In 2005, Dr. Ronald L. Levant (president of the APA
), aware of the above history, penned a daring initiative meant to nudge clinical psychology toward an evidence-based model and away from its present reliance on anecdote and belief. But I think Dr. Levant may have misjudged the present state of clinical practice — on hearing his proposal, rank and file psychologists reacted with a mixture of panic and fury. Here is a quote from Dr. Levant's later defense:
Evidence-based practice in psychology (APA, 2005)
: "Some APA members have asked me why I have chosen to sponsor an APA Presidential Initiative on Evidence-Based Practice (EBP) in Psychology, expressing fears that the results might be used against psychologists by managed-care companies and malpractice lawyers."
The rank and file are right, of course. Any effort to move clinical psychology toward an evidence-based model would expose what until now has been a well-kept secret — clinical psychology is not remotely evidence-based, relying instead on anecdotes, dubious extrapolations from animal research, poor-quality retrospective studies and simple belief. To publicly air these facts would trigger a number of legal and practical consequences that psychologists would be wise to avoid. And so far, they have — after a brief uproar in 2005, the APA proposal has been shelved.
In his most revealing sentence, Dr. Levant says, "... psychology needs to define EBP in psychology or it will be defined for us." This acknowledges something that Levant emphasizes in his article — EBP is a proposal
, a wish
, not a reality. Scientific psychology lies in the future — at present, we only have the acronym.
During the 2006 meeting of the American Psychological Association, psychiatrists admitted they have no scientific tests to prove mental illness and have no cures for these unproven mental illnesses (more here
). I've always thought the first step to learning something new is to acknowledge one's own ignorance. It seems the professionals are willing to take this first step.