Ranked by page views.
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2013 was a big year here on the blog. I’ve crossed 250K pageviews, which is certainly humbling, and broke my monthly traffic record multiple times. Here are the four posts that drew the most eyeballs in 2013, counting down to the top:
DivorceCorp opens in January. It looks great — with one little caveat.
Divorce is big business. Many people can have a hand in the divorce process: lawyers, mediators, custody evaluators, therapists, court systems, and others all say they want to help divorcing couples. And all want to be paid for their services. The entire system can suffer from what might rightly be called perverse incentives — strong pulls for people to act in ways that are more out of self-interest than the true long-term best interest of the couple they claim to be trying to help.
This is the thrust of the documentary DivorceCorp, opening in major cities January 10. The movie looks good and important. Dr. Drew narrates, and it features interviews with some well-known law experts, including Gloria Allred. Here’s the trailer: More information on the film, including local theaters showing the film when it opens, can be found on the official DivorceCorp website. One cautionary note, though: The opening statement in the trailer, “50% of all US marriages end in divorce,” is wrong. As you can read about in more detail over at the excellent DivorceSource web site, the US divorce rate probably never topped 41% and has been declining for several years. As Tara Parker-Pope documented quite well in her book For Better, divorce rates are especially low among those with at least a college education. Over Twitter, the film’s reps have said that there were bigger fish to fry, so to speak. I get that. They’re looking at an entire divorce industry, and my caution is with one statistic. I believe the social conversation about the divorce rate is one specific part of the larger social conversation about divorce that especially needs to change, for reasons I’ll save for a separate post, but don’t let that take you away from the big picture. I’m happy to support the film and eager to see it. # # # Your comments are welcome. You can post them in the comments below, by email to ben[at]bencaldwell[dot]com, or on my Twitter feed.It isn’t experience, and it isn’t the kind of training we usually do.
I’m blogging this week from the Evolution of Psychotherapy Conference in Anaheim, where many of the world’s leaders in psychotherapy gather to discuss the state of the field and share new and innovative research findings.
Therapy is tremendously effective. The average treated client ends up better off than 80% of untreated people with similar problems. Psychotherapy for mental health problems is as effective as coronary bypass surgery for heart problems and four times as effective as flouride toothpaste in preventing dental problems. But we’re not getting better, Scott Miller said in yesterday’s opening workshop.
Miller summarizes our field’s efforts to figure this out thusly: We started by looking at our treatment models, hoping to build better techniques to reach better outcomes. This is where many training programs still live: We teach manualized, empirically-supported treatments in hopes that it will make for the most effective therapists. Except it doesn’t; the models formalize and standardize our work, but they don’t make us any more effective, according to outcome studies.
So we then moved to looking at common factors, those things that work across all theoretical models. But teaching common factors doesn’t seem to make us more effective, nor does it relieve the need to know specific models, since it is through those models that the common factors work. (My good friend Sean Davis has the leading text on common factors in couple and family therapy, and in it he makes the same point.)
So the focus then shifted to the study of outcomes rather than methods, and what we found was that some therapists consistently achieve better outcomes than their peers. That has moved the field into a close examination of excellence and expertise.
The findings there are striking, and I can’t do them full justice here — I’ll address the training issues in more detail in a future post. But the short version is this: We don’t spend a ton of time training students to do the things that actually seem to make them better therapists (“better” here meaning more effective). Miller cited a vast literature identifying deliberate practice — not just more hours seeing clients, but significant time focused on reviewing weaknesses in those sessions while not actively in them and then taking action to address those weaknesses — as the key task in making people more effective. What I hear in my therapy-teacher framework: We need to be doing a lot more videotaping.
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Your comments are welcome. You can post them in the comments below, by email to ben[at]bencaldwell[dot]com, or on my Twitter feed.
When can a therapist decide their own morals and values outweigh those of their clients?
The AAMFT has kindly made my article on conscience clause laws in mental health the cover story for the September issue of Family Therapy Magazine. You can read the article here if you’re an AAMFT member.
Of course I’m biased here, but I think you’ll find it worth the read. While I’ve written about the topic a few times here on the blog (most recently, I wrote about conscience clause laws being considered in Washington, Texas, Arizona, and Michigan), my focus here has been much narrower than it is in the magazine. In the FTM piece I take a broad look at the issue, from the origins of conscience clauses to the best arguments for and against them. While these laws are often spurred by a desire to protect religious practitioners, you don’t need to be religious to be impacted by them, and you might be surprised at what the laws would appear to allow:Is this a price worth paying to protect therapists’ moral views? My skepticism is raised when considering that the religious practitioners and legislators backing these bills often seem to have a desire to legitimize discrimination against gay and lesbian clients. So, you know, that’s not okay. But the issue isn’t black and white, as I hope the magazine article illustrates. In addition to the main article, a sidebar I had written about conscience clause laws being considered or adopted in various states around the country was transformed into a really cool national map infographic. I wish I could take credit for that — it’s great visual layout — but that’s all magazine staff. Check it out. # # # I have another article in the works proposing a way therapists could consider the appropriateness of a conscience-based referral, within the fuzzy boundaries of existing law and the existing AAMFT Code of Ethics. So stay tuned for that (for several months, in all likelihood, but I’ll keep you updated). Your comments are welcome. You can post them in the comments below, or email me at ben[at]bencaldwell[dot]com.Most conscience clause laws are so broadly written that they could allow […] therapists to refuse to treat sexually active unmarried couples, or therapists morally opposed to immigration to refuse treatment to clients based on nationality, even in a mental health emergency.
Of course salary numbers in mental health look bad when you leave out people with the graduate degrees necessary to practice.
NPR ran a story last month punctuated by a graph of the highest- and lowest-earning college majors. The worst on the list, by far, was Counseling Psychology. Those who majored in Counseling Psych brought in a median income of under $30,000 per year.
No one gets into mental health care for the money, but the numbers were a black eye for the Counseling field — the American Counseling Association has even responded by commissioning its own study of salaries among its members.
But there was a big problem with that original chart, one that the researchers themselves had noted but which was often ignored in discussions of their findings: It didn’t include people with graduate degrees.
In just about any mental health field, you need at least a master’s degree to practice. Those who don’t take that extra step are often limited to very basic, entry-level jobs with little hope for advancement.
So NPR is back this week with another chart, one that includes graduate-degree earners. And Counseling Psychology no longer shows up on the list of the 10 lowest-earning undergraduate majors. Counseling Psych majors get a big bump in median incomes when you include those who go on to advanced degrees, as should be expected.
Notably, social work stayed in the bottom 10, even when those who get their graduate degrees are included. Their median incomes went from just under $40,000 a year (with graduate degree earners excluded) to about $45,000 a year (with graduate degree earners included).
It’s hard to place family therapy here, since MFTs come from a wide variety of undergraduate majors, most commonly (but by no means exclusively) psychology or family studies. For MFT salary data, the best place to start is this Bureau of Labor Statistics page.
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Your comments are welcome. You can post them in the comments below, by email to ben[at]bencaldwell[dot]com, or on my Twitter feed.