Article: Sitting on Our Hands While Chaos Reigns!

There are many people like Cho who are crying out for help - and the counseling and therapy profession seems determined not to respond! A brief look at the danger of 'best practices' in counseling. ______________________________________________________________________________________________ THE USE OF 'BEST PRACTICES' IN COUNSELING AND THERAPY The problem with devising preventive/adaptive strategies to cope in advance with people like Cho, is that today, all counseling or therapy must be based in empirically driven research, resulting in what the social sciences call, "best practices." Thus, the best practices used in therapy/counseling are meant to be 'scientifically proven' solutions to specific client problems. The problem is, there are no 'best practices' that help counselors deal with individuals with needs like Cho's. Yet, as our culture becomes more driven by liability concerns than by helping our neediest citizens, counselors have less and less freedom to create new and perhaps very radical responses to match the desperation that people like Cho must feel. This is an example of how our profession's 'best practices' are determined. Through research, we might discover that a certain approach to treating depression in college students produces results that indicate a statistically significant advantage over the use of some other method tested in the study. How do we apply statistics to such a nebulous subject? Simple: we ask the student-subjects to report on their experience with any approach that we want to explore. Typical questions include things like, "Do you feel helped by the treatment you received?" "Do you feel happier since receiving therapy?" Would you say that your relationships are doing better after receiving counseling?" ... etc. If we want to gather more data, we can ask for a responses "on a scale from 1 to 5," or ask subjects to rank their responses as "a little; quite a bit, very much"... etc. Then, this data is 'treated' statistically. Through this process, it is hoped that we can discover things that really work - and have been empirically validated. Of course, any study is only as good as 1) the number of individuals in the study (bigger is better); 2) the thoroughness of the study's design and method; 3) the 'fit' between the study group and those we will try to help by applying our 'best practices.' Another thing to wonder is just how much the study group was helped by our new treatment method. Unfortunately, 'best practices' (like new prescription drugs) are often validated and then accepted after showing very little overall effectiveness - and the level of effect is too easily lost in the complexity of statistical processing. THERE IS NO WAY TO STUDY MASS-MURDERERS IN ADVANCE Problem: there is no way to conduct this kind of study on mass murderers who die in the course of their event. There is no normative data on serial killers or mass murderers that would allow us to preemptively deal with the emotional problems that eventually lead to such tragic actions. Sure, afterwards, we can appear wise and learned. But before the tragedies occur, there is very little we can say that will help the unforeseen outcomes. As in Cho's case, the police cannot act without formal complaints. Many who call the police refuse to complete the process by signing a complaint. After all, if you sign a complaint and the matter goes to court, your identity will be revealed to the person you might rightfully fear! Even with a complaint, the justice system cannot deal effectively with individuals who have not yet broken any laws.

This is often frustrating to members of the public who can see that 'something needs to be done/ For therapists and counselors, it can be an excruciatingly painful reality: even when very disturbed individuals come to the attention of classmates, teachers (etc.), as was the case with Cho, there is often nothing that can be done if we are compelled to stay within the accepted guidelines, when liability issues demand that we provide only 'empirically validated' treatment. So, many professionals - college professors, teachers, counselors, therapists (etc.) are becoming absolutely limited by whatever current concepts of 'best practices' might be - or they run the risk of seriously endangering (or ending) their careers. Sure, any counselor can go against these professional and ethical guidelines, if they feel they have something to offer the disturbed individual that lies outside the current understanding of 'best practices.' Cho, for example, might have responded to touch, hugs, after-class one-on-one social sharing, group interventions, going fishing with a local retiree (etc.). Who can tell? But for any professional, offering such non-standard (and non-PC) contact is a very dangerous process. Because then, when a person like Cho finally 'pops' and commits mayhem, the professional who has offered non-standard help will be attacked for 'taking matters into their own hands' instead of following the approved process. Unfortunately, the 'approved process,' as I have said, has nothing to offer these one-off, non-standard cases. The counseling profession openly challenges what they regard as 'untrained individuals' who think that they might help a truly disturbed individual with some 'informal' therapy. And yet, when these tortured individuals are referred to professionals, all too often we simply fail to act, hobbled by our delusion that we can somehow transform person-to-person helping into a 'real science.' IN THE PAST PEOPLE COULD REACH OUT TO HELP PEOPLE IN NEED... In the past, what we would now regard as counseling occurred mostly at informal levels: a compassionate individual - perhaps a caring teacher, a generous 'granny,' a pastor, a sports coach or a friendly neighbor would 'take someone under their wing,' offering friendship and guidance that often came through simply modeling successful attitudes. Through these informal connections, abandoned kids, troubled students, abused wives and many others in need received care and found they could feel supported within their communities. Whenever needy individuals receive contact and caring from the community, of course the community itself is strengthened. In fact, caring for others can be said to be the very basis of 'community' itself, in all of its forms. In the 60s, a study was done to answer the question, 'Which method of psychotherapy is most effective?' The answer was unexpected: the kindof therapy did not seem to matter. What mattered was the ability of the individual therapist. Some therapists could effect change consistently, no matter what 'method' they might be using. And those who lacked this undefinable ability, seemed to be equally ineffective, no matter what method they used. Is there a message here...? Over the succeeding decades, in our attempts to make therapy 'scientific,' we increasingly have come to reject any therapeutic approach that is based upon the qualities of a particular therapist. Rather, we look for something that every therapist can do. In this same period, psychotherapy has been 'officially' transfered from a person-to-person, private relationship, to an agency service, paid for by insurance and run by a 'managed care' mentality. . WE HAVE CREATED A PERFECT 'CATCH-22' SITUATION! Back again to the problem of mass murderers: There are no scientifically established 'best practices' that could have been applied before Cho committed his acts. Plus... It is illegal or (at least professionally very risky) to do anything that isn't accepted as a 'best practice.' So we have created a perfect 'Catch-22' situation! Somehow, we need to act. Many people saw that, and yet we cannot act due to our increasingly blind allegiance to agency-driven protocols and obviously limited 'best practices.' When Cho's writing professor recognized that he needed help and reported her concerns to the university, the counseling department, police, etc., nothing happened! In our agency approaches, in our teaching institutions, we have sold out valuing the special abilities of individuals in order to feel that every counselor is equally 'special.' Where professional esteem is based in complicity with policies that remove individual agency and expertise, the entire culture is the loser. In following this goal so blindly, we have rendered our profession impotent and incapable of creative response to unique situations. And in this kind of case... we need all the creative ideas we can possibly muster! Until counselors, therapists and social service agencies begin to take responsibility for these very important lacks in our approach, there will be nothing that any concerned professional can do to prevent such things from happening in the future.