22:26

6:56 "New" therapies over the decades 16:30 Every explanation we currently have for a disorder will turn out to be wrong. 20:32 On average therapists get less effective as they gain experience. 21:19 What makes effective therapists 23:29 Why therapists get worse: Protypes and putting patients into categories, losing person-centered perspective. 37:57 We don't know very much about what makes psychotherapy. Quit funding comparisons between two treatments.

Awesome video!

Ce mec est génial !

❤

What does PF mean by "mental disorder"?

I really enjoyed listening to this, thanks for posting it!

Genuineness, kindness, empathy, 'attunement', respect, compatibility You can't really study any of them, but surely they are the most important factors.

Psychologists are clowns.

sure Bruce 'its a complex process' after telling us people unencumbered by training get the same outcomes as professionals and therapist do not improve with time. - therapy doesn't work and can be harmful -like everything else its a bunch of biased, blinded in groups battling for market share by flogging their own preferred brand. Talking and listening or care and compassion can be useful and is needed but no one needs a paid therapist. We need more time and resources to form good family and friendship circles and do away with this guff. Perhaps an apprenticeship of sorts, shadowing those comfortable and motivated to sit in service to others is all thats needed - we are human beings and have helping and harming each other since the dawn of time - method, techniques etc provide an illusion of professionalism and change, all fleeting and largely nonsense. burnout is also high in the field and of course it is because we are human beings not robots - its fundamentally unhealthy for people to be able to turn on empathy, real empathy on the hour 5/6 days a week - going part time, reduced case loads and personal care or being adequately resourced is what people need - sadly its a business and people want more money and status. Therapists are human beings with the same or similar issues, bias and blind spots as anyone else has - no more able to overcome them either - and you cannot practice 'empathy' in fake situations - its a natural occurrence - when its faked or exhausted people often know. you keep talking about 'disorders' when we know there are major issues with the medicalisation of distress, invalid, unreliable and most often harmful.

The therapeutic relationship reminds me a little of a marriage. Some couples are better suited to each other than others. When you ask them what the secret of their successful relationship is, they don't always know or can't put it into words. Of course, expertise, empathy, acceptance, etc. are very important. In some cases it might just have been "that one significant sentence", "those particular words" in that one session on that day although apart from that he/she was crappy as a therapist. I'm exaggerating here. But I think you get my point. 🤔 In the end, though, we don't really know what makes a good therapist. When you ask clients what really helped them to get better, they can't always say. For example, sometimes we don't always know why we like someone either. We just do. Many factors come together when it comes to determining what makes a therapy effective. What is the decisive factor for one person may not be the same for another. So, I'm not sure it's definable. And whether cultural and societal factors also play a role, I don't know. Great talk, enjoyed listening. Thanks to all of you. 🙏

🙏🙏🙏

IAPT for children and adolescent are one huge massive failure, but they are so committed to it they can’t change course. It’s didactic psychoeducation and everyone it’s completely over evaluated constantly.

Thank you for posting this interesting conversation. I found myself feeling quite frustrated that in both speakers’ descriptions of what is needed in therapy and attitudes within the therapist, they were both describing the person-centred modality. There is certainly much research and work to be done within the PC field, but it is alarming to me that we’re describing the need for therapists to be empathic, open-minded and sensitive to the client’s individual needs, when this idea has been around in psychotherapy for 70+ years. I did enjoy the insight into implementing solutions at scale, and how IAPT works in England. I have experienced many anecdotal accounts of IAPT only being effective for clearly definable symptoms and disorders such as phobias, yet actually hindering less definable symptoms and disorders including anxiety and depression. I look forward to seeing further research on this in future.

This is very disturbing. So ... the therapy industry doesn't know "what works", and we should study to see what therapists do to see who is effective, then teach what they do? Disturbing that therapists get paid to wing it -- whatever "it" is, and that the education industry doesn't teach therapists what they need to know., and that there are 1,246 therapies which have very little difference in efficacy rates. Hmmmm.

Do psychologists get a thorough personality test before they are allowed to see patients? If not, there should be one.

Consider using AI, on some level. They are more of standard quality when it comes to treatment procedures, at least better than the bottom 15% psychologists. And it will become cheaper and more affordable for everybody.

Part of it is that economic systems don't allow for rebellion. In the U.S., a lot of kids are living on the edge, paycheck to paycheck, and you can't mess about with rebellion where if you get arrested and lose your job, you are homeless.

I certainly enjoy listening to you guys so far and I'm only 19 mins in. Just wish I could be part of that debate. Just fascinating fellas 🕉

Bruce final point completely blew me away. It’s the complete counterargument to deliberate practice in psychotherapy being reductionistic. What a fantastic anecdote! Thank you so much 🙏🏻

All of them are my heroes <3 incredibly inspiring conversation! Thanks for making it available!

An important conversation among the leaders in this field that should be heard by everyone who trains psychotherapists. Thanks so much for posting this.

thank you for sharing the debate.

This article is worth a read and covers the 2014 study mentioned in the talk. www.theguardian.com/science/blog/2014/jan/23/psychological-therapies-mental-illness-dodo-bird-verdict

Challenge to veteran therapist is decline in identifying innovation or newness in the story of every client. Declined enthusiasm of veteran therapist can unconsciously affect the results negatively.

Any therapy proves to be of advantageous if therapeutic intervention "empowers" client to utilize learned measures in social and personal life.

In my locality, peer supervision is a requirement of being registered with the board.

Although it seems strange that new therapies are developed every so often when therapies that work already exist, I've found in clinical practice that some therapies achieve better outcomes. I know this is not supported by empirical evidence but I certainly can't deny practice-based evidence. Perhaps it's because the therapist is more confident in, and buys more into, certain therapies and therefore come across more competent when delivering those approaches.

*INTERNATIONAL PSYCHOLOGY CONFERENCE* - 2021 organised by 3G School of Psychology Rajister for free www.3gschoolofpsychology.org/#register *_Use referral code 5502_*

Thank you.

excelente

Dodo Hypothesis: In Lewis Caroll's 'Alice in Wonderland', a dodo led Alice and other creatures in a merry race around an island. Stopping abruptly, the dodo declared Alice and all the runners winners, as he said, "all must have prizes." This dodo hypothesis of every entrant a winner applies exquisitely to the numerous schools of psychology whose members run around in conceptual circles, secure in the knowledge that they deserve prizes, when in their fractious and useless confusion, they are merely dodos. from Dr. Mezmer’s Dictionary of Bad Psychology, at doctormezmer.com

....special guest: anders breivik...........

"Evidenced Based the therapeutic Practice" is a misnomer, as I think Dr Wampold is saying. First we do not know what the actual mechanism of pathology is in the patients. We do not know this and we should not represent that we do, we cannot test for a psychiatric disease and demonstrate physically, empirically, that it exists, let alone WHAT exists. Since we don't know what is wrong, when someone experiences positive change, we don't really know what was changed, or how it changed, or why it changed. Therefore the only evidence we have is that THIS treatment seems to be effective in this way with this disorder to some level of confidence but that it is rare that one technique is truly superior. Common Factors say the therapeutic alliance is a major factor in patient change/effective therapy. The therapist must create an environment where epistemic trust can develop and grow. That will ultimately be based on the therapist since the patient is a constant. Therefore therapist skills are more critical than the treatment technique, but nevertheless can we really know what is truly "evidence based" since we know so little about psychopathology? There is no such thing as "effective treatment technique" removed from an "effective therapist". An ineffective therapist applying an evidenced based technique will always be less effective than an effective therapist applying a technique that they are comfortable and skilled with regardless of its empirical basis. Great debate, what is beautiful is that we are all going forward together even when we disagree because, as Dr Wampold says, it will continue to evolve.

Nå har jeg riktignok bare sett på en halv time men opplever at det viktige spørsmålet fra Birgit Undem ikke får reelle svar. Det blir snakket om terapiformer og hvordan en psykolog til slutt ser et bilde og begynner å forstå. Det blir jo ikke tatt tak i at noen ,her Birgit Undem selv forklarer og sier mye men det blir liksom ikke tatt inn. Det hun sier noe om er jo ikke metoder eller hvilke retninger noen jobber etter men rett og slett at " pasienten" selv vet noe som er av større verdi enn all verdens utdanning . Er det mangler i utdannelsen som gjør at psykologer er blinde for at det kommer mennesker til dem som vet noe om sitt liv og at det blir satt i høysetet ?

They missed the point about re-viewing the past..understanding what was/is important and what is always missed...Siri Hustvedt is very conservative and seems to misunderstand the function of rebellion is a desire for connection and enfranchisement an attempted connection between and across genders, classes, groups, ethnicities...

Susie Orbach: One of the things that has struck me since I talked to Finn, earlier today is the fact that we have a conformist culture globally with people of a certain age...I think we've got it with the adults..places that were sites of rebellion have been incorporated into the sense of being a multiple self ...if you look at a pop video you'll see that the person you'll see a person appears in 7 different outfits in 2.5 mins..torn stockings or torn jeans and then be elegant.... then you could have a fairy costume but you have to have great big boots on..you have to be all things at all times..this is a kind of rubbing of alternative identities I'm very interested in this notion of conformity in your study..but not good enough it is in terms whether there's listening instead of tick boxing on the study it is what I've noticed with my kids they come from a rebellious family, they're just like any other kid they might have a bit of individuality in that they're doing stranger things but they're passing in the culture, nobody would know that they're not the same they don't stand out in any way in the way in the way the beat poets, the hippies the leftists...they don't stand out...there's something so bloody well behaved is what you're saying...the behaviour of rebellion or hurt is in their own space, in their own body..in .their own psyche and that is an interesting phenomena because it is like a very old fashioned person it's like several generations back when we weren't allowed to have a voice, when we weren't fighting for a voice we're supposed to pretend to have a voice which actually, we're still all struggling with and it's then that its when we're, the youngsters are taking it out on themselves

Norway ask/speak/survey thousands of young people: doing better attending schools, like their parents, enjoy school but are alienated by design. The map: Are the generations challenged in new ways? Susie Orbach Susie Orbach notes the collaborative culture in Norway, but the forces in society are so intense that you can't insulate their children form the notion of 'success' which has supplanted contribution. Young people share their sorrows but young people seem to have lost the middle range of emotional expression...where are the nuances of expression in this culture? Helping young people by giving them an emotional vocabulary rather than inside grand pictures...(Instagram) the ordinary difficulties of growing up are resonated and resonating so that people aren't split from each other and themselves...Camilla 'always cautious about the knowledge' surveys have been done several times and in many ways perspectives. How have young people changed? They re better or more used to saying they\ are sad in older generations wouldn't admit it..would like to explore the status of the knowledge and the quality of knowledge, would like to look at different countries..do they have the same patterns..how much is linked to the administration of anti depressants...I'm cautious...it's easy to imagine it might well be true we can speculate..how can we get better knowledge...Finn...we see self harm and the constructs people are not only drop outs they are also drop ins they are unhealthy in the midst of health...Liv are they better at reporting, a research bias or trend in youth.in the research there are signs of a generation perfect...well behaved drink less exercise more in terms of physical health there are positive signs ...sleep difficulties.. working signs..disorders family burden conflict, risk factors always there...and new pressures, the cultural part of body image..the perfect generation..that generation consists of children who come from difficult homes how too they perceive things... Siri wonders about increase in externalisation of the self...that sort of scale culture where people become third person instead of first person...internet,n new technologies..every time a tech comes in there is hysteria

INSTITUTIONAL vs INDIGENOUS CULTURAL PSYCHOTHERAPY Peter, "WHY WE GET WORSE AS WE PRACTICE MORE." Marshall McLuhan ('Understanding Media, The Extensions of Man', 1964) would put these questions, issues & debate in terms of understanding the 'medium' or 'processes' by which we are engaged with as a clue to understanding the 'content', which our patients perceive. ie "The medium is the message." or 'Process is content'. How we go about things is where we arrive. For most people, livelihood & belonging are the greatest issues we are faced with. What both Peter & Bruce, as institutional psychotherapists, don't understand is that in terms of helping their patients or clients, talk & professionally intervention is extremely limited in the greater social-economic scheme of things. To better communicate or integrate into the social, economic & living world in which they live, holistic culture intervention as friends & colleagues starts right where people live & work, among their fellows. PROFESSIONAL FRAGMENTATION Why do institutionally trained psychotherapists & other professions such as lawyers, judges, doctors, dentists etc. have such difficulty in culturally integrating their gift into the life of their own 'communities' (Latin 'com' = 'together' + 'munus' = 'gift-or-service') in which they live? Professionals compete with advantage for oligarch printed 'money' (Greek 'mnemosis' = 'memory'), but have limitations in giving & receiving within the larger currency of human resources. Among all groups in society, psychologists & other professionals would seem to be the most alienated from interaction in their own communities considering their habit of getting away to cottages, wreck-reational & other $$$ lifestyle distractions with a comparative lack of social-economic solidarity. Each profession is institutionally fragmented as to its gift, typically delivered institutionally in an office setting rather than within the culture, community & biosphere from which all gifts arise. EXPANDING-SERVICES?!!!!! Bruce, "Expanding the services is not as big an issue as who pays for the service. . . On the whole we're doing a damn good job of helping patients." "Let's study therapists . . . what we do?" This is most often interpreted as saying, when what we do is not serving the majority of the population, let's just intensify the institutional approach. However let's consider cultural interventions & how professionals might assist in this process. COLONIAL-FROZEN-FUNDING-SYNDROME Peter, "Stopping people from falling into the river rather than spending all this money on pulling them out." Aha! Yes, but we need to go much further than isolated individual professional institutional training for 'how-to-pull-people-out-of-the-river' downstream. Prevention requires cultural interaction across whole populations. Culture is meant here in terms of Maslow's hierarchy of needs such as ensuring food, shelter, clothing, warmth & health first for all of earth's 7 billion inhabitants. One doesn't start by 'treating' the privileged, because human solidarity is the key to both personal & cultural understanding & effectiveness. The priority is having the privileged reintegrate back into their communities as well as engaging our collective economy respecting all its contributors locally & worldwide. Colonial violent invasion, as a control-paradigm, starts the process of hierarchal fragmentation of our gifts as well as erasing our cultural memory & connectedness of how to interact. Beholding to world-scale oligarchies & their metal 'money' we have a case of 'frozen-funding-syndrome'. We have all the human & physical resources, which we need to respond, but given colonial amnesia, are oblivious about how to sustainably organize & implement them in a sustainable system of relational-economy. sites.google.com/site/indigenecommunity/relational-economy BACK-TO-THE-FUTURE All humanity's worldwide 'indigenous' (Latin 'self-generating') ancestors first organized 100 person intergenerational interdisciplinary Multihome-Dwelling-Complexes (Longhouse/apartment, Pueblo/townhouse & Kanata/village) critical-mass economies-of-scale with both privacy & proximity for intimate collaboration. Such 100 person intimate yet powerful 'fractal' ('building-block' or 'Multiplier' where at all scales 'the-part-contains-the-whole') human scaling of institutional size meant that everyone including young toddlers knows the faces & voices of all members as well as having the human resources & relationships with which to act. 70% of today's population live in multihomes with an average of 32 dwelling units or 100 people. 100 people represents an earning & domestic spending 'economy' (Greek 'oikos' = 'home' + 'namein' = 'care-&-nurture') of 2 - 40 million dollars per year or that equivalent to a large size business. Note how hierarchal colonial fragmented economy doesn't even recognize the contribution of domestic economy providers & instead only recognizes commercial & industrial labours. Women & men working in domestic-economy barely figure in national accounts. sites.google.com/site/indigenecommunity/relational-economy/extending-our-welcome-participatory-multi-home-cohousing DO-WE-KNOW-WHO-WE-ARE-? Humanity's worldwide Indigenous ancestors before each colonial Zombie-Apocalypse invasion employed Graphic-writing & time-based string-shell-accounting tools to record individual contributions in Production-Society/Guilds in systems of progressive ownership over the course of one's lifetime. String-shell integrated: 'Capital' (L 'cap' = 'head' = 'collective-intelligence'), 'Currency' (flow of giving & receiving), 'Condolence' (Social-security), Collegial mentored-apprentice education, Time-math Communication & Professional Costume seemlessly into one accounting cycle. As well song & other mnemonic devices cultivated by specialized record-keepers for cultural memory of individuals & relationships enabled community & national epidemiology going back 1000s of years, conscious awareness in the present & planning going forward. With inclusive welcoming recognition for all contributions, each specialization is cultivated & communicates with the whole. Indigene Community's 'Do-we-know-who-we-are-?' project reflects indigenous human resource traditions, in developing open-source software for neighbourhoods to post websites with online Human Resource Catalogues HRC, Resource-mapping & accounting in Community Investment & Exchange Systems CIES. sites.google.com/site/indigenecommunity/structure/9-do-we-know-who-we-are

Fruitful discussion

Great talk with lots of challenges to business as usual in psychotherapy. Thank you for making these talks available/

Sett! ;-)

roflol!

BUPA's skulte skuespillertalenter ;-)