IPT Book Reviews

Title: House of Cards: Psychology and Psychotherapy Built on Myth  Positive Review Positive Review
Author: Robyn M. Dawes
Publisher: The Free Press 1994

The Free Press
A Division of Macmillan, Inc.
866 Third Avenue
New York, NY 10022
$22.95
 

Description:

In this 338-page book, psychologist and decision theorist Robyn Dawes critically examines the assumptions, theories, and practices of the profession of clinical psychology.  In the preface, Dawes notes that he was motivated to write the book out of both anger and a sense of obligation.  He believes that psychology has abandoned its commitment to establish a mental health profession that is based on research findings and that bases its practices on well-validated techniques and practices.  He maintains that, instead, professional practice in psychology has grown and achieved status by using techniques known to be invalid.  He is particularly enraged by the mistaken and unsupported reliance on experience and intuition by psychologists who are making decisions and recommendations that affect peoples' lives.

Chapters in the book include a history of the growth of psychology as a profession and the training and practices of psychologists, the myth of expertise and experience in determining patient outcomes, research on the efficacy of therapy, actuarial versus clinical prediction, licensing and the myth of protecting the public, why the unsupported myths are believed, the fraudulent claims of psychologists who testify as experts in trials, New Age psychology and its heavy reliance on feelings and self-esteem, the paternalistic assumptions of professional psychology, and the trend toward assuming that people cannot cope with problems and crises without the help of a professional psychologist.  The book contains endnotes with references for each chapter and there is a brief index.
 

Discussion:

This is an extremely important book that pulls no punches in its criticisms of current psychological practices.  It exposes the myths that have allowed psychologists to develop status and authority in the absence of empirical support for their claims.  Dawes' criticisms and assertions are amply supported by research, which he describes carefully and which make his arguments understandable and persuasive.  He is meticulously accurate for example, he correctly defines "negative reinforcement," which many other psychologists frequently confuse with "punishment."

The style is clear and readable and the basic issues and concepts can be understood by lay people as well as professionals.  Counterintuitive concepts, such as the lack of a relationship between experience and effectiveness, the poor predictive validity of clinical interviews, and the lack of a causal relationship between low self-esteem and a multitude of dependent variables, are discussed in detail.

The behavior of psychologists in terms of child sexual abuse, including the recovered memory movement, comes in for some of Dawes' harshest comments.  He is also sharply critical of New Age psychology, and observes, "But while the New Age psychology begins with the music of Aquarius, it ends with the puerile harmony of pure selfishness" (p.233).  He spends several pages on the unsuccessful research efforts to find an association between self-esteem and a number of behavioral consequences.  His description of the research on the Rorschach Ink Blot test should result in psychologists abandoning the use of this test in forensic settings.  He describes the research on anatomical dolls and comments that the American Psychological Association's conclusion that psychologists can use the dolls if they are competent is quite simply, outrageous" (p. 162).

In fact, throughout, Dawes is critical of the American Psychological Association and he includes an account of his experience on the ethics committee when he resigned following a 6 to 1 vote (Dawes was the lone dissenter) that once a person becomes a client, regardless of the termination of the professional relationship, all subsequent sexual intimacies with that client are unethical.  A client was defined as anyone who had seen a psychologist in any professional relationship for any reason, including as a student, trainee, or business person seeking consultation.  (This decision was later overturned by the lawyers for the APA.)

Dawes, however, believes that psychotherapy can be helpful and effective for people who are upset to the point of feeling unable to cope.  He believes that successful therapy will be based on systematic principles of behavior and theory derived from careful research studies and that people should try to find a therapist who is empathic and whose philosophy about life is compatible with theirs.  But the experience and credentials of the therapist, and the costs of therapy, are not related to effectiveness.

This book should be read not only by psychologists, but by anyone who must interact with psychologists or evaluate the treatment and therapy provided by psychologists.  Attorneys who must cope with psychological testimony will find it particularly helpful.

Reviewed by Hollida Wakefield, Institute for Psychological Therapies, Northfield, Minnesota.

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