Therapy essentials: your “science hat” & bullwhip (no batteries required).

I consider myself a scientist.  I wear this hat officially when conducting research, but I also wear it every time I sit with a patient.  In my research, my science is pretty self-evident: I identify a research question, develop falsifiable hypotheses, and then collect quantifiable data to see whether or not the phenomenon I’m studying behaves the way I think it does.

A very similar process unfolds when I work with you in my clinic.  However, from your vantage point, you might not realize it right away.  Nevertheless, we are two collaborative empiricists.

Most often, you will define the “research question”.  Usually, this is the very reason that you’re coming to see me.  Sometimes the questions we think we’re asking are not necessarily the ones we should be asking.  For example, questions like, “Why is this happening to me?” are often disguised ways of asking, “How can I change this?”  If that’s the case, I’ll help you refine your question.  Our questions will also be guided by the data you bring to your initial assessment.  These data points include your responses to various questionnaires, as well as other important information we discuss (e.g., current symptoms, symptom history).

Next, we’ll develop hypotheses about which strategies are most likely to be helpful for you.  Since I’m an evidence-based medicine kind-of-guy, I’ll let you know what research studies say about the types of interventions that are most likely to be effective for resolving your “research question”. Although not everyone is the same and responds to the exact same treatment protocol, we’ll let science be our guide.  For example, research studies tell us that cognitive behavioral therapy (CBT) is great for reducing symptoms of depression, whereas something called exposure and response prevention (ERP) is particularly good for treating OCD.

We will then implement our plan and collect data to make sure we’re moving in the right direction.  These data points include answers to questions, such as:

• How is your anxiety changing as you are getting more practice with exposure?
• What are you doing now that you’ve avoided in the past?
• How does your day-to-day life reflect your personal values?
• How effective are you at work, at home, and in social situations?
• How many panic attacks are you having per week/month/year now compared to the past?

These are just a few simple questions (there are many, many  more), but as you can see, each reflects a significant potential change in your quality of life.  Additional data points might also include updated scores on symptom inventories like the Beck Depression Inventory, the Y-BOCS, or the SCL-90.

At various points, we’ll review our progress and decide whether or not your “research question” has been sufficiently answered.  If so, it’s time for you to go off into the world and practice your own independent science (of course, I’ll request that you continue to wear your own invisible, honorary scientist hat).  If not, we’ll troubleshoot the problem together and make sure that our question was well-targeted, our method sound, and our data valid.

Whether in the lab, clinic, or real-life, you can’t escape science.  So why not embrace it?

You can read more about my treatment philosophy here.

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