Clinicians Digest Jan/Feb 2008 - Page 2


Critics remain unconvinced. They say the APA's position is merely a self-serving attempt to safeguard billions of dollars of contracts with the Defense Department and to protect its many members who have military ties. Even if the APA truly intends to protect detainees, they contend, for psychologists working within facilities where abuse is rampant and the entire chain of command may be complicit, their complaints will go nowhere, and they merely lend an aura of legitimacy to a system of prisons that violates international law.

This argument has been underscored by Robert J. Lifton, famous for his study of the role of doctors in Nazi Germany, who's said, "Psychologists are meant to heal and not break down, and therefore any consulting or involvement in interrogations . . . should be prohibited by the American Psychological Association."

Motivating Depressed Clients for Therapy

Every therapist knows that clients' ambivalence about change is a primary obstacle to effective treatment. Now there's increasing evidence that an approach called Motivational Interviewing (MI), can help directly address clients' mixed feelings about being in therapy.

Originally developed for work with alcoholics, a notoriously difficult treatment population, MI incorporates old-fashioned Rogerian principles of empathic listening and genuine respect for the client's perspective. It draws on the work of change theorists James Proschaska and Carlo DiClemente, which identifies the distinct stages ambivalent clients need to pass through to develop a more proactive engagement in therapy. Instead of emphasizing prepackaged treatment protocols, MI "rolls with clients' resistance rather than butting up against it," in the words of Allan Zuckoff, of the University of Pittsburgh School of Medicine.

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