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Firstly, let's think about how people become trained clinicians.

People become trained clinicians as a result of their (in brief)

  • completing a specified amount of study across a broad range of topics within the fields of clinical and counselling psychology or other human service field, and across a range of modalities (say, Behavior Therapy, Existential Therapy, use of EMDR, Psychodynamic  Therapy etc -- but usually in a minimum of two different types of therapy. While doing so
  • completing a minimum number of hours of practising a variety of therapies under supervision, especially being cognizant of client's feelings about particular therapies, their expectancies of therapy, and what to do if problems arise with a person's response, or lack thereof, to therapy
  • completing a supervised research study, ideally in a clinically relevant area

It remains an important part of that training that would-be therapists remain scientifically sceptical of any therapies they may call upon. Throughout this training they learn how to develop the ability to ask good questions of a therapy, and of their own practice, and how to try to answer those questions -- what makes good practice, what makes safe and effective practice -- how to compare different therapies against each other. This site attempts to argue for the worth of EFT Emotional Freedom Technique -- but provides detailed discussion of one research study, without highlighting just how poor is the quality of the research done -- what is "talk therapy" against which the approach  is compared -- which one of the hundreds of approaches was used, and then why that one????   http://www.tappingsolutionfoun...cience-and-research/

It is important that the therapies the student wishes to practice are evidence-based -- see here for guides to what is EBP

http://www.samhsa.gov/ebp-web-guide

 https://store.samhsa.gov/shin/...-4205/SMA09-4205.pdf

http://nrepp.samhsa.gov/AllPrograms.aspx

I could not find EFT in any of their lists of evidence-based practices.

As part of this questioning they should remain open to alternative points of view with regards to particular therapies; such as, at least with respect to psychodynamic and behavioral therapies (these are, after all, accepted evidence-based practices), this site http://blogs.plos.org/mindthebrain/

It is important to note that both "behavioral" and "psychodynamic" therapies have been subjected to repeated "component analyses" to try to determine what are the critical components involved in their success -- but this has only been able to happen after the therapies have matured and differentiated -- respectively highlighting the roles of behavioral activation and mentalization, for example. This is what needs to happen for all therapies. In the case of "new" therapies, like EFT, we don't all need to accept that the only effective components are those identified by Church. 

It is not unusual for therapies to gather very positive results early in their development, but when subjected to use by practitioners less accepting of the approaches "message" to later be struggling to convince a broader audience of that therapies effectiveness. Perhaps even more importantly, considerable research now shows, the particular therapy used is much less important than the quality of the relationship between therapist and client.   https://www.centerforclinicalexcellence.com/

It is by the combination of all these skills that one can be assured that the therapies practised will be selected in a stepwise, methodical, safety-focused and thorough process. Further, if problems arise, a trained clinician will be in a position to address both relationship issues and "practice" issues -- those not adequately trained,  who have not had their training and experience accredited, resulting in their not being "registered" (Downunder parlance) or "licenced" (North American context), cannot provide this secure base for their clients. I take part in a number of web forums and recently I was not allowed to say of one technique that it hadn't worked for me, but I did benefit from components of that technique which had been much better refined in a different model. Why was I not allowed? -- the need for reporting such "treatment failures" is now recognised as a crucial part of evaluating therapy alternatives -- see also here   https://www.facebook.com/groups/166671503346266/  Psychiatrist Rob Purssey has written some extremely interesting comments in this area and I encourage readers to obtain his materials.

 

Last edited by Russell Wilson
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I have been off the grid a bit, but wanted to say it's a valuable conversation about clinicians and training and safety.  The client's safety is always paramount, and excellence in training, plus shared field experience, is what keeps us all growing, expanding our tools, applications, peer group and collective wisdom.  I particularly value the thought leaders and bloggers such as you, Jane, and also folks like Guy McPherson, who embrace both far-ranging conversation and and a growing spectrum of uses, served populations and methods. 

That said, I concur that we're all looking for better results for our clients and communities; our natural and professional want is to look at the emerging protocols using the current language of 'evidence-based.'  When doing so, I would urge the mental stance of real curiosity and openness be also given towards what our peer community are finding valuable in other than clinical field trials - meaning actual experience in the field.  

As at least 45% of my training classes are working, licensed healthcare professionals; that puts me in a good position to see a broad spectrum of approaches and real-life experience, in action.  They are hands-down my favorite group to work with, as we quickly generate an atmosphere of collaborative, constructive integration, weaving together new tools, mindsets and protocols for better results, in whatever modalities they already use and for populations they currently serve.  It's a privilege to do this kind of work, and see these kinds of anecdotal results in their private practices and organizations.

So, secondly, I'd like to correct an earlier published opinion that there is scant evidence available on the collective of EP - energy psychology and energy medicine protocols. To date, there are over 80 studies published in peer-reviewed journals (some are listed below), 43 of which are RCT, and 4 meta-studies -- 3 of those demonstrated large effect sizes and 1 moderate effect size.   I am watchful of some recent ones, both published and in progress by Dr. Peta Stapleton of Bond University (AU), and those sponsored by Perdue University (USA) and Dr Amy Gaesser, and the clinical field trials underway at Herzog Hospital (in Jerusalem).  

Re: Standards & Hindrances to Clinical Research of These EP Modalities

My goal here is to include in our conversations the value of standards (that continue to evolve) in meeting the need of client safety, efficacious results and professional application and approaches, AND an open mind towards what might be extremely useful to this group in expanding those standards to include both clinical and anecdoctal research and result reporting.  Specifically, I had brought conversation to the Energy Psychology modality field, a collection of mindful, meridian-based stimulation approaches that I have found helpful to working in ACEs-informed care.  Because the suggestion was not understood under that aegis, I wanted to correct the conversational focus.  

Those curious or interested, read on please.  EP protocols have been studied, and those most likely to be put into clinical field trial are those with a strict algorithm base, rather than their more flexible, more facilitator-dependent meridian tapping sister protocols such as EFT; this does not mean they're less effective - just more flexible in application, which functionally mean they have more variables and are more practitioner-dependent, therefore harder to test in our standard forms of clinical research.

Further, it's just a fact that when it comes to research involving children, IRBs are understandably reluctant to give a lot of leeway, and often the financial implications of a successful outcome may defeat the needs of popular sources of research funding. So while we all value peer-reviewed journals and 'gold-standards' of randomized controls, we also value the wealth of first-hand account reporting of our peers, who use these tools everyday.  I'm proposing that respected peers' documented results and/or anecdotal reporting be considered  as another valuable field of 'evidence' for this community.  Nowhere do I more appreciate the experiential reports than from the hands of skilled licensed healthcare professionals who diligently use and report upon their results, for everyone's benefit.

There is a good selection of peer-reviewed and published studies and meta-analyses, on this link: http://www.energypsych.org/?Research_Landing     Please note that, despite earlier reports to the contrary, SAMSHA does in fact list EP, energy psychology, as 'evidence-based practice' on their NREPP registry.

I am very glad to be in the company of all kinds of very well trained and experienced clinicians, practitioners, facilitators and researchers of every stripe, who value excellence in professional study, application, and results.

I'm hopeful this has been helpful and look forward to the wealth of collegial and hopeful conversations I find on this blog every time I visit. Bless you all.

* these peer-reviewed journals include Journal of Clinical Psychology, Journal of Nervous and Mental Disease, APA journals Psychotherapy: Theory, Research, Practice, Training and Review of General Psychology.

Don't forget for the next five days, the Science of Meditation Summit is on. For those less familiar with Mindfulness / Meditation, there's a monthly online newsletter that's published, resulting in their being not 80 published studies, but thousands! with the end result being the inclusion of Mindfulness / Meditation as at least an adjunctive therapy in the consensus statements for the treatment of PTSD (see Schnyder et al 2015) and Complex Trauma (Cloitre et al 2012) -- something not achieved by EP or EFT, despite their having been around for longer than some others included in those statements. Trained clinicians are, and need to be, guided by such statements. Failure to do so can lead to censure by professional bodies, at the least, providing some degree of protection for the public. As for those "treating" disorders without gaining accreditation by professional bodies (the majority of the people with "training" in EP), what safety is there for them?

https://online.shambhalamounta...35678b6471026d288d02

 

I'll happily take a look at anything members here suggest as helpful or promising. Thank you for the suggested link.  Many people cannot even begin to approach anything resembling Mindfulness or Meditation, until helped into calmer states, so I am eager to see what the link has to say about that.  As I've said many times, the 'adjunctive' factor is very encouraging and desirable, as there are many new  practices and modalities that will help every one of us professionally integrate and enhance whatever skills already possessed, for even better results.

To the other point, I think we can all agree that self-regulation (or censure as you say) is important, and that failure to do so, in any professional endeavor, will soon bring about the attention of authoritative bodies who will seek to do that for us. Towards that end, I've noticed and practice a uniform tenant of any modern professional training -  to teach and reinforce scope of practice, client safety, continuing training and mentoring, self-care and self-discipline.  Of course no one can speak to everyone's different branches of training, levels and vetting, but forums like this help us reinforce best practices and behaviors. There will always be people who resist safety and self-regulation, which is about them, not their modality.  Sadly, all of us will continue to know lousy doctors, therapists, practitioners, no matter how august their initials or training bodies, and yes, that even goes for Mindfulness teachers (which is a very wide body of thought and practices, indeed), but all of us can make a positive difference in each other's lives and that of our clients, by wholehearted participation and cooperation in sharing every helpful and promising development deemed worthy of our collective attention. 

Research by Scott Miller says that 85% of the benefit of any kind of mental health intevention is the relationship built.

Well, there's lots cheaper ways to build relationships, big brothers big sisters, boys and girls clubs, all sports teams, church groups, etc...My agency did a survey of support groups vs sports teams and found that the sports teams had about 95% of the same peer support components present. With 4 times more frequent meetings sessions. 

Another recent article that can be argued supports behavioral therapies incorporating "Prolonged Exposure" to feared stimuli, rather than detracts from them, is by Harned DOI: 10.1080/10503307.2016.1252865

 Evidence supposedly for  people being negatively influenced by behavioral techniques seems to be a single study by German psychodynamic therapists, but this study failed to incorporate treatment fidelity measures. So who knows what "treatment" those said to be receiving Behaviour Therapy really received -- if your allegiance is to a different form of therapy (psychodynamic) and you have a negative preconception of a particular form of therapy (BT), then you might act in ways that are harmful (unconsciously, of course) to patients receiving that form of therapy (more negative therapeutic relationship?).

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