Forum, February 2010

Shout less, listen more

Heaven knows what Dr Freud would have made of the 'flashmob' of occupational psychologists trying to draw attention to themselves in Trafalgar Square. This apparently involved waving signs at passers-by, including 'I'm an Occupational Psychologist. Ask me what I do' (Society, January 2010).

Was this the result of some collective, continuing and unconscious search for the gleam in their mothers' eyes, some narcissistic desire for admiration? Perhaps not, but it did remind me of a profound and prescient remark by one of our own 'founding fathers' the late Sylvia Shimmin. She pointed out that the one great tradition in British occupational psychology was 'to give it all away'. We have clearly, given the need for a flashmob, been very successful at this. Indeed the Society itself has promoted this tradition with, for example, psychometric credentialing courses.

There is thus now a vast army of non-psychologists delivering an array of services that, when I trained 35 years ago, would be work more likely to have been delivered by  an in-house or external occupational psychologist. The demand for work psychology is there and has grown, it is just that we do not appear to have capitalised on this. We do not possess one of the hallmarks of a successful profession: a monopoly of competence.

The flashmob sadly, if anything, underlines our failure as a profession. And in a way the Charter has contributed to this. Simply going through the process of chartering does not guarantee anything for an occupation. It is a strategy that occupations pursue with differing levels of success. We may define ourselves as a profession, but the acid test is whether others accept our self-definition and thus the extent to which we gain control over our occupation and create a monopoly of competence. The need for a flashmob suggests we are almost a textbook case of a failed profession.

Worst still, chartering has convinced large numbers of people to extend their education (and thus debt) to acquire 'professional status'. In doing so they assumed that magically others would suddenly take more notice of them and hire them. The lack of any critical content on most MSc courses also means students are generally not exposed to the literature exploring the contested and problematic nature of professional status.

Anderson et al. (2001) in their centenary review provided a fascinating analysis of the increasing divide and tension between good, pragmatic, evidence-based psychology, and the popular psychology (high in relevance but low in rigour) that the business community finds so seductive. This tension is visible in the lack of critical detachment evident in much of current occupational psychology. We appear willing, along with non-psychologists delivering the same services, to promote fads, products and approaches that have very little scientific support. So perhaps in failing to differentiate ourselves we have lost our distinctiveness and our right to respect.

Clues about the causes of our failure as a profession are evident elsewhere. We appear to insulate ourselves from the external world assuming that expertise is enough. I was shocked to realise this over 20 years ago, when we appeared to be the only psychologists (outside of those employed by government agencies) aware that a Green Paper proposed assessing 629,000 redundant people for retraining. Such assessments had until this point been reserved for the elites in Society, such as redundant middle managers and public school children. This presented a huge logistical issue, how do you deliver assessment on this scale that would be recognisable and comparable in quality to that received by these elites? We set about developing a response in collaboration with a publisher and produced an inexpensive and effective response to this political priority.

This insulation is also seen in the lack of awareness of context more often than not seen in those leaving MSc courses. We have given up using an elementary-level quiz (Who is the Home Secretary? etc.) with candidates. Results are consistently depressing. This is not comparable to others of similar calibre applying for example into the Civil Service.

So perhaps above all we should do the opposite to the flashmob. Instead of jumping up and down and shouting about what we do, we should shut up, and listen more. We should be less self-important, less convinced that our expertise is enough. We should spend more time understanding the political, social and economic agendas that generate the challenges of organisational life in contemporary Britain. And then we might be in a better position to demonstrate how, as an occupation,
we might connect with these.
Peter Rhodes
Worthing

Reference
Anderson, N., Herriot, P. & Hodgkinson G.P. (2001). The practitioner-researcher divide in industrial, work and organizational (IWO) psychology: Where are we now ,and where do we go from here? Journal of Occupational and Organizational Psychology, 74, 391–411.

An ignored syndrome?

As a mother of a child with Down syndrome I was very interested to finally see reference to this condition in the pages of The Psychologist ('Music – shelter for the frazzled mind?', December 2009). While autism features in almost every edition, Down syndrome has had barelya mention in the last 10 years at least. However, Heaton's article was disappointing to me on several counts.

Firstly Heaton refers to 'Down's syndrome', though I note the reference to her original study did not use the old-fashioned 'apostrophe-s'. Secondly, and more offensively, Heaton refers three times to 'Down's syndrome participants', when the appropriate language would be 'participants with Down syndrome', a format I see she uses for those with autism.

Even this linguistic error (which the Down Syndrome Association have cautioned against for a long time) could be overlooked if not for the general tone of the article. Though Heaton specifically raises the question of supposed musical affinity in people with Down syndrome, she only briefly refers to their low levels of performance on a task to identify emotional depiction within music (which apparently does not detract from their appreciation of the music). Of course, this study with children and adolescents tells us little about the capacity of adults with DS to perform on such a task, especially since we know people with Down syndrome continue to learn at a greater pace well into their twenties. It also does not tell us about the full range of people with Down syndrome, since not all have 'verbal mental age scores significantly lower than chronological age scores'. While those with autism are identified as being on a spectrum of low to high functioning, there is no reflection in this article of the huge range of ability in those with Down syndrome.

Unfortunately, I fear that by including such a brief account, this article has given weight to a tired and patronising stereotype that children with Down syndrome love music, when in fact most children love music, so it is unsurprising that most with Down syndrome will demonstrate a 'positive affect' too. But clearly the purpose of mentioning Down syndrome in the article was not to address this group of people directly or to focus on the possibility and implications of increased musicality in those with Down syndrome, but to illustrate a point about autism. How fitting in a publication that focuses so much on this condition and never on Down syndrome! I challenge the editor to change this situation and encourage some informative and up-to-date articles on Down syndrome from the many psychologists engaging in highly beneficial work with this significant group of people who, despite experiencing exciting new horizons of personal development and achievement, still suffer prejudice and discrimination in wider society.

Georgina Hutchison
Huddersfield Down Syndrome Support Group

Jon Sutton, Editor of The Psychologist, replies: Challenge accepted – I will be contacting you about your own work, and looking for additional authors to write on the topic

Mr and Mrs FRS

We were delighted to read the article on the Friths' recent prize (News, January 2010), but very surprised to see that there was no mention anywhere of their status as Fellows of the Royal Society. This exceptional honour for scientific endeavour is rarely found in a married couple. They were, of course, honoured separately for their individual contributions, but, nevertheless, it seems to us to be a wonderful thing to have happened to a couple of psychologists, and should never be ignored!

Ann and Alan Clarke
Barnet
Herts

No such thing as society?

Mark Hayward, Elizabeth Holford and Peter Kinderman, introducing the special issue on social inclusion (January 2010), start: 'In 1988 Margaret Thatcher said: "There is no such thing as society". In contrast, psychologists believe that human beings are quintessentially social animals.'

Mrs Thatcher's remark is from an interview that she gave in October 1987 to Woman's Own magazine. She complained that too many people expected the government to solve their problems. She went on: 'They're casting their problems on society. And, you know, there is no such thing as society. There are individual men and women, and there are families. And no government can do anything except through people, and people must look to themselves first. It's our duty to look after ourselves, and then, also, to look after our neighbour.'

What she was talking about was not the nature of human beings, but the issue of responsibility. She implied, without quite stating, that 'society' is not an agent, such that it can solve individual problems. Government is such an agent, but in her view, not the right one, or at least not the one to be looked to first. She certainly did not say that we are not social animals, indeed she stressed families and neighbours.

Twenty years after her premiership, Margaret Thatcher continues to arouse strong feelings, for and against. The frequent quotation of this phrase, with varied, usually pejorative, applications, seems to me to illustrate the well-known effects of emotion on perception and recollection.

John Radford

Voting for or against

To its credit, the Labour government has since its instalment in 1997 tried to increase participation amongst the young section of the electorate, in local, national and EU elections. At the same time two processes have also been in train, and I wonder whether they are related, and whether any psychologist has or can obtain evidence to throw light on the matter.

The other two processes are a general reluctance of the youngest section of the electorate to participate in elections – where they have to vote for a candidate; and a proliferation of opportunities, in which by all accounts young viewers do participate, to vote against participants in television programmes. These programmes are widely labelled as representing reality, which may, by reaction, leave the youngest part of the electorate perceiving political elections as somehow not immediately real – or at least not exciting or 'socially inclusive'.

Psychology might help by seeking evidence that would either substantiate my hypothesis – in which case the political process might even consider changing the voting systems in 'real' elections; or we would have empirical reason to reject my hypothesis – in which case we would narrow the search for other reasons to explain the relatively low self-inclusionby the young electorate, in the body of opinion that influences their real futures.

Mallory Wober
London NW3

Sandwiches all around!

With great interest I read the article in the December issue discussing how the recession has boosted the uptake of placements within the psychology degrees that offer them. As a current placement student myself, I think it's one of the best decisions I ever made, choosing to opt for a placement year during my undergraduate degree at Aston University.

Of course the year break from exams and coursework is always welcomed, however this year is making me realise the invaluable importance of some practical experience within a psychology degree. Not only do I now have a much-needed opportunity to improve my theoretical knowledge, but crucially I now have an outlet to practically apply this information. Furthermore, I am finally being made aware, first-hand, of the options available to me once I graduate, due to having contact with team members who have been through the process. 

Sian Clancy
Aston University

What about gateway effects?

As many readers will be aware, November 2009 saw a fierce debate arise over the UK government's decision to upgrade cannabis from a Class C to a Class B drug, against the recommendations of the drugs advisory body. The resulting controversy saw the chairman, Professor David Nutt, sacked from his post, and other members resigning in protest. A media frenzy ensued with debates over whether cannabis was harmful, with most focusing on the relationship between cannabis use and psychotic symptoms.

I am writing in relation to another aspect of the potentially harmful effects of cannabis, which I believe is relevant to this debate. Specifically, the potential 'gateway' or 'stepping-stone' effects of cannabis are important to take into account when considering reclassification. However, this issue was absent from the many media reports, as well as from David Nutt's lecture in October that prompted the controversy.

There is evidence to suggest that cannabis use increases the risk of future 'hard' drug use, though causal mechanisms are unclear (Fergusson et al., 2006). Since the 1970s (Goode, 1970) it has been argued that these gateway effects may be moderated by exposure to the black market. Specifically, buying cannabis when it is illegal leads to users becoming familiar with the social and criminal networks that supply the drug. Consequently it becomes easier for cannabis users to get hold of harder drugs, as these same networks may have access to other illegal drugs such as cocaine, Ecstasy and heroin.

This black market theory was one of the reasons that the authorities in Holland decided to decriminalise cannabis. This decision has been controversial, yet it appears to have effectively separated the market for cannabis and harder drugs (MacCoun & Reuter, 2005). Perhaps as a result of this, those who use cannabis in Holland are less likely to progress to using harder drugs than those in countries where cannabis is illegal (Cohen & Sas, 1997). Consequently, a number of authors have discussed the potential benefits of other countries following suit and decriminalising cannabis (Van Den Brink, 2008).

This issue is still being debated and further research is needed, but it seems very relevant to the government's decision to upgrade cannabis. Elevating cannabis to a Class B drug may increase exposure to the black market for harder drugs. This will subsequently increase the likelihood of cannabis users going on to use drugs such as cocaine, which are potentially more harmful. With the recent debate focusing on cannabis and psychosis, this issue has not been raised. Yet changing the classification of cannabis may, in the long run, increase the risk that cannabis users in the UK will abuse harder drugs later in life. Surely this needs to be taken into account.

Thomas Richardson
Mental Health Research and Development Unit
University of Bath

References

Cohen, P. & Sas, A. (1997). Cannabis use, a stepping stone to other drugs? The case of Amsterdam. In L. Böllinger (Ed.) Cannabis science: From prohibition to human rights (pp.49–82). Frankfurt am Main: Peter Lang.
Fergusson, D.M., Boden, J.M. & Horwood, L.J. (2006). Cannabis use and other illicit drug use: Testing the cannabis gateway hypothesis. Addiction, 101, 556–569.
Goode, E. (1970). The marijuana smokers. New York: Basic Books.
MacCoun, R. & Reuter, P. (2001). Evaluating alternative cannabis regimes. British Journal of Psychiatry, 178, 123–128.
Van Den Brink, W. (2008). Decriminalisation of cannabis. Current Opinion in Psychiatry, 21, 122–126. 

 

Registering a concern

I am a Chartered Psychologist and full member of the Division of Health Psychology. For some years I have developed my practice in the direction of counselling psychology. Today I was very pleased to receive from the Health Professions Council (HPC) the good news that I have been grandparented into the counselling psychology part of the applied psychologies register.
 

Consequently I contacted the Society to see if I could become a full member of the Division of Counselling Psychology, and thus join the professional community of my fellow practitioners. I was told that this would not be possible, as the only way to currently become a full member of the Division is via an accredited training route.

 Thus, whilst legally able to practise as a counselling psychologist and use the title, I am not able to join the relevant Division as a full member, despite being a long-standing chartered member of the Society.

I would imagine there are probably many people out there who have acquired competencies in various domains without necessarily following the standard Society-approved routes. What is the Society intending to do about this anomaly whereby state-approved psychologists are not being allowed to join their relevant communities of professional practice? The obvious solution is to re-open grandparenting across all Divisions, thus welcoming newly recognised practitioners and possibly increasing Society revenue. Tony Ward
Newman University College
Birmingham

Reply from Dr Carole Allan, Chair of the Professional Practice Board and Dr Peter Banister, Chair of the Membership and Professional Training Board: We are looking at the role and function of our member networks to ensure they are fit for the Society in a post-statutory regulation environment. Many share the concerns raised, and it is important that we find additional ways for our members to engage with our Divisions and other networks. Indeed, engagement with the Society through divisional membership offers our members a greater relevance to their area of work – and providing more relevant services is at the heart of our improvement initiatives for members.

We will be taking this matter forward with Member Networks.

 

Psychological interventions in Tourette's syndrome

Tourette's syndrome (TS) is a well-known neurological condition that features involuntary sounds and movements (tics). TS is often linked to other behaviours, such as obsessive-compulsive disorder and attention deficit disorders. We would like to highlight recent developments in behavioural treatments and psychoeducation in TS with a view to establishing a network of interested psychologists.

Since Mary Robertson's 2004 article in The Psychologist (see http://bit.ly/4G7xHy) psychological interventions for tics have been developed further in Europe and North America. These include a manualised package based on habit reversal therapy/training, cognitive behavioural therapy (CBT), exposure and response prevention (ERP) and psychoeducation.

Douglas Woods and the American TS Behavioural Science Consortium have developed a comprehensive behavioural intervention for tics with a therapist manual for the treatment of tic disorders entitled Managing Tourette Syndrome (2008). There are three additional workbooks to accompany the manual: for children, parents and adults. Kieron O'Connor takes a different approach and has applied CBT to the treatment of tics in adults. His book Cognitive-Behavioural Management of Tic Disorders (2005) is very accessible and also offers a client manual and a therapist manual with questionnaires and worksheets. A third approach draws on ERP strategies for treating tics. Cara Verdellen (2004) has developed a protocol that encourages the person with tics to endure the premonitory sensation for a period of time (exposure) and resist the tic (response prevention), therefore causing a reduction of tics through habituation.

Resources promoting psychoeducation for the individual, their family and school/workplace (Buffolano, 2008; Robertson & Cavanna, 2008) and group work (Murphy & Heyman, 2007) can be used as an important addition to behavioural treatments. For many people with mild TS, this approach may be intervention enough to enhance quality
of life.

Currently there is a significant level of unmet need for treatments for people with tics in the UK. We would like to help develop these treatments within UK-based services. Although specialist clinics exist, most psychologists working in applied settings will have contact with people with TS at some point. However, a recent survey by the charity Tourettes Action showed that few clinical services in the UK have specialist training in treating tic disorders. There is little contact amongst psychologists with an interest in this area within the UK, unlike other countries where psychologists have developed specialist networks. If you already work in this area or have an interest in learning about using psychological treatments for TS please contact one of us ([email protected] or [email protected]) to discuss the possibility of forming a network.
Liz Murray
Dumfries
Tara Murphy
Great Ormond St Hospital for Children

References
Buffolano, S. (2008). Coping with Tourette syndrome. Oakland, CA: Instant Help Books.
Murphy, T. & Heyman, I. (2007). Group work in young people with Tourette syndrome. Child and Adolescent Mental Health, 12, 46–48.
O'Connor, K. (2005). Cognitive-behavioural management of tic disorders. Chichester: Wiley.
Robertson, M. & Cavanna, A. (2008). Tourette syndrome (The facts). Oxford: Oxford University Press.
Verdellen, C.W.J., Hoogduin, C.A.L. & Keijsers, G.P.J. (2004). Exposure with response prevention versus habit reversal in Tourette's syndrome: A controlled study. Behaviour Research and Therapy, 42, 501–511.
Woods, D.W., Piacentini, J., Chang, S. et al. (2008). Managing Tourette syndrome. New York: Oxford University Press.

 

 

Philosophical contributions

Stephane Duckett (Forum, January 2010) laments his perception that psychologists could do with a helping hand from philosophers, and he cites Gilbert Ryle's philosophical contribution to our field as a way out of Cartesian dualism, which he characterises as a plumber's view of mind–brain relationships.

Unfortunately, Ryle denied that mental events took place and claimed
that linguistically they were a 'category mistake', such as 'She went home in the huff and a yellow cab'. Taking Ryle literally would mean that a depressed person could only find out that life was unbearable by taking their own life – somewhat putting the cart before the horse. Similarly, B.F. Skinner once admitted in a televised interview that there were no thoughts going through his mind, thus echoing Ryle some 20 years later. These examples do little to persuade one that Ryle's logical or Skinner's empirical behaviourism represent a new way forward for 21st-century psychology.

Reductionism is currently very much in vogue thanks to brain-imaging techniques, but a reductionist account of mental phenomena is ultimately either self-refuting or absurd. At a recent seminar I was amused to learn that I had an 'effort centre' in my brain which had been localised precisely. I did not embarrass the speaker by asking how I could tell if what she was saying could in any way be true, as I feared she might have said that if I looked at an image of her brain whilst she was uttering the statement I would be able to see the 'truth centre' being activated.

As for philosophy helping psychologists, I can only recall that it was compulsory for undergraduate psychology and theology students at Edinburgh University to enrol in Metaphysics before they went on to specialise; thereby preventing future error in thought and its expression in language. Had this practice been universally adopted and perpetuated, perhaps our new generation of psychologists could have worked out for themselves what was sense and what was nonsense, such as the proposition that Descartes was a plumber.
Allan Dodds
Nottingham

 

Thinking outside the LEA box

As I approach my 40th year as an educational psychologist I find myself increasingly reflecting on the changes that I have seen, and wondering – especially in the present climate – what the future may hold for our profession. For the majority of my working life I enjoyed being an 'officer' within an LEA which, despite regular cyclical periods of restraint, cut-backs and uncertainty, offered many perks and much relative security, not to mention comradeship, for which I shall always be most grateful.

In my later role I regret that the voice of the independent educational psychologist is – so it seems – rarely heard, even though many of our number are clearly well experienced and qualified, and have succeeded conspicuously in establishing themselves in the rather harsher business world that exists beyond the LEA's gates. The work of the educational psychologist is all too often wrongly understood, even by government itself I suspect, to be synonymous with being an LEA educational psychologist.

Coming to the point, I am wondering whether the work of the independent educational psychologist should be investigated to see whether there may be innovative roles that should be more widely recognised and even worthy of further development by the profession as a whole. In my more pessimistic moments I wonder whether educational psychology is guilty of being too much monopolised and constricted by LEAs, its role too much stifled by political pragmatism, and its vision blinkered by the excessive workloads that are generally imposed upon it. In contrast, many of us have watched in wonder as clinical psychologists – over the same period – seem to have enjoyed stupendous growth and diversification in their own professional roles and duties, now conducted in a wide variety of settings.

Is it perverse, then, to wonder whether there may be a rich role for educational psychologists outside of the LEA? With our training courses, professional journals, and the range of research that is published, I am more and more of the opinion that we may be missing out on a range of different possibilities for future development.

May I invite all qualified educational psychologists who practise outside of the LEAs – whether as employees or independent consultants – to contact me and provide a brief description of their 'alternative' roles. If there is a sufficient response, I will inform the readership through these columns. My personal belief is, increasingly, that potentially there is indeed a much wider professional role for educational psychologists than exists at present, that pioneering work in different settings is already going on, and that if this proves to be so, then a broader view of our work should perhaps be reflected in our national training courses.
Please contact me by e-mail ([email protected]).
David Knapman
Taunton