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Friday, July 29, 2005

 

Destructive Trends in Mental Health - Book Review

BOOK REVIEW: Destructive Trends in Mental Health: The Well-Intentioned Path to Harm, edited by Rogers Wright and Nicholas Cummings

A new book by Rogers Wright and Nicholas Cummings rightly exposes how psychology has been overtaken by psychologists who advance social advocacy over mental health care. Destructive Trends in Mental Health: The Well-Intentioned Path to Harm documents how the mental health professions have been overtaken by social activism to the detriment of scientific inquiry and quality mental health care. Anyone in mental health or who cares about the profession should read this book.

Wright and Cummings are not conservatives, at least in the sense that they necessarily support social conservatism. However, they have been pragmatic and keen observers of the mental health professions over the past 40 years. As a young counselor, I first met Nick Cummings when American Biodyne, the first real managed behavioral health care company, came to Ohio as a manager of the state employees behavioral health care. This was around 1985 at the beginning of the managed care revolution in mental health. I just started my counseling private practice in Portsmouth, Ohio and was looking to get on board the managed care train. Biodyne did something very novel; all therapists in the preferred network were required to be trained by the company leaders, including president, Nick Cummings. In all my years of education both in school and post grad, I have never listened to a better trainer than Nick Cummings. He believed therapy could be a powerful influence in a person's life but it was never to be used to gratify the therapist or to promote a political agenda. That same theme permeates this book.

Cummings and Wright believe that modern psychology has been taken over by forces of social activism and as a consequence face irrelevance. Here are two quotes from the book regarding psychology and sexual orientation therapy:

"In the current climate, it is inevitable that conflict arises among the various subgroups in the marketplace. For example, gay groups within the APA [American Psychological Association] have repeatedly tried to persuade the association to adopt ethical standards that prohibit therapists from offering psychotherapeutic services designed to ameliorate "gayness" on the basis that such efforts are unsuccessful and harmful to the consumer. Psychologists who do not agree are termed homophobic. Such efforts are especially troubling because they abrogate the patient's right to therapist and determine therapeutic goals. They also deny the reality of data demonstrating that psychotherapy can be effective in changing sexual preferences in patients who have a desire to do so." (From the introduction, page xxx, emphasis added).

"Although the APA is reluctant or unable to evaluate questionable practices and has thus avoided addressing the issue of best practices, this did not prevent its Council of Representatives in 2002 from stampeding into a motion to declare the treatment of homosexuality unethical. This was done with the intent of perpetuating homosexuality, even when the homosexual patient willingly and even eagerly seeks treatment...Vigorously pushed by the gay lobby, it was eventually seen by a sufficient number of Council members as runaway political correctness and was defeated by the narrowest of margins...Although the resolution was narrowly defeated, this has not stopped its proponents from deriding colleagues who provide such treatment to patients seeking it." (From Chapter One, by Nick Cummings and William O'Donohue, pp. 17-18).

There are fine chapters regarding the misuse of the term homophobia ("It is most unfortunate when scientists attempt to pass implicit or explicit pejorative evaluations of individuals holding certain open and debatable value positions as part of their science"), abortion, pluralism, political correctness and so on. As noted, Wright and Cummings are less concerned about the social outcomes of psychology's misadventures into social activism than they are with the consequences to the profession. They paint a picture of psychologists being unable to support themselves as psychologists because the profession has become enamored with social change.

Mental health care in the US is adequate but barely so. Any practicing counselors knows how difficult it is to find quality services anywhere outside of the metropolitan areas of this country. Cummings and Wright correctly observe that the professions preoccupation with social activism threaten to make the professional associations irrelevant as forces for quality and affordable health care for all people. The book was apparently completed before both APA's went headlong into the same sex marriage debate, but I believe favoring same sex marriage is just more of the same activity lamented by the Cummings, Wright and colleagues. When it comes to mental health delivery, Nick Cummings has rarely been wrong in his predictions. I don't think he is wrong this time.

Destructive Trends in Mental Health: The Well-Intentioned Path to Harm, edited by Rogers Wright and Nicholas Cummings is published by Routledge.

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