Neuropsychotherapy? No, I hadn’t heard of it either.

Recently, a friend asked me to look into the back-story of a fellow called Dr. Pieter Roussouw, who is offering some very expensive 2-day workshops for professional development using terms like “neuropsychotherapy”.

Of course, my bullshit-meter started buzzing like mad, so I had a quick look online.

The first few results looked legitimate enough. He is apparently on the staff at the University of Queensland, where he is a Director of the Master of Counselling Program and a Senior Lecturer in the School of Social Work and Human Services. He is also a member of the Australian Psychological Society; and, although it isn’t mentioned on the UQ site, he also has his own company, Mediros Clinical Solutions. The slogan of the company is “How talking therapies change the brain”, and there’s the usual gratuitous picture of a transparent head with a glowing brain in it.

He is also on the Advisory Board of The Neuropsychotherapist, where is is claimed that he “is an expert in anxiety and mood disorders”, and has “published five scientific books and twenty scientific articles”. Indeed, there are around this number of articles listed on the UQ site, but oddly a PubMed search only reveals two papers (neither of them first-author papers, and neither of them in neuroscience – both relate to internet-delivered CBT). Looking for the “five scientific books”, the only book I could find was “BrainWise Leadership: Practical neuroscience to survive and thrive at work”. He is second author on this book, which is also advertised on his company website. I could not find any other books, though it is possible they were published through small academic publishers and are now out of print.

Returning to the UQ site, it seems almost all of the claimed journal publications are in a journal called Neurospychotherapy. What is this journal? Delving not-very-deeply (i.e. Googling it), Neurospychotherapy turns out to be a “free e-journal” available through Dr. Roussouw’s company website. So… not exactly what I would have thought the University of Queensland would recognise as a peer-reviewed publication. There are a few others in another outlet called Neurospychotherapy in Australia, of which Dr. Roussouw is an editor (this appears to be another free e-journal).

His profile on The Neuropsychotherapist says “Currently he is involved in full-time research in the fields of neurobiology and neuropsychotherapy as well as clinical training for clinicians, psychologists and general practitioners” (my emphasis). It seems odd for someone who is engaged in full-time research in neurobiology not to have any publications in peer-reviewed journals on the topic.

Mediros seems a well set up company. They have a slick-looking website with lots of information about upcoming workshops being offered, each with its own sciencey-sounding link to Things About the Brain. It’s tuned right in to the latest zeitgeist of Neuro-everything. Let’s zoom in for a minute on the “NEW!” workshop on “The Adolescent Brain”.

“The workshop also focuses on the effect of the current model of teaching/education on the neural development and why countries like Australia is [sic] falling behind in the Global Education Revolution and what needs to be done to effectively address this from brain-based perspective.”

Really? There’s a Global Education Revolution? Apparently it involves things like:

“Neural plasticity, neurogenesis and mirror neurons.” (YAWN – doesn’t everything these days?)

“How the brain get programmed to become anxious” (sic)

“Establishing control by changing neural firing” (Really? That sounds rather ominous.)

“Brain based interventions – key to wellness.” (sic)

The Early Bird Rate for the two-day workshop is $595; standard rate is $645, or $495 for students (proof of student status required). Apparently this includes morning and afternoon tea, but there’s no mention of lunch. The workshop qualifies you for 12 hours of specialised training in neuropsychotherapy (as far as I can see, a term that Dr. Roussouw has invented, or at least makes more use of than anyone else), that may be counted towards Continuing Professional Development.

There’s a good piece here about the epidemic of neuromyths in education that people should perhaps read before they stump up for the workshop.

Other workshops seem somewhat less alarming. The one on Depression offers information that mostly seems to be based on genuine research – after all, we do know quite a bit about the neuroscience of depression, and psychologists should probably understand neurotransmitters if they are to treat patients who are taking medication. However, I am rather concerned that these workshops, which heavily emphasise the brain and neurobiology, are being run by someone with apparently no training or experience whatsoever in neuroscience, who seems to be inflating his credentials with self-published papers and a pop-psychology book. (Is anyone seeing a pattern here?)

I am also interested in why is someone with such clear financial interests allowed to run a Masters of Counselling Program at UQ. I have contacted their Personnel department for a copy of his CV, but have not received it to date. If anyone knows more, or has attended one of these workshops, I would be most interested to hear about it.

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.

The New Pseudoscience of Attachment via Mindfulness

So this lobbed into my inbox today, via the official channel of our staff email list:

Mindfulness, Neuroscience and Attachment Theory: A Powerful Approach for Changing the Brain, Transforming Negative Emotions and Improving Client Outcomes

The course costs $335.00 and is available in all of Australia’s major capital cities. It’s being held at mostly conference-centre type venues, so presumably they’re expecting pretty big numbers. There are some pretty big promises here, and as a neuroscientist my alarm bells immediately started ringing.

“….advances in neuroscience and attachment theory have led to revolutionary work in the application of mindfulness in the treatment of anxiety, depression, emotional dysregulation, anger and stress.”

“…In this seminar, we will explore an integrated approach — incorporating advances in neuroscience, new insights about attachment theory and The Five Core Skills of Mindfulness — that accelerates healthy change and improves client outcomes.”

“…Take home cutting-edge information on the interface between neuroscience, mindfulness and therapy. “

Is this workshop endorsed by the APS? Apparently not, though the organisers are somewhat evasive about it: …”APS: Activities do not need to be endorsed by APS. Members can accrue 7 CPD hours by participating in this activity”

So who is this Terry Fralich (LCPC)? (And what does that stand for? Licensed Clinical Professional Counsellor, apparently, although it’s not clear which body did the licensing.) According to the official website, “Terry Fralich is an adjunct faculty member of the University of Southern Maine Graduate School and a Co-Founder of the Mindfulness Centre of Southern Maine.” However, although it seems that there is a Ms. Julie Fralich listed on the official University of Southern Maine faculty list (http://usm.maine.edu/muskie/cutler/julie-fralich), there is no Terry Fralich listed. The only mention at all on the website is of his wife Rebecca Wing (a co-presenter at the workshops and co-founder of the Mindfulness Center – see below), who is an alumnus of their School of Music (class of ’84).

He does show up on a lot of sites about mindfulness, the top hit being his “Mindfulness Retreat Center of Maine”, which showcases its lovely views and comfortable accommodation (prices are available on application). They also sell “Books and CDs”, although the only actual book listed is Mr Fralich’s book “Cultivating Lasting Happiness – a 7-step Guide to Mindfulness”. According to Amazon, this seems to have been the only book he has written (reviews are generally positive, though one reader found it did not cover any new ground). It seems to be a pretty standard practical guide to mindfulness meditation – nothing wrong with that in itself, I guess.

So where are this guy’s credentials in neuroscience and attachment theory? A search on Google Scholar turned up only the aforementioned book, but no academic papers. His only relevant qualification seems to be a Masters Degree in Clinical Counselling (although I could not find out where this qualification was obtained – if anyone knows, mention it in the comments). Apparently he has studied with the Dalai Lama for more than 25 years; according to his website, “Prior to becoming a mindfulness therapist, academic and counsellor, Terry was an attorney who practiced law in New York City, Los Angeles and Portland, Maine.” I guess this experience should make him careful about making claims which can’t be verified.

Here’s a YouTube teaser for one of his lectures: http://www.youtube.com/watch?v=ce9zqrxvGFA

I also found a link to a PDF for the program: http://www.tatratraining.com/wp-content/themes/shopperpress/thumbs/Terry-Fralich-2014-Program.pdf

It incorporates sciencey-sounding things like “The triune brain” (huh?), “Fight-or-flight-or-freeze and stress responses”, and of course today’s essential buzzword, “neuroplasticity”. A particularly scary phrase is “Reconsolidation of negative memories: transforming unhealthy patterns and messages.” How are they going to teach therapists to do this – these people who have no training at all in neuroscience, attachment theory, memory or indeed, it seems, even CBT?

I am concerned that our institution is promoting this extremely questionable training seminar from people who appear to be unqualified gurus, and calling it neuroscience. This is not neuroscience, it’s neurobollocks.

Update: I received an apology from the secretary who forwarded the email. She said ‘This Tatra organisation send quite a few of e-mails to the enquiries office, and I normally just trash them but for some reason when I saw the words “mindfulness” and “neuroscience” and knowing that we have courses on neuroscience and thinking that it might be useful to our lecturers, I forwarded it without looking further and also as I mentioned, at least I know of one of our clinical students had done research on mindfulness.’ I don’t think we can really blame her – if they are booking conference centres in all the major capital cities, they must be taking in quite a few institutions and clinicians.

James Coyne to host workshops at ANU: Using social media to write and promote your scientific papers

Date: Wednesday 10 September

Time: 9-10:30 or 11-12:30

Venue: Chelt Seminar Room, Building 10T1

To enrol in these workshops, please email Mark Paul – mark.paul@anu.edu.au

Summary:

Social media provide a powerful set of tools for organising research teams, conducting research, crowdsourcing expertise, and obtaining preliminary peer review of your scientific papers. Social media also provide powerful ways to publicise and disseminate newly published papers to a broad audience.

Writing groups organised on the Internet increasingly publish papers in JAMA, PNAS and BMJ, as well as open access journals. Individual authors often develop their ideas in tweets, short and long read blog posts, and then solicit feedback on drafts.

Authors and universities increasingly engage in social media campaigns to publicise and discuss recently published papers. High impact journals undertake their own such efforts.

Powerful tools such as PubMed Commons provide increasingly respected post publication peer review. Alt-metrics now quantify such activities.

This workshop provides exposure and hands-on experience in use of these tools at all stages of writing and promoting scientific work.

Objectives

1. Familiarise participants with tools such as Twitter, blogs, Rebel Mouse, and Facebook to develop research and promote it after publication.

2. Provide concrete case examples of successful application of these tools to both the knowledge production and dissemination.

3. Engage participants in utilizing these tools with the projects they bring to the workshop.

Workshop activities

Didactic presentation of tools and concrete examples of their application will be followed by a highly interactive session in which participants will be invited to develop their ideas for organising paper writing and subsequent promotion using social media.

Description of the intended participants

The workshop will be of greatest interest to junior and senior researchers who are actively writing papers.

Participants will be encouraged to bring ideas and works in progress. If they have forthcoming papers, they may use the workshop to construct social media strategies for promoting and disseminating their work.

---

 

++++++++++++++++  Speaker Bio: ++++++++++++++++

James C. Coyne, PhD is Professor of Health Psychology at University Medical Center, Groningen, the Netherlands where he teaches scientific writing and critical thinking. He is also Visiting Professor, Institute for Health, Health Care Policy & Aging Research, Rutgers, the State University of New Jersey.

Dr. Coyne is Emeritus Professor of Psychology in Psychiatry, where he was also Director of Behavioral Oncology, Abramson Cancer Center and Senior Fellow Leonard Davis Institute of Health Economics. He has served as External Scientific Advisor to a decade of European Commission funded community-based programs to improve care for depression in the community.

He has written over 350 articles and chapters, including systematic reviews of screening for distress and depression in medical settings and classic articles about stress and coping, couples research, and interpersonal aspects of depression. He has been designated by ISI Web of Science as one of the most impactful psychologists and psychiatrists in the world. His books include Screening for Depression in Clinical Settings: An Evidence-Based Review edited with Alex Mitchell (Oxford University Press; 2009).

He also blogs and is a regular contributor to the blog Science Based Medicine and to the PLOS One Blog, Mind the Brain. He is known for giving lively, controversial lectures using scientific evidence to challenge assumptions about the optimal way of providing psychosocial care and care for depression to medical patients.

What do the religious Right have against Gardasil?

It has somewhat belatedly come to my attention (sadly, via my own mother) that the latest target of the anti-vaxxers is Gardasil and/or Cervarix, the recently developed vaccines against human papilloma virus (HPV), the virus which causes around 70% of cervical cancers.

Now, when this vaccine was introduced, I was very excited, and so happy that my daughter could be vaccinated for free at school. Why would I care so much? Well, I had cervical cancer myself back in 1997. It wasn’t detected with conventional screening, because it was in a weird place (quite high up on the cervix), and it was only my own and my doctor’s vigilance and insistence on further testing that led to detection of the cancer. I had to have a “radical hysterectomy”, which is the removal of the entire uterus, the cervix, and most of the surrounding lymph nodes (but not the ovaries). I was 30 years old.

Luckily I managed to avoid further treatment, and now 16 years on I’m perfectly healthy, although I have an impressive scar down the middle of my belly. But you can imagine my distress when my mother started speaking out against Gardasil, and even posted that “cervical cancer is a sexually-transmitted disease – if you don’t have sex before marriage, you won’t get it.”

What?

Is this really what they’re telling their daughters?

In the US, things are more serious. Apparently many parents are refusing to vaccinate their daughters for fear that the vaccine will make them promiscuous, despite excellent evidence to the contrary: http://www.ncbi.nlm.nih.gov/pubmed/23071201

I found some blog posts here detailing some of the bizarre mess that’s been going on in the UK as well:

http://jdc325.wordpress.com/tag/hpv/

Here’s another blog that looks specifically at the religious right and its activities in suppressing Gardasil vaccination:

Religion vs Gardasil

I’m worried about the effect this will have on girls. Why should girls not have the right to be protected from the disease that might have killed me and has killed many other women?

To end on a positive note, my 24-year-old son (living in the US) has recently finished his course of Gardasil.  At least someone’s doing the right thing.

Hello world!

This is my first post. I’m leaving it at “Hello World” because Jeremy told me that’s the first program you should write in any programming language.

I think I’ll mainly be blogging about science, open science, and neuroscience, but there might be a few cat pictures too.