Wednesday, August 17, 2016
Life's Little Ironies: Arthur Becker-Weidman Instructs ATTACh About Evidence-Based Treatment
I usually avoid looking at the website of ATTACh (Association for the Treatment and Training of Attachment in Children), the parent-professional organization that pushes the belief that emotional attachment is behind most unwanted behavior-- also, that they know how to “fix” this. However, my attention was called to the brochure for ATTACh’s September 2016 conference by a prospective adoptive parent who is being strong-armed to attend. I had a look at it to see what speakers were scheduled. There were some goodies:
Lark Eshleman-- was the therapist for the family of Nathaniel Craver, a Russian adoptee who died, apparently as the result of abuse.
Terry Levy-- one of the old school of holding therapists. He edited a book that included advice to limit quantity and variety of food as part of treatment for Reactive Attachment Disorder.
Michael Trout-- according to lectures he gave for the Association for Pre- and Perinatal Psychology and Health (APPPAH), he believes that attachment occurs before birth and that the fetus is conscious of what the mother says, does, and thinks about. (Yes, just what Scientologists think.)
But the cream of the brochure is that Arthur Becker-Weidman is presenting about evidence-based treatments! This is really quite unbelievable, because B-W has repeatedly published the claim that Dyadic Developmental Psychotherapy is an evidence-based treatment when it is quite clearly not eligible for that category. I won’t get into the whole story here, but it is recounted in detail at http://www.springer.com/psychology/personality+%26+social+psychology/journal/10560/PS2. (This is free to readers and is the last article in the table of contents you will see.) I don’t know whether the problem between them was this tendency to make unfounded claims, or what, but it is clear that Daniel Hughes, the originator of Dyadic Developmental Psychotherapy, has cut his former colleague B-W adrift and no longer even mentions their co-authored publications about DDP. I am not sure Hughes ever mentioned B-W’s retracted papers.
I’ve never completely understood why B-W has made and repeated his unfounded statements about the evidence basis of DDP. Does he actually not know what is required before a treatment can be said to be evidence-based? Or can it be that (not unlike some others) he simply regards the evidence-based designation as a marketing tool that can be used to sell a treatment—and to sell himself as a lecturer and trainer?
In either case, what on earth is ATTACh doing, allowing him to further entrench himself as a therapist and adviser to adoptive families? Well… I suppose the answer is obvious. ATTACh is using its annual conference to attract parents and quasiprofessionals and to make them more willing to purchase the organization’s services and publications. ATTACh used to do this by talking about attachment all the time; now they do it might repeating current buzzwords like “trauma” and “evidence-based treatment” (EBT). The connection between EBT and treatment funding /insurance coverage is a value-added factor for ATTACh’s sponsorship of a presentation on EBT—especially one whose past approaches to the issue have been highly problematic.
Is it important for people attending the ATTACh conference to understand what an EBT is? It would be good in a general way if they knew this, of course, but I find it difficult to imagine taking a mixed audience of people who just want to know how to raise adopted children, and trying to convey to them the nature of random assignment to groups, the problem of confounded variables, statistical significance and effect size, and quite a few other things that are involved in deciding whether a treatment should be called evidence-based—in an hour or two. (I make this statement as one who spent some 30 years teaching psychological research methods.) Most people are quite willing to accept testimonials and anecdotes as “evidence” and become bored very soon with any argument saying there is evidence that is more important than personal experience. Also, they don’t like math, and to teach this properly there has to be some math.
If I were running the ATTACh conference—an idea that no doubt would draw gasps of horror from the ATTACh board-- I would organize a presentation about the use of Internet sources to look up evaluations of the evidence for a treatment. Although they are far from perfect, the California Evidence Based Clearinghouse for Child Welfare, the National Registry of Evidence-based Programs and Practices, and Effective Child Therapy all provide extensive resources for checking into whether a child mental health intervention has been strongly supported by empirical work. Adoptive parents who know how to use these websites can spare themselves and their children some regrettable tangles with ineffective or even harmful treatments.
But if ATTACh simply must get EBT into the discussion, let them get a presenter whose history shows that he or she can do the job properly.