Florida State University Libraries Electronic Theses, Treatises and Dissertations The Graduate School 2009 The Use of Novel Unsupported and Empirically Supported Therapies by Licensed Clinical Social Workers Monica Pignotti Follow this and additional works at the FSU Digital Library. For more information, please contact [email protected] THE FLORIDA STATE UNIVERSITY COLLEGE OF SOCIAL WORK THE USE OF NOVEL UNSUPPORTED AND EMPIRICALLY SUPPORTED THERAPIES BY LICENSED CLINICAL SOCIAL WORKERS By MONICA PIGNOTTI A Dissertation submitted to the College of Social Work in partial fulfillment of the requirements for the degree of Doctor of Philosophy Degree Awarded: Fall Semester, 2009 The members of the committee approve the dissertation of Monica Pignotti defended on June 18, 2009. 8 __________________________ Bruce A. Thyer Professor Directi g Dissertatio 8 _________________________ Ke eth Brummel8Smith U i3ersity Represe tati3e 8 _________________________ Martell Teasley Committee Member Appro3ed. _________________________________ Nicholas Ma::a, Dea , College of Social Work The Graduate School has 3erified a d appro3ed the abo3e8 amed committee members. ii I dedicate this to my pare ts, Alfio a d Ruth Pig otti, who ha3e always supported a d e couraged me i pursui g my educatio a d excelle ce i all I do a d who i stilled i me the stro g work ethic it takes to complete a doctoral program. iii ACKNOWLEDGEMENTS I would like to ack owledge a d tha k all of the people who stimulated a d e couraged my i terest i the topics of e3ide ce8based practice, critical thi ki g, a d disti guishi g scie ce from pseudoscie ce i me tal health practice i cludi g Drs. Bra do A. Gaudia o, Richard Gist, 4ames D. Herbert, Scott O. Lilie feld, 4effrey M. Lohr, Ste3e 4ay Ly , Richard 4. McNally, 4oh Riolo, a d Gerald Rose . Dr. Riolo was the first perso i the social work professio I had co tact with who expressed co cer s a d skepticism about u supported claims bei g made about o3el i ter3e tio s o the I ter et a d I am 3ery grateful for the issues he made me aware of. The other i di3iduals listed abo3e bega as critics of earlier 3iews I held, but through my ow exami atio of their criticism, I ha3e come to recog i:e the 3alidity of ma y of the poi ts they raised, which I ow tha k them for raisi g a d for the support a d e courageme t they ga3e me to pursue my studies i this area. I would also like to tha k each of my Committee members. Tha ks go to my committee chair, Bruce Thyer for all of the treme dous support a d e courageme t he has gi3e me throughout my doctoral program, ot o ly for the writi g of my dissertatio but also for gi3i g me the opportu ity to co8author publicatio s a d for all the support he has gi3e me with my job search. I also wish to tha k Charles Figley, who was i itially part of my committee before his mo3e to a differe t faculty positio , for all his support a d passio for de3elopi g effecti3e i ter3e tio s for trauma. Dr. Figley was the o e who i itially e couraged me to apply to a d atte d Florida State U i3ersity’s doctoral program. I also tha k Dr. Martell Teasley for steppi g i as a committee member after Dr. Figley’s departure a d for all the support he has gi3e me as a professor, i my job search, a d as a committee member. Tha ks also go to Dr. Ke eth Brummel8Smith for bei g my outside committee member a d co tributi g his expertise a d his excelle t feedback that has impro3ed this ma uscript. I am also grateful to Drs. Bra do Gaudia o a d Ia Sharp for bei g my expert re3iewers for classificatio of the i ter3e tio s my respo de ts reported. As published experts i this area, their expertise was 3ery much 3alued a d appreciated a d greatly appro3ed the 3alidity of my assig me t of i ter3e tio s to categories a d thus, the ,uality of this dissertatio . i3 TABLE OF CONTENTS List of Tables 3ii Abstract 3iii 1. CONCEPTUAL OVERVIEW AND PROBLEM STATEMENT 1 1.1 I troductio 1 1.0 Pseudoscie ce 0 1.3 A tiscie ce 7 1.4 New Age Therapies 8 1.A No3el U supported Therapies (NUTsC 2 1.D E3ide ce8Based Practice a d Empirically Supported Therapies 11 0. LITERATURE REVIEW 1A 0.1 I clusio Criteria 1A 0.0 Database a d Search Terms 1A 0.3 Summary of Studies o Social Workers Prior to 1221 1D 0.4 I 8Depth Re3iew of Studies Co ducted si ce 1221 18 0.A Summary a d Co clusio s 07 0.D Ide tificatio of Gaps i the Literature a d Recomme datio s for Future Research 08 3. RESEARCH EUESTIONS, HYPOTHESES AND METHODS 31 3.1 Research Euestio s 31 3.0 Hypotheses 31 3.3 Methods 31 4. RESULTS 41 4.1 Sample Descriptio 41 4.0 Practice Characteristics 40 4.3 A alysis of early 3s. late respo ders 4A 4.4 Research Euestio 1 4A 4.A Research Euestio 0 4A 4.D Research Euestio 3 42 4.7 Research Euestio 4 A1 4.8 Research Euestio A A1 4.2 Research Euestio D A1 4.11 Research Euestio 7 AD 4.11 Research Euestio 8 A7 4.10 Hypothesis 1 A7 4.13 Hypothesis 0 A8 4.14 Hypothesis 3 A8 4.1A Hypothesis 4 D1 4.1D Hypothesis A D1 3 A. DISCUSSION, CONCLUSIONS AND IMPLICATIONS FOR SOCIAL WORK PRACTICE D0 A.1 Key Fi di gs D0 A.0 Study Limitatio s DD A.3 Recomme datio s for Future Research D7 A.4 Implicatio s for Social Work Practice 71 APPENDICES 73 A. NOVEL UNSUPPORTED PRACTICES ON THE INTERNET 73 B. SYSTEMATIC LITERATURE REVIEW 7D C. DATA COLLECTION INSTRUMENT 28 D. IRB APPROVAL LETTER 117 REFERENCES 112 BIOGRAPHICAL SKETCH 101 3i LIST OF TABLES Table 1 Sample Descriptio . Demographics 41 Table 0 Practice Descriptio 40 Table 3 Areas of speciali:atio amed by participa ts 44 Table 4 I ter3e tio s me tio ed most fre,ue tly by each particular respo de t 4D Table A I ter3e tio s a d assessme t procedures respo de ts reported curre tly usi g i a y fre,ue cy withi the past year a d i the past/disco ti ued 47 Table D Usage of NUTs, CUTs, CNUTs, a d ESTs A1 Table 7 Relatio ship betwee Demographics a d Number of NUTs, CUTs, CNUTs, a d ESTs A1 Table 8 Relatio ship betwee Demographics a d Usage of NUTs, CUTs, a d CNUTs (dichotomi:edC A0 Table 2 Relatio ship betwee Practice Characteristics a d Number of NUTs, CUTs, CNUTs, a d ESTs A3 Table 11 Relatio ship betwee Practice Characteristics a d Usage of NUTs, CUTs, a d CNUTs (dichotomi:edC A4 Table 11 Relatio ship of use of NUTs, CUTS, a d ESTs a d CBT Theoretical Orie tatio to EBPAS scores AD Table 10 Relatio ship of reaso s for choosi g i ter3e tio s to CBT theoretical orie tatio A2 Table 13 Examples of o3el u supported practices by lice sed cli ical social workers promoted o the worldwide web 73 Table 14 Summary of studies re3iewed o theoretical orie tatio , therapy choice, a d attitudes towards EBP or ESTs 7D 3ii ABSTRACT I rece t years there has bee a growi g i terest regardi g the i tegratio of e3ide ce8 based practice i to social work curricula a d practice (Howard, McMille , G Pollio, 0113H Thyer, 0114C. Howe3er, there has also bee a growi g co cer about the proliferatio of o3el i ter3e tio s that lack empirical support a d yet make claims of efficacy i the abse ce of e3ide ce (Thyer, 0117C as well as co 3e tio al social work i ter3e tio s that lack empirical support a d yet remai u ,uestio ed (Gambrill, 011DC. Although studies ha3e bee co ducted that ha3e exami ed the theoretical orie tatio s a d other practice patter s of cli ical social workers, to date, with the exceptio of the pilot study (Pig otti G Thyer, 0112C that preceded this dissertatio , o study has systematically exami ed the i ter3e tio choices of lice sed cli ical social workers (LCSWsC i cludi g the use of o3el u supported therapies. The prese t dissertatio exami ed the reported usage of o3el a d co 3e tio al u supported a d empirically supported therapies by 411 LCSWs from 32 differe t states who respo ded to a I ter et sur3ey. The purpose of the study was to determi e what i ter3e tio s were reported curre tly bei g used by LCSWs, reaso s for choosi g i ter3e tio s, a d their attitudes towards e3ide ce8based practice. Prior to data a alysis, the list of the therapies reported bei g used by LCSWs was prese ted to a pa el of expert re3iewers a d therapies were classified as empirically supported therapies (ESTsC, o3el u supported therapies (NUTsC or co 3e tio al u supported therapies (CUTsC.