1.4 Science and Clinical Practice

Again, psychology is the scientific study of behavior and mental processes. But it is also the application of scientific research to “benefit society and improve people’s lives” (American Psychological Association, 2018). By far the most common and widely known application is the clinical practice of psychologyThe diagnosis and treatment of psychological disorders and related problems.—the diagnosis and treatment of psychological disorders and related problems. Let us use the term clinical practice broadly to refer to the activities of clinical and counseling psychologists, school psychologists, marriage and family therapists, licensed clinical social workers, and others who work with people individually or in small groups to identify and address their psychological difficulties. It is important to consider the relationship between scientific research and clinical practice because many students are especially interested in clinical practice, perhaps even as a career.

The main point here is that psychological disorders are part of the natural world. This means that questions about their nature, causes, and consequences are empirically testable and therefore subject to scientific study. As with other questions about human behavior, we cannot rely on our intuition or common sense for detailed and accurate answers. Consider, for example, that dozens of popular books and thousands of websites claim that adult children of people who abuse alcohol have a distinct personality profile, including low self-esteem, feelings of powerlessness, and difficulties with intimacy. Although this sounds plausible, scientific research has demonstrated that adult children of people who abuse alcohol are no more likely to have these problems than anybody else (Lilienfeld et al., 2010).

Similarly, questions about whether a particular psychotherapy works are empirically testable questions that can be answered by scientific research. If a new psychotherapy is an effective treatment for depression, then systematic observation should reveal that people who are depressed who receive this psychotherapy improve more than a similar group of people who are depressed who do not receive this psychotherapy (or who receive some alternative treatment). An empirically supported treatmentA psychological treatment that has been shown to be effective in scientific research studies. is one that has been studied scientifically and shown to result in greater improvement than no treatment, a placebo, or some alternative treatment. The Society for Clinical Psychology website provides a detailed list of empirically supported treatments for psychological disorders. This list is quite extensive and continues to be updated as new research is conducted. Below is a small sample of treatments that are currently considered to have “strong” support.

At the same time, however, it is also true that many clinical practitioners do not value science as a source of knowledge about psychological disorders or their treatment. In fact, some are outright hostile to it—often claiming that the clinical practice of psychology is an “art” that cannot be evaluated according to scientific criteria (Dawes, 1994). Unfortunately, these attitudes can lead to the creation and spread of pseudoscientific and potentially harmful treatments. One such treatment is “past life regression therapy,” which is based on the assumption that people’s psychological disorders are caused by traumas they experienced in past lives. The treatment involves hypnotizing them and encouraging them to recall these traumas so they can cope with them more effectively in the present. Not surprisingly, there is absolutely no scientific evidence for any of these claims.

One of the great challenges of the field of clinical practice is continuing to promote the scientific approach—which has proved immensely fruitful—and discouraging the pseudoscientific and potentially harmful ones.