Posted by Mitchell on December 29, 2002, at 11:23:07
In reply to Re: Court-ordered discussion » Mitchell, posted by OddipusRex on December 29, 2002, at 9:20:17
Oddipus,
It's fortunate that we don't all see things the same way. Can you imagine 6 billion people sharing the same two eyes?
Technically, courts don't order clients into group therapy; they usually order them to attend educational meetings as part of a probationary sentence. Usually, contracts with non-profit providers mask differences in the putative educational sentence and the prohibition based behavioral modification tactics employed by contractors who operate the groups.
The two (PBF and court-ordered education) are similar in that in each an arbiter determines direction of group discussion.
The availability of a similar group nearby (PBS), in my view, does little to resolve flaws in the educational process proposed on PBF.
PB and Co. are not styled as psychotherapy, for sure. But education and support, in their myriad forms, are recognized as therapeutic procedures across the spectrum of medical services. Time spent directing medical self-help groups or providing educational information is often a billable medical cost. This site is styled to minimize the medical input of the medical professional who directs group process. However, when administrative duty is solely in the hands of a single high-level practitioner, the administration implies, nay it indicates that direction of a medical site is in the hands of a medical professional.
It matters none whether Robert Hsuing plays doctor when he arbitrates and PBCs. Regardless the lack of pretense in his presentation, he is a doctor. He holds the license, but we the people licensed him. In a remote emergency, I would ask him to employ his best medical judgement. I absolutely expect it in his research work.
Consider a theorized medical doctor who creates a site where only positive statements can be written about the value of leeches in medical therapy. A local hierarchy of credibility is allowed to form around nominally selected users' experience, and around who most aggressively or most carefully presents their personal views. When a physician directs formal, public, ongoing medical dialogue, regardless caveats and disclaimers, the public must make a determination about the merits of a medical service offered by a physician. Lucy's trick of taking the football Charlie Brown is trying to kick might not be the best way for doctors to teach the public to use their own best judgement.
Do I think Dr. Hsuing considers participation in PBF to be psychologically helpful for some people, and that harm may come from allowing others to participate? If he is a doctor and he is encouraging participation, I hope his best medical judgement is that participation is helpful. I know of no other rational reason he would exclude participation than that he felt some participation to be harmful, at least in the microcosm of this group. The only benevolent reason I have imagined a doctor would encourage people to participate in an educational process he does not believe therapeutic would be if he does not know if the procedure is helpful, but for research purposes wants to assess efficacy of the procedure.
Do I think being told by a doctor that one is harmful to a group can in turn be harmful to the person turned away? If I did not think so, I would not be as interested in arbitrary exclusions. If the smooth operation of a research project has eclipsed a physician's concern for the therapeutic value of his services, we have a problem. Otherwise, it is an interesting dilemma.
poster:Mitchell
thread:8516
URL: http://www.dr-bob.org/babble/admin/20021128/msgs/8641.html