Monday, October 28, 2013

34 YEARS the Feds. say nothing less than measurable proof of therapeutic success would be acceptable

From "Coping with Psychiatric and Psychological Testimony", by Dr. David Faust,  and Jay Ziskin

If this was quoted in 1979 to psychologist in the monthly magazine the monitor.  Why are all
the Federal Agencies continue to promote pseudoscientifically procedures?  Patients have the
right to know, and we should cause a big fuzz and write to the directors and chiefs of this
federal agencies.  Perhaps I will make a list of emails for you all to write to them.

This Evidence Based treatment have fallen in deaf ears. In fact the first record I find is
in the Chief of what is not SAMHSA back in the 1970, for those who are interested I find the
reference..... In fact I just found it. it was a Dr. Gerald Klerman, in 1979 wrote to the American
Psychiatric Association in APA's magazine The Monitor November 1979 page 9. quoted as
saying that nothing less than measurable proof of therapeutic success would be acceptable
to the government. "One can not demonstrate the efficacy of therapy in terms of the
"INTENTION OF ITS PROPONENT... never can a therapy can be consider routine and
acceptable on the basis of testimony of authorities... it goes on.

Here is the whole article. If you want a copy of the actual "The APA Monitor this article came out in November 1979 I will be glad to do so. Please email me at

Klerman Challenges Professions To Prove Therapy Works
Alcohol, Drug Abuse and Mental Health Administration (ADAMHA) chief Gerald Klerman, addressing the annual meeting of the American Psychological Association in September, called on the mental health professions to take on the task of psychotherapy evaluation, noting that the promise of national health insurance and the consumer movement have led to a climate which demands more than custom as justification for reimbursement. Elaborating on an earlier speech in which he underscored the need,, to circumscribe legitimate mental health activity, Klerman told APA that nothing less-.than measurable proof of therapeutic success would be acceptable given the federal government's sizable and expanding role as a third-party payer. "We can attack the problem of defining boundaries in part by returning to the practical problem that many therapeutic methods are well intended; but poorly established in terms of safety, efficacy and economy. One cannot demonstrate the efficacy of a therapy in terms of the intentions of its proponents." "Neither can a therapy be considered routine and acceptable on the basis of the testimony of authorities--that is/ because outstanding •members of the profession are of the opinion that it is useful, safe and effective. I believe that only evidence as to outcomes will suffice in the rigorous climate of consumerism and health insuranc~ coverage."
Klerman pointed to the recently established National Center for Health Care Technology as a sign of the times. The center is currently evaluating 40 treatment methods for efficacy, including aversive drug treat- ment of alcoholism. "I view this as a possible prototype," Klerman said--"a 'shadow of the future.' Next year, evaluation of the efficacy of group treatment of family distress might be requested. Or of chlorpromazine for treatment of schizophrenia. Or Librium for sleep and anxiety." "The establishment of this center within a short time of the formation of the Health Care Financing Administration to tighten the federal reimbursement purse strings, in my view, makes it especially noteworthy," Klerman added. "As the federal third-party payer, HCFA dispenses dollars in the 'megabillion' range. It thus inevitably sets a tone which other reimbursers may follow." The public no longer accepts credentialing and licensure as sufficient guarantees of effective and safe service, Klerman said. "The new consumerism demands •a  new 10ok at these protections. It demands not just good training, but good services. It demands an evaluation not just of the state of the artist, but the state of the art .... If we don't respond, i~ will be brought upon us." W.H.

Please note that this article was written in 1979, that is over 34 years ago, and clinician continue to do their own thing and call it treatment.

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