Speaking about his 46th book Eleven Blunders that Have Crippled Psychotherapy in America: A Remedial Unblundering and his diagnosis of and prescription for the ailments he sees in his profession.
Nicholas Cummings Ph.D. ’58 once said, “I have not had a career; I’ve had a series of careers.” It’s a fitting way to describe the many roles he has played in the psychology profession. Among his accomplishments are: serving as chief of mental health for Kaiser Permanente; founding the four campuses of the California School of Professional Psychology, the nation’s first independent professional psychology program; serving as president of the American Psychological Association; and launching American Biodyne, the nation’s first managed behavioral health organization. Throughout, he has maintained a robust clinical psychology practice, and he continues to teach in the psychology department at the University of Nevada School of Medicine. A prolific and at times controversial author, he will publish later this year his 46th book, Eleven Blunders that Have Crippled Psychotherapy in America: A Remedial Unblundering.
Of the 11 blunders you mention, which one or which ones do you see as the most egregious?
It’s a toss up between not recognizing that we’re part of healthcare and not just mental health…and the inabilities to realize the practices of business.
You describe fellow psychologists as hero worshippers who fall into various camps, or “psycho-religions.” What camp(s) do you fall into and who are your heroes in the field?
Gordon Derner was one of my very early heroes. Before him was probably Dr. Frieda Frohm-Reichman, who really got me interested in psychology when I was still in the army in World War II…They were way ahead of their time. What they both taught me was that psychotherapy should be where the patient is.
In your book, you warn that the psychologist’s traditional 50-minute hour is outmoded in the face of managed healthcare and patients’ needs. I’m curious about the complaint that “my doctor spends no time with me,” that we so often hear about physicians trying to see hundreds of patients. Do psychologists run that risk if they scale back the length of their therapy sessions?
Abandoning the 50-minute hour doesn’t mean shrinking the time you spend with a patient. It may even expand it…We’re talking about flexibility here. We’re not talking about shrinking time…We also found that for some 60-plus psychological conditions, tailored, evidence-based group therapy was superior to individual therapy…Being mired all this time in the 50-minute hour has prevented us from innovating.
What can psychologists learn from dentists?
Dentistry 20 years ago was a dead profession. Fluoride had come in. The mainstay of dentistry was filling cavities, and fluoride so reduced that for children especially that dentistry was languishing. The American Dental Association, the ADA, mounted a program to teach dentists how to develop practices that patients wanted and needed…And dentistry now is flourishing. In many respects, dentists are doing better than primary care physicians.
Why is it important for those teaching psychology to also maintain practices, or at least stay in touch with practice trends?
It’s true of all practice professions…You lose touch with the patient when you don’t have hands-on practice…The farther away you get from hands-on delivery of services with the patient, the less and less able you are to properly teach it…All through his teaching, Gordon Derner had a practice. He had a very, very extensive practice…Gordon Derner was such a good teacher because he was a committed practitioner.
Why is it important for psychologists to think like business people?
Because business is the basis of practice…If you’re going to help people, you’ve got to be able to make a living at it.
How confident are you that psychology can, in your term, unblunder itself and how long will this process take?
Well, it’s not quite too late yet, but the point of no return is fast approaching.
How, in your view, has political correctness affected psychology practice?
It politicizes science and practice integrity, so that we go toward not scientific evidence and professional integrity, we go with what is politically correct, and it blinds us.
What is “victimology” and why is it dangerous?
“Victimology” had a firm grip on psychology for almost two decades. It said that certain groups had been so victimized that we have to excuse their behavior. And consequently, psychotherapy unfortunately and inadvertently, what can I say, exaggerated and encouraged the victim’s status, rather than helping the person pull herself or himself up from the mire…“Victimology” is a dead end…We adopted “victimology” out of our sense of compassion…We’re compassionate people, and we blundered into “victimology.”
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