Letters, April 2012

Emotional responses in research and supervision

As a newly qualified clinical psychologist, I have recently finished my doctoral research, and in this I found that there were parallels seeming to occur between the relationship with research participants, results and research supervision. I have been wondering if this is a universal phenomenon, what to do about it and whether it is often overlooked or ignored?

Searles (1955) noted the experience of parallel processes as a reflection process coming to light as the counsellor played out the client's issues in supervision, with the supervisor experiencing the same emotions that the counsellor did in the therapeutic relationship. Does this mean that science practitioners such as clinical psychologists are in a unique position to identify this additional information, or is it a job hazard? If so, then what should be done about it?

In conducting my research around 'parent and child anxiety, illness beliefs and management of child Type 1 diabetes' I was surprised to find myself wanting to reject the work I was doing, wishing I could ignore it and struggling to find coherence despite being incredibly aware of the importance of completing it. I needed support in understanding its complexity and to feel confident with each step of analysis before being able to continue. I would have preferred for someone else to take the responsibility away. On reflection in supervision, this had never been my usual style of addressing my work.

Through discussion and exploration in research supervision it came to light that when my supervisor and I had a congruent understanding of the research a collaborative management began and emotions were contained. The research felt possible and it began to make sense.

In parallel with the supervision process, the results from the parents and children seemed to say similar things about the illness. Children didn't want diabetes in their life, and although they knew it was serious and that good control was important, unless the management made sense, and unless they had good self-efficacy and understanding was congruent between parents and children, responsibility was not shared and parent and child anxiety and emotional distress increased.

In discussion with colleagues I have become aware of others experiencing a similar process, for example when research around foster placement breakdown broke down. I would be interested to hear others' views on their experience and the questions raised, as I have yet to come across any literature on this subject.

Dr Jade Smith
Driffield

Reference

Searles, H.F. (1955). The informational value of the supervisor's emotional experience. Psychiatry, 18, 135–146.

Impact of psychology research

Am I one of the few psychologists who believes that British psychology research is 'sleepwalking towards disaster'? I had always assumed that psychologists took great pride in the primacy of research. Journal impact factors suggest that psychology is now lagging seriously behind other professions. The British Medical Journal has an impact factor of 13.471, the British Journal of Psychiatry 5.947 and the International Journal of Nursing Studies 2.103. Contrast this with the impact factor of, for example, two leading BPS journals, the British Journal of Psychology 2.172 and the British Journal of Clinical Psychology 1.697.

Indeed, a leading academic psychologist recently told me that they rarely published in British psychology journals. They gave two main reasons for this. First, reviewers were often very difficult. Second, as the impact factors of psychology journals were so poor. Within my own profession of clinical psychology, the top clinical academics realise this, and hence publish their research paradoxically in psychiatry journals. Should the profession be concerned?

Dr Jerome Carson
London E17

Professor Andy Tolmie, Chair of the Society's Editorial Advisory Group, replies: The impact factors of top psychology journals worldwide are nowhere near those of medical journals, for a variety of reasons, and a score over 2 is actually pretty good.

Lots of UK researchers choose of course to submit to US journals because of exposure, but equally, British journals receive large numbers of submissions from North American authors – the last analysis we did for the British Journal of Educational Psychology showed 15 per cent of submissions were from there (against 30 per cent from the UK), and the numbers have almost certainly gone up since then.

It's also worth noting that the recent ESRC benchmarking exercise for psychology (conducted by an international panel) concluded: 'Overall, the quality of UK psychology research is very high, bettered only by psychology research from the USA. In a substantial number of areas, UK psychology research is unsurpassed anywhere in the world. The Panel's view is corroborated both by the outcome of the 2008 Research Assessment Exercise and bibliometric analysis.'

I wouldn't want to be complacent, and it would be interesting to hear the views of others. But I think the UK profile is actually very high.

Theoretical work psychology?

In the final weeks of the taught portion of my occupational psychology master's programme I had begun to tire a little of some of the studies and research programmes that I felt were conducted under a staid and little-changing gestalt. At around this time the course lecturers arranged a session in which they offered students the opportunity to put wide-ranging questions to them. Being a great devotee of Thomas Kuhn's ideas my query was – 'What are the exciting new paradigms in work psychology?' My lecturers talked a lot, but they didn't or couldn't answer the question.

Last Saturday I was in the audience at the Sheffield Lyceum theatre for a production of Michael Frayn's play Copenhagen. For those who are unaware, this work attempts to understand a meeting that took place between nuclear physicists Niels Bohr and Werner Heisenberg in 1941. Werner Heisenberg was working on the Nazi weapons programme and Bohr was soon to escape to America where he would contribute to the development of the bomb that would later be dropped on Hiroshima.

The play explored a number of different topics, and one of the concepts that it hinted at was the unwitting utility of separating theoretical from experimental physics. The tools of the theoreticians were ideas, mathematics and, to a lesser extent, philosophy. The experimentalists naturally laid greater emphasis on empirical work and measurement. The play suggested that the German establishment at that point held experimental knowledge in much higher esteem than its theoretical counterpart. This is why many of the theoreticians were Jewish – these were the only positions in academia open to them.

However, in the long run it was the theoreticians' creative thinking, philosophy and calculations that propelled the science, such that the application of nuclear fission could become a reality. In an instant, I realised that I had found part of the answer to the question that I had asked my lecturers. Where's the new paradigm? Perhaps this dearth of truly new thinking may be the result of the determined empiricism of work psychology (cross-sectional analyses, Likert scales, etc.). The solution to this state of affairs may reside in a theoretical element of this discipline.

Imagine a stratum of work psychology within which the tethers of empiricism are loosened. Those working in this area would be focused upon creative theorising and prediction. Researchers in this subsector would be free – and perhaps encouraged – to draw on philosophy, and to use metaphors from the arts and the natural sciences. One could foresee that this may offer a wealth of new ideas that the empiricists could apply their skills to. Indeed such theorising may even include proposals of new methodologies that are (more?) suitable for this discipline.

A major difference between theoretical physics and any 'theoretical work psychology' would be the difficulty of supporting postulations by means of calculation as the physicists are able to do. However, as at present, theory would be evaluated on the basis of the elegance of the extrapolation from existing empirical work. It would also be determined by the logic of the deductions from other ideas (philosophy, art, etc., as mentioned above) into work psychology.

Two things: I am aware that this happens to a degree at present. However, it may be argued that current thinking is too closely aligned to empiricism. There are some things that are difficult to test; therefore a focus upon theory, based on what we know and can imagine, may be useful (e.g. the big bang).

Secondly, the idea of creative theorising is likely to have its opponents; not least because it resurrects the old (work) psychology as pseudoscience debate. However, if the split between theory and empiricism is good enough for nuclear physicists, and it proves itself by its utility, then I'm all for it. In the oft-repeated words of Werner Heisenberg in Frayn's play, the test is – 'if something works, it works'.

Peter Johnson
Sheffield

Little Albert – answering the criticism

We appreciate the coverage given by The Psychologist (News, March 2012) of our History of Psychology paper (Fridlund et al., 2012). The article concluded with criticisms of our work by Professor Ben Harris, who authored an excellent 1979 paper on misrepresentations of the Little Albert study in the literature.

As it is often said, critics are entitled to their opinions but not to their own facts. Professor Harris's criticisms are rife with errors. We are grateful, therefore, for the chance to respond.

Professor Harris chides us for 'poor historical scholarship (there are no quotes from the medical records)'. Our article contains 35 references and 12 direct quotes from Douglas Merritte's medical files. It gives us no satisfaction to ponder the two possible explanations for Professor Harris's criticism. He may have read our paper and failed to notice the 35 references and/or 12 quotations. Alternatively, Harris may have provided commentary to The Psychologist on an article that he never read.

Professor Harris criticises the 'lack of independence and historical expertise of the people who assessed the film footage of Little Albert ("...the current article features only the analysis of a fan of Beck and a friend of that fan," he said)'. We find it insulting and inappropriate to refer to Fridlund as a 'fan' or Goldie as a 'friend of that fan'. Professor Harris has never interacted with Fridlund or Goldie, has no knowledge of the interrelationships of our research team, and has no idea of our investigative strategy. In sum, Professor Harris's criticism implies a personal intimacy and knowledge of our work that he does not have.

With respect to the independence of the assessments, there were three behavioural analyses of Little Albert on film: Fridlund's, followed by William Goldie's independent, blind assessment (Goldie became a co-author much later), and – to ensure concurrent validity - a third assessment by a UCLA clinical psychologist with expertise in child psychopathology (none of us had prior acquaintance with her). Her assessment was also conducted independently and blind to the prior findings and tentative hypotheses; it is provided as a footnote and spans two-thirds of a page, and apparently went unnoticed by Professor Harris.

With regard to a lack of 'historical expertise', we obtained reviews of the paper by three independent, renowned historians of science and medical ethics, apart from the journal's internal reviewers (see acknowledgements in our paper).

Professor Harris accuses our research team of being 'closed and secretive. For example, he says they won't release the medical records.' We are not being secretive about Douglas's medical records. Douglas Merritte's medical documents are the property of Johns Hopkins University, and are released by the Johns Hopkins Archives on an investigator-by-investigator basis by standard application.

Indeed, in order to aid other investigators to inspect Douglas's records in toto, or access any other collections in the archives, we included a footnote in our paper stating: 'Qualified scholars may make application to review these [Douglas's files] and many other papers related to Watson.'

Professor Harris accuses us of 'an ignorance of the details of Watson's study (e.g. the paediatrician Goldie observes the absence of an approach avoidance reaction in Albert, even though this behaviour is noted by Watson)'. First, Goldie is a paediatric neurologist; he isn't, and never was, a paediatrician. He specialises in children's brain disorders, a particularly useful skillset given the nature of our inquiry.

The 'approach avoidance' reactions Professor Harris mentions were noted by Watson and Rayner when Albert was 11 months 21 days of age, and at 1 year 20 days of age. Professor Harris appears to have missed the point of Goldie's observation entirely. Goldie was struck by the absence of approach avoidance in Albert at nine months of age, when it should have already been apparent. That was the clinically significant finding.

Harris castigates us for a 'dependence on post-hoc logic': 'Because Douglas Merritte had symptom "a" and "b" and "c", the authors worked hard and found those symptoms in Albert as filmed by Watson, although no one had seen them in the past 90 years.' Oddly, Professor Harris has the timing exactly backwards. As our paper clearly recounts, we had completed our behavioural analyses of Albert on film before Douglas Merritte's medical files became available.

We were preparing to submit our paper with our clinical inductions that Albert had been impaired, but with numerous diagnostic possibilities that might never be resolved. The release of the Merritte medical files provided definitive medical documentation of the conditions from which Douglas/Albert had suffered, and produced an account that squared solidly with Albert's behaviour on film as we had previously assessed it.

Harris argues that Little Albert's identity is of little interest to historians. We wonder whether Professor Harris can rightfully speak for all historians. We would invite readers to look at our paper, though, not just for the further substantiation of Albert's identity as Douglas Merritte, but for the issues that arose in the process of that discovery: the widespread use of institutionalised children in medical experimentation (Douglas/Albert may have been one), the medical misogyny toward wet nurses (his mother was one), and the mores and ethics of experimentation generally circa 1920 (there were little). That, of course, is the great lesson of historical research: facts like Albert's identity and fate are never uncovered in isolation, but within an entire historical context.

In our paper, we tried to illuminate that broader context.

Professor Harris contests our claim that Little Albert's fate is one 'of the greatest mysteries in our discipline'. He replies that '[t]his is nonsense', especially when compared to 'what causes schizophrenia or the nature of memory'. He's got us there. Either of those questions is far more important than Albert's fate or his identity. Nonetheless, the 'Little Albert' study always calls out for us as psychologists to treat our subjects and our patients with dignity, respect and humanity. That message is timeless.

Alan J. Fridlund
University of California, Santa Barbara

Hall P. Beck
Appalachian State University

William D. Goldie
University of California, Los Angeles, and the University of Southern California

Gary Irons
Finksburg, Maryland, United States

Reference

Fridlund, A.J., Beck, H.P., Goldie, W.D. & Irons, G. (2012). Little Albert: A neurologically impaired child. History of Psychology. doi: 10.1037/a0026720

Clinically dismayed

I read your special feature on paediatric psychology (March 2012) with interest and found it both engaging and inspiring. However, even before opening the front cover of the publication, I was dismayed to see it termed 'Paediatric clinical psychology' (italics added). Whilst the first article acknowledges that 'practically all' posts are filled by clinical psychologists, what is to preclude a suitably experienced counselling or health psychologist from fulfilling this role with equal competence?

As a counselling psychologist, I have the greatest respect for my clinical colleagues and the posts to which the article refers have undoubtedly been filled by those deemed best equipped during each recruitment process. However, to start formally naming a branch of practice 'clinical' on this basis begins formally to exclude other branches of psychology and gives the impression, to this reader at least, that the BPS does not recognise their potential for contribution to this area of practice.

Sophy Cawdry
Senior Counselling Psychologist
Clonmel, Republic of Ireland

Call for a Royal College of Healthcare Psychologists

We are academic, clinical, counselling, forensic and health psychologists, neuropsychologists and others, qualified or in training, who believe, along with several other BPS members, that there is now a pressing need to establish a Royal College of Healthcare Psychologists (along the same lines of the several other royal colleges that serve many of our health professional colleagues).

The function of the proposed RCHP would be: to provide a collective public voice, in the media and elsewhere, for applied psychologists working, researching and/ or training in the healthcare sector; to act as a lobbying group; to provide informed and expert opinion on matters relating to applied healthcare psychology; and to promote the highest standards in education, training, research and practice of applied psychology in healthcare.

We call on the Society, following appropriate consultations with the membership of the Society, to petition Her Majesty the Queen in Council, in this, her Diamond Jubilee year, to permit a variation to the Society's Royal Charter to allow for the establishment of a Royal College of Healthcare Psychologists (RCHP).

Prof. Jamie G.H. Hacker Hughes
Anglia Ruskin University
and 45 other signatories

Guest Column - Psychology at Work

Psychology has a wealth of information about leadership. We are good at researching the topic, identifying leadership potential and coaching others to be more effective in that role. Yet we often fail to identify and promote leadership within our profession.

There is an endless fascination with the cult of leadership, and it is tempting to turn to world leaders in search of the recipe for success. How would we compare Barack Obama's style with tha of Vladimir Putin? What is the likely outcome of the Republican nomination race? In the UK, David Cameron has highlighted the dearth of women in the boardroom and looked to the Swedish quota model for potential answers.

As Elin Hurvenes, founder of the Professional Boards Forum, says, 'Various companies have found concrete benefits in such measures. They feel the boardroom discussions are better, and they conclude that the decisions are better.' Yet we have psychological evidence which questions the overall value of quotas and explores the unintended consequences. Women do not want to be recruited just on the basis of gender, but on their capability to do the role.

So how can psychology contribute to this wider debate, and have we got our own house in order?

We are not short of quality research or innovative practice in applying the psychology of leadership in the workplace, NHS and beyond. Professor Michelle Ryan's work on the glass cliff, highlighted in last month's Psychologist, explores the attitudes, expectations and situational factors that impact on the selection of women to the boardroom.

We appreciate the value of different leadership models – trait, behavioural and transformational – and how these apply in the concept of development. As a highly interpersonal profession, psychology should not be seduced by the charismatic leader but look for ways in which we can enhance performance and impact.

Indeed different leadership approaches can be very powerful in times of transformation. It is not always those who lead by example who succeed; the enabler or those who are subservient can be highly effective in the change process.

Within our own profession, psychologists must lead and inspire others in order to have a strong impact on the broader agenda. What are the core skills and capabilities of an effective leader in the context of psychology? A good example of this is the development of The Clinical Psychology Leadership Competency framework, which highlights the critical success factors for psychologists in the NHS and associated environments.

Importance is placed on interpersonal skills, decision-making, implementation and motivation. In the NHS there is emphasis on personal qualities coupled with strategic direction, service improvement and working well with others.

This month, the Division of Occupational Psychology conducted the first of three modules in a programme designed to develop talent and to enhance the leadership impact of psychologists within the Division and beyond. It is the first programme of its kind to target psychologists working in the volunteer context, and is an excellent example of the developmental opportunities that we must offer.

The framework includes interpersonal, implementation and individual characteristics. The ability to empower and engage is critical as is communication with others, collaborative working and cultivating relationships with different people and organisational cultures.

Yet, as Lord and Maher say, 'To be a leader you have to be perceived as a leader'. We must be prepared to stand out as leaders, to develop the skills within our profession, to take the initiative and thus to shape and drive the agenda. Physicians, heal thyself.

Hazel Stevenson is a non-executive Director at Saville Consulting. Share your views on this and other workplace-related issues via [email protected]

Integrity – a parable

I remember when my dad was knocked from his bicycle. I was about 11 years old, marvelling as he regaled us with the story of his inaugural flight across the Small Heath Expressway. Luckily he was unharmed – not only do working-class people have a tendency to bounce, but he was sensibly protected by a cycle helmet when he had his ballistic adventure. Dad bemoaned the expense of having to fork out for a new one after cracking it off a kerb, which I countered by pointing out that no damage was really visible – surely it would be fine? '

It only takes one knock, kid; it's useless. The whole thing's weaker now, the cracks run deep, even if they're too small to see. It's been compromised. Do you understand?'I understood. Not only that how easily integrity can be compromised, but also that appearances can be deceptive…And it only takes one knock.

My tardy entrance into higher education was fuelled by a rationalist revolution. Breaking down my world to embrace objectivity, atheism and empiricism, I recognised a higher sense of purpose in humans who work to find the truth. Science dictates endeavours taken on, not in order to prove oneself right, but to test whether an assertion is true. For five years I believed that anyone working within the sciences, either as student or scholar, had the same motivations. At the end of those five years, I was sadly disillusioned.

During my undergraduate degree I heard of scholars who use the peer review system to block papers which might potentially challenge their leading theory; how 'publish or perish' can be re-interpreted as 'perjure or perish' (a former supervisor of mine has openly said 'We're going to publish this, even though it's flawed'); students who declare that 'You can make these numbers look like anything, it doesn't have to make sense' and go unattested; ostensibly honourable scholars who predate at conventions for fresh young meat; and first-class degrees being awarded of students who – and I quote – 'Don't know what an ANOVA is'; and let's not even start on the cheating.

I've met and spoken with countless experimental psychologists from the most illustrious of institutions, many of whom talk freely about proving their hypotheses, never about testing, or even supporting their ideas.

And now as a graduate, I say this: to the data-peekers and cleansers, the status-hungry, the removers of outliers and the out-and-out liars; you know who you are, and I'll be looking for you. I'd like to say that you're only cheating yourself, but we all know that isn't true. Your compromised integrity weakens us all. Without integrity, psychology is as worthless as my old man's helmet.

Hayley Burgess
Oldbury
West Midlands

Supervision of assistant psychologists

Just over a year ago, the two of us obtained our first paid assistant psychologist positions within a private organisation for young people with autistic spectrum disorder. Working within the private sector has highlighted a number of key issues to consider, and we are keen to discover how representative this may be of the private sector as a whole.

Our experience of developing relationships and trust has been valuable, but being the first and only full-time members of clinical teams has sometimes been difficult. Being mindful of accountability and our limitations, we have had to continuously explain our unqualified status, whilst still seeking to provide support and encourage others to think reflectively and psychologically. This may sometimes be perceived as making excuses, and may reduce people's confidence in clinicians and portray clinical teams as unreliable and inefficient.

According to the British Psychological Society Guidelines for employment of assistant psychologists: 'Supervisors have the responsibility of informing and liaising with staff with whom the assistant psychologists are to work. They should inform staff of the assistant psychologist's unqualified status, role and level of responsibility in writing and remind as required'.

'At least a minimum of two hours per week quality supervision… If a single assistant psychologist is working in an isolated service they may need to receive more supervision.'

From our experiences, we understand the importance of such guidelines. These are not just written documents; we expect these to be adhered to in practice, as much as feasibly possible. It is essential that assistant psychologists have regular access to a qualified psychologist, so that they have someone to assist. In our view, recruitment of an assistant psychologist should only take place if this can be ensured and maintained.

We feel that employing assistant psychologists in services where there is limited access to qualified psychologists, and not providing sufficient education to the services we work for, and other professionals and service users, is doing an injustice to the service, to our development, and to our profession.

Referring to the BPS Guidelines as previously mentioned, supervision is critical. Within our current jobs, access to clinical supervision has not been consistent, which is a key issue when working in isolated residential services. Irregular supervision impacts upon our personal and professional development, our motivation and faith in the profession, and on our ability to make progress with our work.

We now truly understand the importance of BPS guidelines, and hopefully will be able to utilise these and our experiences in the future as qualified psychologists.

What are other peoples thoughts regarding this matter? Has anyone had similar experiences? How can we emphasise the importance of such guidelines and ensure that they are adhered to in practice? One means in which psychologists are meant to inspire and guide the next generation of psychologists is via supervision… it is crucial.

Names and addresses supplied

Obituary

Tony Coxon (1938–2012)

Professor Tony Coxon died on 7 February 2012, having been diagnosed with a brain tumour in late 2011.

Although not a psychologist, Tony made a major contribution to psychology indirectly, through his work on research methods. His worked touched on all aspects of social sciences, and he is particularly well known for his work on multidimensional scaling and the method of sorting. He was one of the few methodologists who could successfully combine quantitative with qualitative methods, and even developed software to do this (see HAMLET).

A lesser-known contribution was that Tony introduced SPSS to the UK research community, accurately predicting how popular it would become. He thought that this popularity stemmed from how SPSS reflected what social scientists actually did, rather than on what statisticians thought they ought to be doing!

Tony's research began with social stratification and 'cognitive sociology' and then moved to sexual behaviour, funded by a major grant from the Medical Research Council and Department of Health. This developed into the SIGMA research project, which still runs today, recording aspects of gay/bisexual men's sexual behaviour. He made a major contribution to HIV prevention efforts, and to research methods across the social sciences.

Dr Gareth Hagger-Johnson
Department of Epidemiology and Public Health
University College London

See the PDF for full article including obituaries for Gerald George Kent (1948–2012), Amanda Caine (1954–2011), Michael Siegal (1950–2012), James Smith (1943–2012).