Misplaced Pages

Revision as of 16:11, 18 July 2006

This is my article and I am the holder of the copyright. When the article was previously printed I allowed printing of the article, but retained ownership of the copyright.

Arthur Becker-Weidman, Ph.D., Center For Family Development 716-810-0790 AWeidman@Concentric.net

The comment above relates to an earlier version of the article, which had been marked as a possible copyright infringement. It was published on another site, but the assertion seems genuine enough to me. During the review, User:AWeidman followed the procedure given for rewriting the article on a /Temp subpage. As that version seemed to me more in the style of a encyclopedia article, and was better referenced etc., I moved it in place over the original version, which remains available in the page history. --Michael Snow 22:49, 28 March 2006 (UTC)

The claim that DDP meets the criteria for the EBT designation is a very questionable one, as I recently pointed out in a letter to the editorial board of the Child and Adolescent Social Work journal, cc'd to Becker-Weidman. My comments on the nature of evidentiary bases, especially as they relate to Becker-Weidman's publication, will shortly be posted on www.childrenintherapy.org -- under the title "EBT or not EBT?" I would appreciate editing of this page to include any rebuttal to those remarks that Becker-Weidman may be able to provide. Proof by assertion is not acceptable evidence, and if Misplaced Pages permits simple assertions on controversial issues, it may as well declare itself a blog. Jean Mercer.

The material was published in a professional peer-reviewed journal. Child and Adolescent Social Work found the study valid, reliable, and as meeting criteria for evidence-based-treatment as described in the article. Your comments have not yet appeared in the journal. Will they be published or was you letter dismissed as irrelevant. The article demonstrates that Dyadic Developmental Psychotherapy is an evidence based treatment and subsequent resarch that has also been published confirms that.

Please note that my comments were not written for publication, but as a letter to the editorial board, as I felt it would be desirable to allow the journal to handle the matter in a private way. I do notice that the article did not appear in the issue referenced in this article. Child and Adolescent Social Work Journal accepted the article; this is not an indication that they considered the material valid or reliable (and indeed i don't see what those adjectives have to do with a CCT study), or that they consider DDP to meet criteria for an evidentiary basis-- for example, meeting the TREND guidelines. As i am sure you know, I have commented elsewhere on this peer review issue. Not all journals have well-organized review procedures,and even when they do, mistakes can be made. You cannot segue from a journal's statement that it is peer-reviewed to the conclusion that any material published there automatically meets criteria for an evidentiary basis-- this is apples and oranges, even pineapples or kiwi fruit. In fact, DDP does not have a satisfactory basis of evidence for a number of reasons: 1)participants were self-selected, introducing confounding variables; no explanation was given for the failure of the comparison group to enter treatment, and no demographic comparison of the groups was presented; 2)there has been no independent replication of these findings; 3)researchers were apparently not blind to the treatment status of participants; 4)human subjects protection guidelines were not observed; 5)no specific description of treatment seems to be available, and the description given in the Wiki piece under consideration is at variance with the description in the "Dr. Art" book currently available on Becker-Weidman's web site; 6) the statistical analysis is problematic, substituting the easy but dangerous multiple-t approach to the ANOVA which should have been done here; 7) although the Wiki piece stresses the CBCL findings, the journal article (as it was posted on the web site) refers also to the use of the egregiously faulty RADQ checklist. If anyone would like to provide substantive counter-arguments to these points, as opposed to simply deleting my comments or mounting personal attacks, I would be very pleased to read them and to see them included in the article.Jean Mercer 15:52, 11 July 2006 (UTC)

Well, they obvioulsy rejected your "letter" and chose not to publish it. The journal, as far as I can see is a professional peer-reviewed journal that found Dr. Becker-Weidman's article worthy of publication and as providing substantive and valuable material that would be of use to professionals. The article did describe that those in the control group came for evaluation only and the statistics clearly show that the two groups did not differ in a significant way on a broad range of demographic, clinical, and test score data. CBCL scores are valid and reliable. Overall, the claims you make are irrelevant as the journal's acceptance of the article suggests your "issues" with the article are minor and do not take away from the scientific validity and value of this study. RalphLender 17:54, 11 July 2006 (UTC)

No, what it suggests is that CASWJ is not particularly concerned with research design. Not all journals have the same concerns. But from the point of view of establishing an evidentiary basis, my questions need to be addressed. Volunteers are different from non-volunteers, that's well known. So, why did some people come for evaluation only, and others for evaluation plus treatment? What were the basic differences between the groups? Did they have to do with family needs-- did some of the parents not like the offered treatment-- were other treatments chosen instead? All of those questions are relevant to interpretation of the outcome, as are the points that always go unmentioned, the transparency issues, the use of the RADQ, and the choice of statistics... not to mention compliance with guidelines for protection of human subjects.Scott Lilienfeld has been telling us that clinicians are not educated to understand these issues, and I'm afraid he may be right.

Look, a lot of people have thought and written a great deal about establishing evidence to support the efficacy and safety of treatments. It's quite difficult to do a good CCT study. I don't demand that you randomize-- that can be almost impossible, especially in private practice. I don't even demand that you have a better design. But I do demand transparency in reporting, including appropriate statistical handling. By the way, it's really unconscionable to leave the incorrect reference information on this page and elsewhere, making it impossible for many readers to examine the paper for themselves. If you believe that there is really clear-cut evidence to support DDP, put it out there where readers can get at it, and explain why you think the design and analysis are acceptable.

Once again, the real issue is not who is King of the Attachment Therapists or Big Expert on Research Design. The question is about protection of children and families, especially highly vulnerable adoptive families. It is a blow against those people to claim that a treatment is effective without unimpeachable evidence.To convince them of what is not true is to persuade them to spend their scarce resources and get nothing in return. I don't know what your ethics code says about that, but mine disapproves. Jean Mercer 20:25, 11 July 2006 (UTC)

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Someone with an IP address from the Buffalo, NY, area seems to so much lack a secure base that s/he can't tolerate any discussion. So s/he deletes things (like the paragraph before last) in an Orwellian attempt to rewrite history. So I've put back the paragraph and remind that s/he can't rewrite the Misplaced Pages history. For the sake of his/her rapidly declining reputation, s/he should try explaining or justifying his/her editing behavior. 206.81.65.234 21:50, 24 April 2006 (UTC) A friend (not an alter ego) of Jean Mercer and of the truth

Page is growing nicely

This page is growing well. The evidence base for this form of treatment is rapidly expanding. Forgot to sign in RalphLender 20:41, 5 July 2006 (UTC)

I've read some very interesting material about this treatment and find it very compelling RalphLender 20:41, 5 July 2006 (UTC)

I have done some editng that I think reflects reality a bit better than the previous version. However, I notice a great deal of disorganization and repetition in the article. Are the original study and the follow-up really as identical as is presented here? One does think of Sir Cyril Burtt. Jean Mercer 22:13, 11 July 2006 (UTC)

I added a citation and cleaned up some of the material to be more neutral and correct DPeterson 00:34, 12 July 2006 (UTC)

Perhaps, if for "neutral" one reads "positive." however, I see you left the apostrophes I inserted-- that's a step in the right direction. My questions from 11 july still need to be answered, and the article is not well organized. I would propose the following parts: definition; description of treatment; theoretical background; evidentiary basis. Every point currently in the article could be placed in one of these categories. In the description and the theoretical sections, the material needs to be more concisely descriptive; presently there are a lot of words, but the naive reader would not know much after wading through them. The descriptive section also needs to clarify the work done with parents-- the "Dr. Art" book on Becker-Weidman's web site does not suggest much about this except that parents are apparently advised to bottle-feed school-age children. In the section about theory, I would think a reference to Stern would be a propos. Also, because of Hughes' remarks in his 1997 (I think) book, it would seem that Foster Cline's contribution should be acknowledged-- Hughes has never given a clear statement about his current view on this and why it has altered, if it has. Although the concept of attachment is shared with Bowlby, much of the background lies elsewhere; Bowlby never suggested that early stages of attachment could be re-worked by imitating the normal events of those periods. This is an important point to deal with, because the APSAC task force report specifically rejected the use of age regression techniques (see the november issue of Child Maltreatment for a LTE proposing a definition of age regression.)To claim compliance with APSAC, proponents of DDP need to offer a rationale for their use of bottle-feeding and similar practices.Jean Mercer 12:52, 12 July 2006 (UTC)

As a reader of this, and other pages, it might be useful for you to read the book 'Creating Capacity For Attachment' edited by Dr. Becker-Weidman & Deborah Shell, Wood N Barnes, Oklahoma City:OK 2005 as that has an excellent description of the theory base for Dyadic Developmental Psychotherapy. I found nothing in that book that suggest the approach is coercive. I aldo found no references to Foster Cline. The book has an excellent chapter about work with parents too; this has nothing in it about "age regression," which, to my reading, is not a part of this treatment approach. The approach is consistent with APSAC and various other practice parameters. So, I think all your concerns have been addressed in that text. RalphLender 15:27, 12 July 2006 (UTC)

The reference to Foster Cline had to do with Hughes, whose work is said to be the foundation of DDP. I have no doubt that the B-W and Shell book does not index age regression or use this term, but there is some category of practices that APSAC termed "age regression" (and unfortunately, in the midst of their fine work, they neglected to define the term). I assume that no one is speaking seriously of hypnotic age regression, past-lives regression, or any of that stuff, so I see nothing else for age regression to mean except practices that treat the child in age-inappropriate ways such as bottle-feeding and prolonged gaze, with the intention of re-working emotional processes that are thought to have gone wrong long before. If I am wrong, perhaps you can tell me what APSAC meant by rejecting age regression, and what practices would be relevant here. Your explanation would need to include a rationale for Dr. Becker-Weidman's mentioning on his web site the practice of bottle-feeding a school-age child.12.75.151.203 16:12, 12 July 2006 (UTC) Sorry, i thought I'd signed in. Jean Mercer 21:52, 12 July 2006 (UTC)

Well, since the book does not referernce Foster Cline and does not include recommendations or treatment methods that meet 12.75.151.203's def. of age-regerssion, this is now a non-issue and not relevant to this discussion. So, this discussion can be closed at this time. RalphLender 17:07, 12 July 2006 (UTC)

Not quite so fast, perhaps. Examining the actual theoretical and historical background of an idea may take more time and work than the idea's proponents sometimes think. Often examination of earlier work from which a current author drew concepts will tell you a lot about a theme that's being elaborated. I'm suggesting that Hughes' past enthusiasm for holding therapy, in the Foster Cline pattern, is a foundation for DDP; this seems especially likely to be relevant because Becker-Weidman states that he received training in Evergreen. Of course, not too many people would want to cite Cline nowadays, so i don't expect this to be mentioned in the edited book. As for age regression, are you suggesting that the material on Dr. Becker-Weidman's web site is not congruent with his statements in his paper in that edited book? If that's the case, perhaps you'd better discuss the matter in this article. Treatment methods certainly evolve-- are you saying that's happened here? There is no question that the Dr. Art book refers to bottle-feeding, so perhaps there's more to be discussed about this treatment than has yet appeared. Jean Mercer 21:52, 12 July 2006 (UTC)

Incidentally, the report of the follow-up study has one quite remarkable characteristic, and other researchers would be most appreciative if Dr. Becker-Weidman would tell us how he managed this. It would appear that no participants from either the treatment or the comparison group were lost to follow-up after an interval of almost four years. Even in residential treatment this would be surprising.Jean Mercer 21:58, 12 July 2006 (UTC)

That is just silly. Must we discuss surgery pre-Anesthesia if discussing new developments in surgery? No, what you suggest is not relevant to articles here. The book speaks for itself. Dr. Becker-Weidman's credentials are extensive and impressive and his publications are compelling and well-respected in the professional community; at least as I read it. I am not going to answer every one of your questions as these are irrelvant and "red-herrings." In addition, you obviously did not read the two studies published by Dr. Becker-Weidman carefully as there is specific discussion of attrition. This now makes one wonder about the veracity of your other statements if you either did not read the material carefully ore are misrepresenting it. In any event you are incorrect. I'd say this line of discussion if completed...Next. DPeterson 22:25, 12 July 2006 (UTC)

This Wiki article, right here, says the two studies had the same numbers of people and appears to say that they were there both initially and at the later assessments. If this was not the case-- e.g. there were 100 initially in the treatment group, in the treatment goup, and this was reduced to 34 at the end of the treatment period with 34 still present a couple of years later-- this should be said, especially because there's so much detail being given. Why not just refer the reader to the published paper if a full discussion is not to be given? (Speaking of that-- got any page numbers for the CASWJ article? Without page numbers, you know, readers can't get it on interlibrary loan if that's what they need to do, and it is an obscure publication.)

As for the anesthesia analogy, no, of course, if you're talking about methods, there would be no reason to talk about history. But if you were talking about a theory of anesthesia and how it gave rise to current work in anesthesia, then you would need to talk about history. This article and other related pieces make a point of mentioning the theoretical background of DDP--- you needn't do this if you don't want to, but if you do it you need to discuss the historical development from one thing to another. Otherwise, you're just waving the name Bowlby around as a symbol of authority, not actually considering the development of ideas. In any case, it's an interesting question: how come Hughes was into holding ten years ago, now he's not? What is the explanation? Can Hughes or B-W explain this change of thinking? If they can, it's awfully important, because they are the people who might be able to turn around the group who still use coercive restraint. So the question about background is very meaningful at every level, including protections for children presently in treatment. Jean Mercer 23:45, 12 July 2006 (UTC)

Again, read the book and the articles so you have your 'facts' straight. An article about anesthesia would not include the material you describe...that would just be irrelevant. Dr. Hughes and Dr. Becker-Weidmaan do not need to describe changes in their practice. Do we ask the cancer surgeon to explain in excruiting detail, as you seem to want, why the surgeon no longer routinely does radical mastectomies when the surgeon did that routinely ten years ago? No, of course not!

The practice of Dyadic Developmental Psychotherapy appears to meet all professional standards, APA, NASW, APSAC, Amer Academy of Pediatrics, etc., etc., etc....

Again, raising "red-herrings," much as the ACT group and other fringe groups do is not productive here, so the discussion really ought to end...but if you insist on acting as a spokesperson for ACT, at least say so. A Neutral Point of View is much preferred....68.66.160.228 00:33, 13 July 2006 (UTC)

• • • When beliefs are diametrically opposed, the only neutrality involves two statements, each clarifying the stand of one group. Is that what you would like to do?12.75.168.251 17:55, 13 July 2006 (UTC)Jean Mercer (sorry , flubbed sign-in somehow)

I agree. The book and articles are clear. The approach is not coercive and does not use "age-regression" as part of the method. I see no point in continuing this "dialogue" and giving validity to views that are not relevant. The facts, as previously put, are quite clear. RalphLender 13:57, 13 July 2006 (UTC)

Saying the facts are clear doesn't make them so, and repeating a claim of effectiveness is just a quaint rhetorical device. This is an encyclopedia article and therefore should be accessible to the lay reader. If that person wanted to read all the original material, he or she would go and do so; whatever is stated in the article should provide the information in a concise but complete form that the average reader can deal with. That means 1)the whole article needs to be re-written for organization-- I suggested earlier a format that would work; 2)if details of research are mentioned at all (and they need not be), necessary information should be included, and unnecessary repetition should be omitted; 3)where any point is made, it needs to be a meaningful part of the whole communication, not just a signal commanding belief; this is why I say, either remove the allusion to theory completely, or if you think it's important do a proper job on it.

I wouldn't expect a description of anesthesia to refer to background unless the writer alluded to it to begin with-- then I'd want to know what the connection was. You (or somebody) have made the allusion to theory, so either complete it or remove it. And, as for explaining why a change has been made, I'd say that a professional who has advised others to follow practices that the practitioner later sees as inappropriate, has an obligation to correct the ill effects of their earlier advice. Anyone can make a mistake, but people with fiduciary responsibilities have a particular obligation to correct theirs in public.

With respect to age regression, the Becker-Weidman web site does refer to relevant practices, but they aren't mentioned here in this article. Does that mean that there's more to DDP than is discussed here? Or does it mean that B-W's treatment is not DDP? The latter would be of interest, because the data reported here all came out of his office as far as I know.

Well, guys, this has been real, but you can't be having fun all the time. I'm going out of town for a few days. See ya next week, no doubt.12.75.168.251 17:55, 13 July 2006 (UTC) Comments by unknown persons are suspect...It would be better to sign in. RalphLender 18:05, 13 July 2006 (UTC) It was me, Jean Mercer-- I thought I had signed in Jean Mercer 19:23, 13 July 2006 (UTC)

But the facts are clear...continuing to say they are not does not make that true. Your suggestions are not helpful in creating a useful article. The inclusion to theory is well written. I disagree with your assessment. The article is good as it is. While you may have a particular point to advocate for, based on memberhip, etc., this is probably not the place to do so. I see no references to "age-regression" on the site for the Center For Family Development, of which Dr. Becker-Weidman is a member. The book he co-edited and his articles "speak for themselves," on this subject and clearly preclude coercive interventions. RalphLender 21:05, 13 July 2006 (UTC)

I have to agree with RalphLender JonesRD 21:55, 13 July 2006 (UTC)

Yes, the article is very good: well written and with appropriate citations and support. I agree with the comments of RalphLender regarding Dr. Becker-Weidman. He is a licensed mental health professioal with many years experience and a number of publications to his credit. I disagree with mercer's comments and advocacy. DPeterson 02:34, 18 July 2006 (UTC)

Supporting References =

I added a couple of references that show support for several of the principles of Dyadic Developmental Psychotherapy. If others have references or thoughts, let me know. DPeterson 02:39, 18 July 2006 (UTC)

I find it quite incredible that anyone thinks this article is well-written-- even those who are committed to the content. But, be that as it may, I repeat for the benefit of any newcomers that there is more than one point of view here. I am working on an additional section that will be a critical analysis of the existing material, including the Hughes work.I cannot believe that it would be congruent with Wiki principles for anyone to resist the inclusion of critical material of this type. I intend to include discussion of the age regression concept, by the way.Jean Mercer 14:15, 18 July 2006 (UTC)

I find the material on this page excellent. It is important that editors maintain a neutral point of view and not act as advocates or spokespersons for particular groups. Misplaced Pages articles should represent mainstream consensus views on topics and not be platforms for fringe groups or extreme points of view, which are not neutral points of view. RalphLender 16:11, 18 July 2006 (UTC)