The diagnosis of mental health disorders in the US has nearly doubled in the past 20 years and clinical psychologists and therapists are on the front lines of handling it but many are falling short because they use methods that are out of date or lack any scientific rigor or both.
How is that possible? Because many of the training programs, and especially some Doctorate of Psychology (PsyD) programs and for-profit training centers, are not grounded in science, according to a new report in Psychological Science in the Public Interest.
A panel of clinical scientists - Timothy Baker from the University of Wisconsin-Madison, Richard McFall from Indiana University and Varda Shoham from the University of Arizona - have called for the reform of clinical psychology training programs and are making appeals for a new accreditation system to ensure that mental health clinicians are trained to use the most effective research to treat patients.
They state that there are multiple practices in clinical psychology that are grounded in science and proven to work but in the absence of standardized science-based training, those treatments go unused.
As an example, they state that cognitive-behavioral therapy (CBT) has been shown to be the most effective treatment for Post-traumatic stress disorder (PTSD) and has the fewest side-effects yet many psychologists do not use this method. Baker and colleagues cite a study in which only 30 percent of psychologists were trained to perform CBT for PTSD and only half of those psychologists elected to use it.
That means that six of every seven sufferers were not getting the best PTSD care available from their clinicians and they state that CBT has both long-term and immediate benefits as a treatment for PTSD whereas medications such as Paxil have shown 25 to 50 percent relapse rates.
The report suggests that the rising cost of mental health care treatment has reduced the use of psychological treatments and shifted care to general health care facilities and the authors stress the importance of coupling psychosocial interventions with medicine because they say many behavioral therapies have been shown to reduce costs and provide longer term benefits for the client.
Baker and colleagues conclude that a new accreditation system is the key to reforming training in clinical psychology. This new system is already under development: the Psychological Clinical Science Accreditation System (PCSAS www.pcsas.org).
