitioner even after the boulder model is due to lack of understanding diversity and clinical feedback by educators and clinicians. (George W. Albee, 2000) Emphasizing on clinical scientific practice, George Stricker cites Mc Fall and Entwistle that describe clinical practice as a scientific practice. They emphasize in reducing tensions between sciences and practice that reduces the gap between scientific and clinical practice. However, the community did not realize this model and this is the main reason for gap between scientific results and clinical practice. Stricker cites Peterson also; who states the straight application of science in clinic is limited by bounds of science. The lack of understanding did not address the bound of science in clinic. According to Cronbach the skills of clinician assume unusual importance for the clinician. This prompted him to endorse the intensive local observation and concluded that all scientific work rests on observational skills. Stricker also cited Shakow, who emphasized the importance of observational skills essential for scientific professionals and clinical practitioners. The above argument brings to the fore the importance of interaction between clinic and scientific laboratory or clinical trials for scientific experiments. (George Stricker, 1995). Hence, the scientific practitioner model comes to the fore. The Scientist Practitioner Model In understanding the scientist practitioner model, the definition of psychology is necessary. However, Lilien Feld cites Henrique’s thought of psychology being a concept that resists definition. (Lilien Feld, 2004) The absence of definition may result in lack of understanding between science and practice. Despite that concept if we consider the understanding about it, according to Schneider, the Perception regarding psychology is as a study of mental life. Though, the development of thought from assuming psychology as an art to study helped little, the important hurdle in minimizing the scientist practitioner gap did not happen for longtime. Schneider cites Wundt’s opinion of laboratory psychology being limited to the relevance of the psychological subject. (Kirk J. Schneider, 1998) Despite these efforts, there is no effort to bridge the gap between scientific and clinical practices in the history. As a result, Schneider proposed humanistic, existential and psychodynamic therapies in clinical psychology. Perez, supports standardization in scientific and clinical practices, criticizes the above therapies as romanticism. He cites the 400 different therapies for treatment of disorders but absence of scientific evidence for them. The afore-mentioned argument gives rise to scientific practitioner model. (Perez, 1999) However, the above argument leads to the probability of science and practice being incommensurable paradigms. This is because; the scientists and practitioners differ in their orientations. The different orientations decrease the possibility of communication resulting in lack of scientific knowledge in practice and lack of ground realities in scientific practices. This is due to incompatibility. The removal of incompatibility may improve the condition regarding relation between scientists and practitioners. George Stricker cited Peterson’s remark about compatibility. In turn, he opines that this leads to different approaches in scientific and clinical practices. (George Stricker, 1997) According to afore-mentioned opinion, setting common standards for scientific and clinical practices may help in reducing the lack of compatibility between scientists and practitioners. Even after thinking about removal of lack of compatibility, Stricker further emphasizes on removal of ignorance in educators and clinicians. His intention is that the educators and clinicians did not apply scientific practitioner model reasonably in the post boulder years and resulted in ignorance or distorted the development of clinical psychology in US despite majority of psychologists having a Ph. D in their field. The bimodal distribution of programs left little room in the center for programs that truly emphasized both scientific and clinical approaches. As a result, the distortion of interaction between science and clinic happened. This resulted in clinicians being technicians rather than professionals. (Stricker, 2000) The reduction of compatibility and lack of coordination between scientist and practitioner are reducible when the community considers that the science and practice are inseparable. Hayes cites the Witmer’s quote that the one practice fosters the other. This resulted in the formation of American Psychological Association that considers the role clinical practitioner as a scientist. However, Hayes cites the Frederick C. Throne’s quotations that the clinical practice is empirical and based on experience rather than facts. This gives rises to the question “How the experience does equals the experiment?” Throne opined that every individual case is an experiment and diagnosis of it gives experience. (Hayes, 1997) However, diagnosis procedure is a result of scientific practices in the laboratory or due to efforts of scientist based on clinical observations. One can answer that the experience gives enough knowledge to do a good experiment. Thus, experience helps in compiling enough information and organizing it into knowledge. Despite the above discussion, Gorman in 2001 expresses doubts about scientific practitioner Model. He cites the foundation role of science in the model as there is no enough evidence for what was accepted in psychology in 20th Century. He cites Lakatos’s view of auxiliary hypothesis in Science that are in contrary to the data in clinics. The insufficient practical contribution of science to psychology also reduced the importance of scientist practitioner model, despite being a trusted model for number of years. He concludes that if it is not scientific, it is not a good practice and if it is not practical, it is not good science. This argument emphasizes the importance of Clinical Trial Methodology and supports it. (Gorman, 2001) Clinical Trial Methodology The number of efforts after boulder conference the clinical trial methodology that gave essence of scientific to clinical practice came into existence. According to Larner, this resulted in psychotherapy that works by enhancing the personal or contextual meaning and understanding. The reviews in different Journals like American Psychologist, Journal of Consulting and Clinical Psychology, Journal of Clinical Psychology from 1996 to 2000 published the articles about what and who is necessary for the practice. The discussion of evidence-based practice came to the fore and the scientist –practitioner model is under pressure. (Larner, 2001) The lack of information exchange between practitioner and scientist may be one of the causes for the pressure on scientist-practitioner model. The above discussion emphasizes on results of link between empirical research and clinical practice. Simionato opines that psychological practitioners rarely consult empirical research to guide their practice. This resulted in practitioners consuming little research and that is due to lack of interaction between scientific and clinical practices. The interaction is stressed along with empirical research because, the revised views of science resulted in emphasizing that the scientific statements are interpretations or socially constructed perspectives influenced by scientist’s presuppositions. (Renato Simionato, 1991) To remove this interpretations and presuppositions, the interaction between clinic and science lab or the methodology of clinical trails is necessary. Conclusion The discussion in the paper ends with support for clinical trail methodology. However, one cannot ignore scientific practitioner model as long as the scientific and clinical practices support each other with empirical and practical data and information. The interaction between science and clinical practice is important in scientific practitioner model as well as clinical trail methodology. One can conclude that the failure or criticism on scientific practitioner model is due to lack of interaction between science and practice. References: John, 1998, The Scientist Practitioner Model: A Critical Examination, Australian Psychologist, Volume 33, pages 24-30. David B. Baker, Ludy T. Benjamin, 2000, The Affirmation of Scientist-Practitioner, American Psychologist, Volume 55, pages 241-247. Donald K. Routh, 2000, Clinical Psychology Training, American Psychologist, Volume 55, Pages 236-241. George Stricker, 1997, Are Science and Practice Commensurable, American Psychologist, Volume 52, 442,228. Hayes, 1997, The Scientist and Practitioner, The Scientist-Practitioner Ideal, Volume information not available, pages 1-15. Larner, 2001, The Clinical Practitioner Model in Therapy, Australian Psychologist, Volume 38, Pages 36-43. George W. Albee, 2000, The Boulder Model’s Fatal Law, American Psychologist, Volume 55, pages 247-248. George Stricker, 1995, The Local Clinical Scientist, American Psychologist, Volume 50, pages 995-1002. George Stricker, 2000, The Scientific Practitioner Model, American Psychologist, Volume 50, pages 253-254. Renato Simionato, 1991, The Link Between Empirical Research, Epistemic Values and Psychological Practice, American Psychologist, Volume 26, pages 123-127. Scott O. Lilien Feld, 2004, Defining Psychology: Is it worth the Trouble?, Journal of Clinical Psychology, Volume 60, pages 1249-1253. Kirk J. Schneider, 1998, Toward a Science of a heart, American Psychologist, Volume 53, pages 277-289. Gorman, 2001, The Scientist Practitioner Model and its Critics, Australian Psychologist, Volume 36, pages 164-169. Read More