The Behavior Therapist
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ISSN 0278-8403 ASSOCIATION FOR BEHAVIORAL AND COGNITIVE THERAPIES VOLUME 37, NO. 3•MARCH 2014 the Behavior Therapist President’s Message Contents Media, Science, and President’s Message Cognitive-Behavior Dean McKay Therapy Media, Science, and Cognitive-Behavior Therapy • 53 Dean McKay, Fo rdham University Clinical Tr aining Update Torrey A. Creed, Shannon Wiltsey Stirman, When The New Yo rk Times scratches its head, get Arthur C. Evans, and Aaron T. Beck ready for total baldness as you tear out your hair. A Model for Implementation of Cognitive Therapy in —CHRISTOPHER HITCHENS Community Mental Health: The Beck Initiative • 56 cience reporting in the media can be the source Sof considerable frustra- Science Forum tion. FoR example, how often Michele Berk, Molly Adrian, Elizabeth McCauley, have you thought that science Joan Asarnow, Claudia Avina, and Marsha Linehan reporting was oversimplified, Conducting Research on Adolescent Suicide Attempters: and/or overly alarming? How often have you heard contra- Dilemmas and Decisions • 65 dictory science reports occurring within days of one another? In a thorough evaluation of the fac- tors contributing to this, one would identify The Lighter Side problems in science education, public interest in Jonathan Hoffman and Dean McKay small and easy-to-digest findings, and, in all CBTers ASSEMBLE!! Episode 1: “A Tweet for Help” • 70 likelihood, a proneness by the media for sensa- tionalism. However, when it comes to how CBT is reported upon, it appears that change is slowly At ABCT taking place, and in a positive direction. A few years ago I reported in these pages on Call for Applicants • 75 media biases in how CBT was presented com- pared to psychoanalytic approaches and psy- chopharmacology (McKay, 2010). At that time, my concerns were significant. My survey of the available articles in The New York Times sug- gested that CBT was mischaracterized, underre- ported, and/or unfairly lumped together with other approaches that had lower efficacy rates. http://www.abct.org CBT was also reported consistently as a new tBT is now therapy, despite these same reports presenting Journals ON-LINE ! methods that have been available for well over the Behavior Therapist 40 years, at least since the founding of ABCT.By 2005–present ! the time I completed my article, my reaction [continued on p. 55] March • 2014 53 the Behavior Therapist Published by the Association for Behavioral and Cognitive Therapies 305 Seventh Avenue - 16th Floor New Yo rk, NY 10001-6008 (212) 647-1890/Fax: (212) 647-1865 www.abct.org EDITOR ·············· Brett Deacon Editorial Assistant . Melissa Them Behavior Assessment . Matthew Tu ll Book Reviews ··········· C. Alix Timko Clinical Forum ············· Kim Gratz Clinical Dialogues . Brian P. Marx Clinical Tr aining Update . .Steven E. Bruce Institutional Settings. Dennis Combs Lighter Side ············ Elizabeth Moore Medical and Health Care Settings . Laura E. Dreer News and Notes. Nicholas Forand OTING James W. Sturges Shannon Wiltsey-Stirman electronic Professional and Legislative Issues . Susan Wenze V Public Health Issues. Giao Tr an Research-Practice Once again, we offer you, the members of ABCT, the opportunity to elect officers Links David J. Hansen ················ electronically. All full members and new member professionals who are in good Research-Training Links ··················· Stephen Hupp standing will receive emails with a unique username and password for voting. We will alert you as to when the election portal is open: April 1. We will send Science Forum··········· Jeffrey M. Lohr Special Interest emails to your primary email address only, where you receive emails from ABCT. Groups ·············· Aleta Angelosante Student Forum ·········· David DiLillo Te chnology Update. Steve Whiteside INSTRUCTIONS Ñçê AUTHORS ABCT President . ... ..Dean McKay The Association for Behavioral and Submissions must be accompanied by Executive Director······ Mary Jane Eimer Cognitive Therapies publishes the Behavior a Copyright Tr ansfer Form (a form is Director of Education & Therapist as a service to its membership. printed on p. 35 of the February 2011 Meeting Services . Mary Ellen Brown Eight issues are published annually. The issue of tBT, or download a form from our Director of Communications David Te isler purpose is to provide a vehicle for the rapid website): submissions will not be reviewed dissemination of news, recent advances, without a copyright transfer form. Prior to Managing Editor..... Stephanie Schwartz and innovative applications in behavior publication authors will be asked to sub- Copyright © 2014 by the Association for Behavioral therapy. mit a final electronic version of their man- and Cognitive Therapies. All rights reserved. No Feature articles that are approximately uscript. Authors submitting materials to part of this publication may be reproduced or trans- tBT do so with the understanding that the mitted in any form, or by any means, electronic or 16 double-spaced manuscript pages may mechanical, including photocopy, recording, or any be submitted. copyright of the published materials shall information storage and retrieval system, without be assigned exclusively to ABCT. permission in writing from the copyright owner. Brief articles, approximately 6 to 12 Electronic submissions are preferred and Subscription information: the Behavior Therapist is double-spaced manuscript pages, are published in 8 issues per year. It is provided free to should be directed to the editor at ABCT members. Nonmember subscriptions are preferred. [email protected]. Please include available at $40.00 per year (+$32.00 airmail Feature articles and brief articles postage outside North America). the phrase tBT submission and the au- Change of address: 6 to 8 weeks are required for should be accompanied by a 75- to thor’s last name (e.g., tBT Submission - address changes. Send both old and new addresses to 100-word abstract. Smith et al.) in the subject line of your e- the ABCT office. ABCT is committed to a policy of equal opportu- Letters to the Editor may be used to mail. Include the corresponding author's nity in all of its activities, including employment. respond to articles published in the e-mail address on the cover page of the ABCT does not discriminate on the basis of race, color, creed, religion, national or ethnic origin, sex, Behavior Therapist or to voice a profes- manuscript attachment. Please also in- sexual orientation, gender identity or expression, sional opinion. Letters should be lim- clude, as an attachment, the completed age, disability, or veteran status. ited to approximately 3 double-spaced copyright transfer document. All items published in the Behavior Therapist, including advertisements, are for the information of manuscript pages. our readers, and publication does not imply endorse- ment by the Association. 54 was largely consistent with how Hitchens ment is sufficient and that the empirically ability of training in our treatment meth- suggested one would be when reading the supported treatments were no better than ods. This in turn will hopefully have the ef- newspaper of record for the United States. treatment as usual. This drew a series of fect of increasing the likelihood that clients In the intervening years since my survey, critical comments. Anestis, Anestis, and receive empirically supported interventions. it appears that the situation has been im- Lilienfeld (2011) noted that Shedler was It is here that I would like to share an proving for how CBT is portrayed in the highly selective in his review of the litera- anecdote. In my years as a practitioner, I media. In my admittedly unscientific fol- ture in drawing his conclusions. I noted that have had many clients who have reported low-up search of The New York Times for the Shedler overlooked the absence of validated receiving non-empirically-based therapy past 12 months (as of this writing, on mechanisms in general psychotherapy, and before coming to my office. Worse, many of January 30, 2014), I found 11 articles in that a common factors approach did not these same clients knew the kind of treat- which CBT was featured.1 But in my esti- leave clinicians with guidelines should ment that was appropriate for their condi- mation, what was more striking was that treatment fail (McKay, 2011). Tr yon and tion, went to providers who claimed they some of these articles emphasized the need Tr yon (2011) noted that common factors could and would conduct this form of treat- for consumers to seek out “evidence-based were part of any good therapeutic enter- ment, only to later offer excuses for why it treatments” (i.e., Brown, 2013). This is a prise at a minimum, and so any treatment was not applicable in the client’s particular marked change from 2010, when the pic- should advance beyond the efficacy of gen- case. Informally, I will note that this unique ture I observed was fairly bleak. eral psychotherapy, which CBT succeeds in subgroup of clients typically did their due accomplishing. Thombs et al. (2011) noted Where Are Things Going? diligence and asked prospective clinicians if that Shedler’s examination of existing they had been properly trained in the meth- Progress in how CBT is presented to the meta-analyses was flawed because of an un- ods of therapy they sought. The clinicians public via the media is indeed encouraging, critical acceptance of the available studies, all “passed” the client interview and were rather than a more careful parsing of the if we rely on The NeW York Times as a guide. able to substantiate that they had indeed re- findings from well-controlled trials of psy- Nonetheless, we cannot afford to be com- ceived some form of training (typically chodynamic therapy. Shedler, in his reply placent. While the media portrayal has im- workshops). And yet, these clients did not (2011), asserted, “Over the past two proved, if The New York Times is any guide, it receive the treatment they sought—but decades or so, a ‘master narrative’ has is unfortunately just one outlet in an ever- they had the kind of savvy to know what emerged in the academic world that psy- expanding network of sources clients may they needed.