More on questionable training workshops for clinical psychologists

After the last post, I was intrigued to know more about the organisation that is hosting the Terry Fralich workshops, Tatra Training, as our secretary mentioned she receives a lot of emails from them asking her to advertise their other workshops.

I had a look at the list of trainers on Tatra Training’s website. It seems that a number of them are associated with an organization called the Dialectical Behaviour Therapy National Certification and Accreditation Association (DBTNCAA), allegedly “the first active organisation to certify DBT providers and accredit DBT programs.” – notably, the appropriately-named Dr. Cathy Moonshine (alcohol and chemical dependency treatment counselor), and Lane Pederson (PsyD, President/CEO). However, this organization is not in any way endorsed by the founder of Dialectical Behaviour Therapy herself, Marsha Linehan. In fact, there is a disclaimer on Cathy Moonshine’s site to this effect:

“All trainings, clinical support, and products sold by Dr. Moonshine are of her own creation without collaboration with Dr. Linehan, or Dr. Linehan’s affiliated company, Behavioral Tech, LLC. Dr. Moonshine’s products are not sanctioned by, sponsored, licensed, or affiliated with Dr. Linehan and/or Behavioral Tech, LLC.”

Thus, it seems Linehan herself has a competing company, but she does at least have an impressive CV with many research articles to back her up. I have contacted her for comment on the DBTNCAA and Tatra Training, but she has not responded to date.

Let’s have a look at some of the other “trainers” and their biographies. Dr. Daniel Short is listed as a Faculty Member at Argosy University, a for-profit college in Minnesota that has changed its name and is at now being sued by former students for fraud:

http://www.bizjournals.com/denver/news/2013/12/05/argosy-university-pays-colorado-33m.html?page=all

Dr Gregory Lester’s biography claims that he has published papers in “The Journal of the American Medical Association, The Western Journal of Medicine, The Journal of Marriage and Family Therapy, The Journal of Behaviour Therapy, Emergency Medicine News, The Yearbook of Family Practice, The Transactional Analysis Journal, and The Sceptical Inquirer”. But a PubMed search reveals none of these publications. An online list from his own website reveals very few relevant publications, and does not even include all of the outlets listed above; instead, there are things like “Dealing with the Difficult Diner”, in Restaurant Hospitality, and “Dealing with personality disorders” in The Priest Magazine. In addition, there are several books, which you can presumably buy at his workshops.

Interestingly, his bio also states that “… he has specialised in Personality Disorders for over 25 years, and has been a participant in multiple studies that form the basis for the DSM V revision of the section on Personality Disorders.” He has participated in these studies? Was he a control, or does he have a personality disorder himself? Because he certainly wasn’t an author on any of these studies.

Dr Brett Deacon seems to check out OK. Surprising to find him associated with this bunch.

Dr Daniel Fox is said to be the author of “numerous articles on personality, ethics, and neurofeedback”, but only one on neurofeedback (in the Journal of Applied Psychophysiology and Biofeedback) turned up in PubMed. This seems to be a review rather than an original research piece. An author search on “Fox, DJ [AU] and Ethics” returned no hits, and neither did “personality”, He also seems to have a book, which comes with optional seminar bundles!

Jerold J Kreisman is another of the Tatra stars and seems to feature as the Borderline Personality expert. The site claims breathlessly that he ‘…has appeared on many media programs, including The Oprah Winfrey and Sally Jesse Raphael Shows. He has been listed in “Top Doctors,” “Best Doctors in America,” “Patients’ Choice Doctors,” and “Who’s Who.”’. It also, more seriously, claims he has published “over twenty articles and book chapters”; however, PubMed only turns up four publications, one if which is from 1975 so is probably not by the same JJ Kreisman. Of the three remaining publications, only one 1996 paper (on which he is third author) is related to BPD, and this seems subject to an erratum (though the erratum itself seems impossible to find; the article seems to have been subject to a Letter to the Editor, which also is hard to find.). The only relevant publications seem to be, again, pop-psych-style books with titles like I Hate You–Don’t Leave Me: Understanding the Borderline Personality.

What about Ronald Potter-Efron, the facilitator of Healing the Angry Brain: Changing the Brain & Behaviours of Angry, Aggressive, Raging & Domestically Violent Clients? Again, he is a prolific author of self-help books. Google Scholar and Scopus do turn up about five academic publications, all from the late 1980s and early 1990s. Since then, he seems to have turned to the more lucrative self-help industry.

So all in all, it seems the Tatra Training people work via a fairly aggressive marketing campaign to clinical psychology academic departments and, presumably, clinicians themselves, as well as other “Corporate and Allied Health” practitioners. Their main address is in Adelaide, South Australia; Google Street View shows an anonymous-looking office block. Tatra was founded by Hanna Nowicki (LLB, BA Psych., Postgrad. Soc. Admin, Cert IV Training & Workplace Assessment), who seems to have no qualification in psychology other than her B.A. Psych, although this hasn’t stopped her developing and presenting “…multiple workshops on personality disorders, self injury, suicide risk assessment, depression, engagement techniques and introduction to mental health.”

Disturbingly, the list of clients includes many government organisations such as Centrelink, Correctional Services, Housing SA, Worklink Queensland, and more nebulously-named organisations such as “Residential Care Services”, “Brain Injury and Disability Services”, “Public Mental Health Services”, “Hospital Social Work Departments”, and so on.

How much money are these people making per workshop? Well, if the Sydney venue is anything to go by, the Wesley Conference Centre in Sydney seats 875 people, so if that sells out at $335 a head that’s $293,125. (The Wesley Centre does have smaller venues, so perhaps the organisers aren’t expecting such a large crowd. Their general preference for booking conference centres and Leagues Clubs, though, suggests that they are.) If the workshop is held in all five major cities (assume most are smaller than Sydney, so let’s be conservative and assume gross takings of $200,000 per workshop), then that’s a tidy sum ($1m per workshop, so $2m per year if only 2 workshops are held, as in 2014 and 2015). Of course one must subtract venue hire, advertising costs, speaker fees, catering, etc. etc., but all the same this seems quite a promising business model, particularly when combined with the in-house training offered.

I am concerned that these people are pushing a product that is not what is advertised, and claiming to be experts when they are not, sometimes supported by what seem to be questionable claims. I am concerned that naïve young mental health professionals, looking for accreditation hours, are being fed misleading information that is not based on scientific evidence. If anyone has direct experience of these workshops, I would be very interested to know about it.

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