RE: theory/practice

From: Phillip Capper (phillip.capper@webresearch.co.nz)
Date: Tue Aug 28 2001 - 16:34:07 PDT


On one level I kind of sympathise with Eric's pragmatic response below,
without in any way feeling comfortable with the positivistic tools he uses
(one of the ironies that Ruth, Gary and Bill remind us of is that
positivistic approaches to psychology are most unpositivistic in their
consequences).

But what makes me especially sensitive to what Eric says at present is the
situation here in New Zealand. In a country of 3.8 million people we
currently have 3 murder trials going on at the same time where people who
have been experiencing a 10 year old experiment in the 'service delivery'
approach to mental health have been cast adrift to kill, in two cases, their
mothers and in the third case a flatmate. This follows a sequence of seven
similar trials over the past year as well as three cases this year where a
family member receiving 'services' from the mental health system, has
murdered a child under 12 months old.

Not surprisingly this is causing a huge public call for reappraisal of the
whole philosophy - and a lot of sanctimonious 'told you so's' from those who
warned of this outcome. The trouble is, of course, that the demand for
'objective' assessment in order to determine how resources are to be
allocated is actually a cost control mechanism in the eyes of those who
legislate for them. But because the 'positivistic' measures focus on the
characteristics of the individual, and do not factor in the nature of the
environment in which the individual lives, then regular misallocation of
resources occurs. The point is, Eric, that 'current fashions' in assessment
practices are not idiosyncratic, but are a response grounded in whatever set
of values and assumptions is currently in the ascendancy in the eternal
debate about the roles and responsibilities of the state in respect of those
whose mental condition or circumstances renders them temporarily or
permanently incapable in meeting the demands of community membership.

The whole environment in which an individual functions (or fails to) is
something that can only be assessed by the careful professional judgements
of field professionals given the resources to make such assessments. In
America your incredibly dangerous litigation environment makes it difficult
for health professionals to be willing to expose themselves in that way.
Here we don't have that excuse, but we are doing exactly the same things in
the name of 'accountability'.

The trouble with accountability is that when you have it nobody takes
responsibility for anything. Accountability leads us to trite 'positivistic'
measures, which are a nonsense because they only measure (and then
inefficiently) one factor in the system. But what they do allow is for the
beleaguered health professional to go into court (in the US) or a career
destroying media frenzy (in NZ) and deny RESPONSIBILITY for the disaster
because they acted in accordance with the health system's ACCOUNTABILITY
mechanisms.

Phillip Capper
WEB Research
PO Box 2855
(Level 9, 142 Featherston Street)
Wellington
New Zealand

Ph: (64) 4 499 8140
Fx: (64) 4 499 8395

  -----Original Message-----
  From: MnFamilyMan@aol.com [mailto:MnFamilyMan@aol.com]
  Sent: Wednesday, 29 August 2001 10:04
  To: xmca@weber.ucsd.edu
  Subject: Re: theory/practice

  Ruth, Gary, and Bill,

  Believe me I understand the cultural emphasis which can determine a
person's
  intelligence and the best practice for measururing and whether what we are
  measuring is intelligence or merely the skill of being able to repsond in
a
  culturally appropriate manner. But from the standpoint of someone who is
  responsible for both assessing and providing subsequent service for those
who
  qualify I am telling the those of you who construct theory that at the
point
  of practice if there hasn't been any data gathered using a positivist
  methodology then often what is gathered is charged with emotional baggage.
  Yes, sometimes emotions come into play and actually can be helpful.
However,
  if gut feelings are all that is used to plan for a client's service then
the
  plan will waiver with the person's current emotions. Therefore, the way I
  see it, service providers need to be able to measure some ablities that
  remain somewhat constant over time. If not intellectual potential, then
what?

  More to follow,
  eric



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