Tim Carey, David Goldstein

From [Marc Abrams (980204.1145)]

Fellas, Hope ya don't mind but I'm gonna jump into this one :slight_smile:

[From Tim Carey (980205.1955)]

Hi David (and Dick),
Thanks for your post, from my point of view .... I give up ..... I

honestly

and sincerely can't comprehend how someone can claim to subscribe to

PCT

and all that it implies (e.g., about ... conflict, reorganisation,
awareness, etc., etc., ) on the one hand and yet only use MOL (which

is the therapeutic

approach derived *directly* from the premises of PCT) in conjunction

with a

bunch of other strategies which *do not* derive from PCT, on the

other hand.

I think its simply a matter of keeping ones job. If you do not do what
is _prescribed_ by the powers that be you don't work. It's really
pretty simple. It doesn't matter wether it works or not. Doesn't even
matter if its useful. If its the prescribed course of action and the
insurance companies will pay for it (thats probably _the_ certifying
body in the medical domain) then lets do it.

Obviously, I'm missing something here,

Tim, I don't think your missing a damn thing. I just wish there were
more people like yourself with the determination and conviction to
_try_ and do whats right. This is not to condemn either David or Dick.
We all like to eat. I just think we need more Tim Careys in this world
period.

but I won't pester you anymore with it. I think this thread has

outlived it's usefulness .... I'll go back to

the MOL discussion groups I was having and try and figure things out

there.

I am going to try the MOL in a business setting. Not for therapy but
for discovery. I think it could be very useful in helping build
activity maps of organizational processes. (ie. built up from the
individual
perceptions of what is _currently_ going on) I hope you will share
your MOL experiences with us.

David said:

In reply to the points you raise: Several reasons why the exclusive

use of MOL would be considered

irresponsible, at this time, by others:

(1) There are no studies which show that it is an effective therapy

for

any identified problem.

Tim replied:

And how will there *ever* be any studies which show it as an

effective

therapy while clinical psychologists who are in a position to know it

best,

see it only as a tool to be used in conjunction with a variety of

other

therapeutic approaches?

David, are we talking about the same studies that have no clue as to
what the "identified problems" _actually_ are. You and I had this
conversation once a while ago. How do you know _what_ to do when you
don't really know what is wrong. How do you know things are getting
better? How do you know the "identified problems" have been solved.?
The answer is simple. You don't.

David said:

(2) There are studies like this for other treatment appraoches.

And what did these studies suggest that provided such an overwhelming
finding that all other treatments should be withheld or not tried.

Tim replied:

So what's the problem with conducting studies like this for MOL? ...

I

understand that both you and Dick are currently in practice, you must

have

a bunch of clients, or at least some who would be willing to

participate, the sample

sizes of clinical studies are typically not very large. This is

something

that I'll certainly be looking to do once I've finished my course but

as

you alluded to in an earlier post, at the moment I'm pretty well

under the

direction of my course supervisors.

David said:

For example, to take the case of OCD, the established treatment
approaches include: medication, certain kinds of behavioral

therapy.

Tim Replied:

How did these get to be the "established treatment approaches" David?

Was it

from approaching them as "tools" to be used within a total

therapeutic package?

No Tim. The insurance companies decided to pay for it :slight_smile:

David said:

If one used just MOL, and one did not present it as an

experimental

procedure, and one did not inform the patient of the other known
treatment approaches which are considered established, the person

would

probably have a good legal case.

Interesting. David, Do you currently inform _each_ of your patients
what the current "cure" rate is for their particular "identified
problem" with the "established" therapies and what the probable
chances are for _them_ of being either partially or fully cured? What
are the current rates of mis-diagnosis? How would you know if in fact
you _did_ miss diagnosis someone? Don't these questions bother you?

Tim replied:

So .... present it as an experimental procedure and inform the

patient of

other known treatment approaches which are considered established ...

Seems pretty straight forward to me :slight_smile:

David Said:

All of the above is why I said that you are at a good point in your
career to ride the PCT pony. As a student, and as part of a

research

project, you could evaluate the therapeutic benefits of MOL

Therapy

exclusively for people who fall in certain diagnostic categories.

After

a trial of MOL Therapy one would reevaluate the patient. If no
significant gains occurred then the person could be referred for
standard treatments.

What utter BS. As I said before, we all like to eat. Why not just say
so David. The reason you deal with certain kinds of "diagnostic
categories" (don't even think of getting me started on the DSM :-))
and certain "standard treatments" is because that is _how_ you make
your _living_. It is certainly _not_ based on the _fact_ that these
"diagnostic categories" _exist_. It is not based on the _fact_ of
_known_ "cure" rates. It is all based on BS. Top to bottom.

Tim replied:

If I can possibly get an opportunity to do this at all, I'll be going

for
.it without a doubt. And if it doesn't happen while I'm on the course,
it

*will* happend once I graduate.

I bet it will.

David said:

Seligman, the current present of the American Psychological
Association, has edited a book called effective therapies. By

looking

at this book, you could get a sense of what is considered to be

the

established treatment approaches for a wide variety of problems.

Who made him god? . What specifcally makes _him_ rather then say Bill
Powers or Rick Marken (Nice ring to it. President Marken :-))
_qualified_ to designate treatments for conditions no one really knows
exists. Did the APA members vote on these treatments? What was the
criteria for submitting a "treatment"? How many successful treatments
does it take to get listed?

Tim replied:
I have a couple of books that give a run down on different therapies.
My
opinion is, is that they're all making guesses at what works (some are
guessing better than others) because they don't have a plausible model
of
how humans are put together to base their "stories" on.
But this is starting to go over old ground. You and Dick both have
much
more experience at this than I, so for the time being I'm bowing out.
I'll
defer to your experience from time in the trenches.
Thanks for your patience
Tim

_Very_ tactful Tim.:slight_smile:

Marc

[From Tim Carey (980206.0620)]

>From [Marc Abrams (980204.1145)]

Fellas, Hope ya don't mind but I'm gonna jump into this one :slight_smile:

Hi Marc,

Thanks for your post ....

I think its simply a matter of keeping ones job. If you do not do what
is _prescribed_ by the powers that be you don't work. It's really
pretty simple. It doesn't matter wether it works or not. Doesn't even
matter if its useful. If its the prescribed course of action and the
insurance companies will pay for it (thats probably _the_ certifying
body in the medical domain) then lets do it.

.... And if that's what's going on that's fine. I like to eat as much as
the next person. If I was in this position, however (and I may well be with
the course I'm doing and the strong 'cognitive-behavioural' ethos that is
at the university) I wouldn't kid myself for one minute that I was doing
these things because that was the responsible or ethical or scientific
thing to do.

Actually, wouldn't it be ironic, if, in years to come when PCT is accepted
as *the* theoretical perspective in the life sciences, and PCT methodology
is *the* methodology by which important research is done, and MOL is *the*
therapeutic approach derived from scientific principles that is taught as
*the* therapeutic approach to be used when people are having problems of a
control nature (which would probably be everything) and their problems are
no longer identified by the DSM-IV ..... yes, wouldn't it be ironic if
people who knew PCT and MOL and didn't use it were the ones in danger of
litigation??

When survival in the job is *actually* the case then I think you should do
whatever is required so that you (a) keep the job and (b) sleep at night.
Often, though, we have a lot more freedom in our jobs than we think we do.
I have worked as a behaviour management specialist with the education
department (over here our education is state governed) for a number of
years. In the early days, I was a behaviourist from hell. I could shape and
chain and reinforce and extinguish with the best of them (poor deluded soul
that I was). Once I discovered PCT and Ed Ford's RTP as an application of
PCT there was no going back. When schools would call me out to work with a
kid, I would explain how I worked and what I could do, and if they didn't
want what I could offer, they got another behaviour specialist. I
understand Mark Hammill in Amarillo, Texas (Mark also used Ed's approach)
does the same thing. After learning PCT, I would have seen it as
irresponsible of me to establish token economies or fancy reinforcement
schedules, etc., etc.

Thanks again for your post, Marc. I'd be really interested to know how MOL
goes in the business setting.

I really didn't mean for this long conversation to get into a discussion on
what is or is not "responsible" in the work place. My only issue is with
using MOL as a "tool". For me personally, I don't understand how people can
believe in PCT on the one hand, and use therapeutic procedures that are
inconsistent with the theory on the other. Maybe you're right, it might
will be a case of higher priority references.

In fact, this idea of being ecclectic seems only to come from
practitioners. In the reading I have done on different therapeutic
approaches (Rogers, Adler, Perls, Freud, Ellis, Beck, etc., etc.,), I have
*never* read anywhere these guys advocating that *their particular approach
be used as a tool along with other therapeutic interventions.

Has any reseach been done on the validity of ecclecticism? Is there an
actual ecclectic package that tells which quantities of which approaches to
use with which disorder? If not, don't you need to be concerned about the
legal issues if you use an ecclectic approach?

I'm aware I'm getting less tactful :wink: (oooh, I think I just jumped to
another level!!)

I'm off to MOL myself .... (which is the equivalent of taking my bat and
ball and going home)

Good talking to you Marc,

Cheers,

Tim