[Script Info]
Title: 
[Events]
Format: Layer, Start, End, Style, Name, MarginL, MarginR, MarginV, Effect, Text
Dialogue: 0,0:00:00.13,0:00:01.52,Default,,0000,0000,0000,,What?\N>> In the same way
Dialogue: 0,0:00:01.52,0:00:03.52,Default,,0000,0000,0000,,that if I had somebody\Nwho was an alcoholic
Dialogue: 0,0:00:03.52,0:00:05.88,Default,,0000,0000,0000,,for example and was\Ndrinking way too much
Dialogue: 0,0:00:05.88,0:00:08.11,Default,,0000,0000,0000,,there would be a way\Nin which I could say
Dialogue: 0,0:00:08.11,0:00:10.39,Default,,0000,0000,0000,,and I could frame it\Nas I need to help you
Dialogue: 0,0:00:10.39,0:00:12.73,Default,,0000,0000,0000,,to be a better and \Nsafer alcoholic.
Dialogue: 0,0:00:12.73,0:00:15.13,Default,,0000,0000,0000,,Now that might not be\Nmy first choice right
Dialogue: 0,0:00:15.13,0:00:17.16,Default,,0000,0000,0000,,in terms of treatment,\Nmy first choice in terms
Dialogue: 0,0:00:17.16,0:00:18.95,Default,,0000,0000,0000,,of treatment might be to\Nsay how can I help you
Dialogue: 0,0:00:18.95,0:00:20.60,Default,,0000,0000,0000,,to stop being an alcoholic?
Dialogue: 0,0:00:20.60,0:00:23.46,Default,,0000,0000,0000,,But if in fact that's not\Navailable to me for whatever
Dialogue: 0,0:00:23.46,0:00:26.32,Default,,0000,0000,0000,,reason or that type of \Ntherapeutic work is not working
Dialogue: 0,0:00:26.32,0:00:28.88,Default,,0000,0000,0000,,and isn't moving we would\Nat least want to say
Dialogue: 0,0:00:28.88,0:00:31.15,Default,,0000,0000,0000,,for example, if you're going\Nto keep drinking,
Dialogue: 0,0:00:31.15,0:00:32.58,Default,,0000,0000,0000,,I want you to stop driving.\N
Dialogue: 0,0:00:33.93,0:00:34.75,Default,,0000,0000,0000,,>> Okay.
Dialogue: 0,0:00:34.75,0:00:36.32,Default,,0000,0000,0000,,>> Instead of focusing\Non trying to get you
Dialogue: 0,0:00:36.32,0:00:37.08,Default,,0000,0000,0000,,to stop drinking,\N
Dialogue: 0,0:00:37.08,0:00:39.71,Default,,0000,0000,0000,,I'm going to focus on trying\Nto get you to stop driving drunk,
Dialogue: 0,0:00:39.71,0:00:41.82,Default,,0000,0000,0000,,and make you a safer drunk.
Dialogue: 0,0:00:42.50,0:00:44.50,Default,,0000,0000,0000,,>> Okay, and that I--\N>> It's a similar kind
Dialogue: 0,0:00:44.50,0:00:45.39,Default,,0000,0000,0000,,of a way to think though.
Dialogue: 0,0:00:45.39,0:00:47.52,Default,,0000,0000,0000,,>> That I get.\N>> If he becomes a better
Dialogue: 0,0:00:47.52,0:00:49.10,Default,,0000,0000,0000,,gambler he's less likely\Nto lose money.
Dialogue: 0,0:00:49.10,0:00:52.60,Default,,0000,0000,0000,,That's less negatively\Nimpactful for that person
Dialogue: 0,0:00:52.60,0:00:53.47,Default,,0000,0000,0000,,potentially.
Dialogue: 0,0:00:53.72,0:00:56.14,Default,,0000,0000,0000,,>> I thought I was proposing\Nsomething that would
Dialogue: 0,0:00:56.14,0:00:57.82,Default,,0000,0000,0000,,be sort of off limits.
Dialogue: 0,0:00:57.82,0:01:00.47,Default,,0000,0000,0000,,But there's this thing\Ncalled the harm reduction--
Dialogue: 0,0:01:00.47,0:01:02.71,Default,,0000,0000,0000,,>> Harm reduction model. \N>> Harm reduction model.
Dialogue: 0,0:01:02.71,0:01:07.50,Default,,0000,0000,0000,,Which I guess in some\Ncontext could be construed
Dialogue: 0,0:01:07.50,0:01:12.84,Default,,0000,0000,0000,,to say therapeutically\Nit's helpful to help your
Dialogue: 0,0:01:12.84,0:01:17.39,Default,,0000,0000,0000,,client, patient engage in \N>> More safely...
Dialogue: 0,0:01:17.39,0:01:21.53,Default,,0000,0000,0000,,>> a more safe variation\Nof the detrimental,
Dialogue: 0,0:01:21.53,0:01:23.14,Default,,0000,0000,0000,,problematic behaviors\Nthat they've already
Dialogue: 0,0:01:23.14,0:01:24.25,Default,,0000,0000,0000,,been engaging in.
Dialogue: 0,0:01:24.25,0:01:25.70,Default,,0000,0000,0000,,>> At the far edge of this,\Nthis can include things
Dialogue: 0,0:01:25.70,0:01:28.64,Default,,0000,0000,0000,,like methodone replacement\Nfor heroine for example.
Dialogue: 0,0:01:28.76,0:01:31.97,Default,,0000,0000,0000,,Methodone is still a drug,\Nit's still addictive even
Dialogue: 0,0:01:31.97,0:01:35.03,Default,,0000,0000,0000,,but it's less dangerous\Nthan heroine and so
Dialogue: 0,0:01:35.03,0:01:37.96,Default,,0000,0000,0000,,it's an improvement\Nover that even though our
Dialogue: 0,0:01:37.96,0:01:40.31,Default,,0000,0000,0000,,first choice might be to \Nsay hey no more heroine
Dialogue: 0,0:01:40.31,0:01:41.82,Default,,0000,0000,0000,,for you, okay.
Dialogue: 0,0:01:42.07,0:01:43.78,Default,,0000,0000,0000,,But if in fact that's not\Ngoing to work,
Dialogue: 0,0:01:43.78,0:01:47.33,Default,,0000,0000,0000,,similarly we would say--\Nlet's say abstinence is
Dialogue: 0,0:01:47.33,0:01:50.72,Default,,0000,0000,0000,,the best choice for \Nteenagers in terms of sex.
Dialogue: 0,0:01:50.72,0:01:54.01,Default,,0000,0000,0000,,Yeah great but let's also\Nuse a harm reduction
Dialogue: 0,0:01:54.01,0:01:55.84,Default,,0000,0000,0000,,kind of orientation on this\Nand say
Dialogue: 0,0:01:55.84,0:01:57.87,Default,,0000,0000,0000,,that if you are going to\Nhave sex,
Dialogue: 0,0:01:57.87,0:02:00.32,Default,,0000,0000,0000,,please use birth control,\Nplease use condoms.
Dialogue: 0,0:02:00.32,0:02:02.95,Default,,0000,0000,0000,,All of those kinds of\Nthings are harm reduction
Dialogue: 0,0:02:02.95,0:02:05.45,Default,,0000,0000,0000,,interventions so it could\Nbe that if you frame it
Dialogue: 0,0:02:05.45,0:02:06.93,Default,,0000,0000,0000,,that way, now there's a\Nfine line here between
Dialogue: 0,0:02:06.93,0:02:12.07,Default,,0000,0000,0000,,enabling and encouraging\Nthe behavior or helping
Dialogue: 0,0:02:12.07,0:02:14.21,Default,,0000,0000,0000,,it to be in a safer framework.
Dialogue: 0,0:02:14.21,0:02:16.48,Default,,0000,0000,0000,,I think that's where some \Nsubjectivitiy could
Dialogue: 0,0:02:16.48,0:02:18.73,Default,,0000,0000,0000,,definitely come in and \Nif where for example
Dialogue: 0,0:02:18.73,0:02:20.37,Default,,0000,0000,0000,,you yourself were\Nsomebody who really
Dialogue: 0,0:02:20.37,0:02:23.96,Default,,0000,0000,0000,,enjoys gambling--\Nthis might have an impact
Dialogue: 0,0:02:23.96,0:02:26.59,Default,,0000,0000,0000,,right on the subjectivity--\N>> Right right right...
Dialogue: 0,0:02:26.59,0:02:31.76,Default,,0000,0000,0000,,so once again, as both the\Nsubject of the judgement
Dialogue: 0,0:02:31.76,0:02:35.53,Default,,0000,0000,0000,,as well as the person that\Ngets to make that judgement
Dialogue: 0,0:02:35.53,0:02:38.19,Default,,0000,0000,0000,,and execute on that\Njudgement you're--
Dialogue: 0,0:02:38.19,0:02:40.71,Default,,0000,0000,0000,,the clinicians's on a very very\Nprecarious role.
Dialogue: 0,0:02:41.68,0:02:44.29,Default,,0000,0000,0000,,Wow, very complicated.\N>> I think we're usually
Dialogue: 0,0:02:44.29,0:02:47.21,Default,,0000,0000,0000,,in very precarious roles,\Nclinicians are.
Dialogue: 0,0:02:47.50,0:02:49.49,Default,,0000,0000,0000,,Really often, that's one of\Nthe things that I've often
Dialogue: 0,0:02:49.49,0:02:52.07,Default,,0000,0000,0000,,thought about as a difference\Nbetween our worlds.
Dialogue: 0,0:02:52.07,0:02:54.54,Default,,0000,0000,0000,,A lot of the time, \Njust kind of everyday,
Dialogue: 0,0:02:54.54,0:02:57.93,Default,,0000,0000,0000,,clinical practice involves\Na lot of like there's a lot
Dialogue: 0,0:02:57.93,0:02:59.30,Default,,0000,0000,0000,,of stuff hanging in the \Nbalance.
Dialogue: 0,0:02:59.30,0:03:01.55,Default,,0000,0000,0000,,There are definitely \Neveryday these sorts of
Dialogue: 0,0:03:01.55,0:03:02.79,Default,,0000,0000,0000,,decisions that we make.
Dialogue: 0,0:03:02.79,0:03:05.80,Default,,0000,0000,0000,,It is not uncommon \Nfor me to have to say to myself,
Dialogue: 0,0:03:05.80,0:03:08.90,Default,,0000,0000,0000,,okay, how do I want to \Nrespond to what this
Dialogue: 0,0:03:08.90,0:03:11.20,Default,,0000,0000,0000,,person is saying to me \Nabout a dangerous behavior
Dialogue: 0,0:03:11.20,0:03:13.48,Default,,0000,0000,0000,,or a difficult behavior,\None that I think is not
Dialogue: 0,0:03:13.48,0:03:16.58,Default,,0000,0000,0000,,ideally healthy for them,\Nhow do I want to react to that?
Dialogue: 0,0:03:16.58,0:03:18.87,Default,,0000,0000,0000,,Do I want to come at it \Ndirectly and actually say
Dialogue: 0,0:03:18.87,0:03:21.47,Default,,0000,0000,0000,,perhaps that's not the\Nhealthiest behavior--
Dialogue: 0,0:03:21.47,0:03:24.22,Default,,0000,0000,0000,,very often that's actually\Nnot the most therapeutic approach
Dialogue: 0,0:03:24.22,0:03:26.60,Default,,0000,0000,0000,,for people and so we find\Nourselves in a position
Dialogue: 0,0:03:26.60,0:03:29.69,Default,,0000,0000,0000,,a lot of times of trying\Nto watch and wait for the
Dialogue: 0,0:03:29.69,0:03:31.16,Default,,0000,0000,0000,,right times to intervene,
Dialogue: 0,0:03:31.16,0:03:33.25,Default,,0000,0000,0000,,the moment when you're\Ngoing to actually be able
Dialogue: 0,0:03:33.25,0:03:35.08,Default,,0000,0000,0000,,to have an influence\Nthat kind of thing.
Dialogue: 0,0:03:35.08,0:03:37.60,Default,,0000,0000,0000,,We have all kinds of\Ntechniques set up,
Dialogue: 0,0:03:37.60,0:03:40.04,Default,,0000,0000,0000,,motivational interviewing\Nfor example is a technique
Dialogue: 0,0:03:40.04,0:03:41.30,Default,,0000,0000,0000,,that I use really often.
Dialogue: 0,0:03:41.30,0:03:44.48,Default,,0000,0000,0000,,Motivational interviewing is\Na technique that allows
Dialogue: 0,0:03:44.48,0:03:47.86,Default,,0000,0000,0000,,you to reduce resistance\Nand to increase motivation
Dialogue: 0,0:03:47.86,0:03:49.94,Default,,0000,0000,0000,,for helping positive behaviors.
Dialogue: 0,0:03:49.94,0:03:52.87,Default,,0000,0000,0000,,It's super manipulative\Nin some sense right
Dialogue: 0,0:03:52.87,0:03:55.40,Default,,0000,0000,0000,,like it's a very deliberate\Nway of trying to adjust
Dialogue: 0,0:03:55.40,0:03:58.76,Default,,0000,0000,0000,,what somebody is thinking\Nabout a goal that they have.
Dialogue: 0,0:03:58.76,0:04:01.94,Default,,0000,0000,0000,,A lot of the time we have \Nto do a lot of that type of work
Dialogue: 0,0:04:01.94,0:04:04.100,Default,,0000,0000,0000,,just to get the place where \Nwe're shifting things
Dialogue: 0,0:04:04.100,0:04:06.36,Default,,0000,0000,0000,,for people's behavior.
Dialogue: 0,0:04:06.70,0:04:09.15,Default,,0000,0000,0000,,It's not a very direct\Nthing very often,
Dialogue: 0,0:04:09.15,0:04:11.10,Default,,0000,0000,0000,,it's very often a very\Nindirect approach and
Dialogue: 0,0:04:11.10,0:04:13.94,Default,,0000,0000,0000,,takes a little patience\Nthat kind of thing right.
Dialogue: 0,0:04:14.84,0:04:16.91,Default,,0000,0000,0000,,>> So when somebody \Ncomes in to see you,
Dialogue: 0,0:04:16.91,0:04:22.46,Default,,0000,0000,0000,,and they pose, whatever\Ntheir issue happens--
Dialogue: 0,0:04:22.80,0:04:24.47,Default,,0000,0000,0000,,>> They call this the \Npresenting problem.
Dialogue: 0,0:04:24.47,0:04:25.90,Default,,0000,0000,0000,,>> Presenting problem,\Nokay.
Dialogue: 0,0:04:25.90,0:04:29.10,Default,,0000,0000,0000,,You know your situation\Nis a little bit,
Dialogue: 0,0:04:29.10,0:04:31.04,Default,,0000,0000,0000,,I think it's a little bit \Ndifferent from mine.
Dialogue: 0,0:04:31.04,0:04:35.35,Default,,0000,0000,0000,,So I guess in my \Nmathematical world,
Dialogue: 0,0:04:35.35,0:04:38.66,Default,,0000,0000,0000,,I have people come \Nin with their presenting problem.
Dialogue: 0,0:04:38.66,0:04:42.53,Default,,0000,0000,0000,,They've got their data \Ncollection situation,
Dialogue: 0,0:04:42.53,0:04:44.32,Default,,0000,0000,0000,,they've got something \Nthey want to do,
Dialogue: 0,0:04:44.32,0:04:46.80,Default,,0000,0000,0000,,they've got some research\Nquestion that they want to answer.
Dialogue: 0,0:04:46.80,0:04:50.60,Default,,0000,0000,0000,,And I've got some array of \Ntechniques that I can devote
Dialogue: 0,0:04:50.60,0:04:53.41,Default,,0000,0000,0000,,to the question at hand.
Dialogue: 0,0:04:53.41,0:04:58.40,Default,,0000,0000,0000,,Some number of those \Ntechniques are going to be
Dialogue: 0,0:04:58.40,0:05:02.05,Default,,0000,0000,0000,,the sorts of things that \Nwould be generally well regarded
Dialogue: 0,0:05:02.05,0:05:05.78,Default,,0000,0000,0000,,by the statistical community\Nas reasonable approaches
Dialogue: 0,0:05:05.78,0:05:06.72,Default,,0000,0000,0000,,to take.
Dialogue: 0,0:05:07.44,0:05:09.83,Default,,0000,0000,0000,,Some of them might not be.
Dialogue: 0,0:05:10.08,0:05:14.94,Default,,0000,0000,0000,,So there's always a very\Nwrong way to do an analysis.
Dialogue: 0,0:05:14.94,0:05:17.29,Default,,0000,0000,0000,,I mean there's some--\N>> There's always a very
Dialogue: 0,0:05:17.29,0:05:18.91,Default,,0000,0000,0000,,wrong way to do therapy too.\N>> Right exactly.
Dialogue: 0,0:05:18.91,0:05:21.76,Default,,0000,0000,0000,,So there's some clearly \Nwrong things I could do.
Dialogue: 0,0:05:21.76,0:05:24.98,Default,,0000,0000,0000,,You could always just do\Nthings that are completely
Dialogue: 0,0:05:24.98,0:05:25.77,Default,,0000,0000,0000,,off the wall.
Dialogue: 0,0:05:25.77,0:05:28.02,Default,,0000,0000,0000,,You could consult a Ouija\Nboard or something like that.
Dialogue: 0,0:05:28.44,0:05:30.86,Default,,0000,0000,0000,,And the status issue consult\Nthe Ouija board
Dialogue: 0,0:05:30.86,0:05:32.48,Default,,0000,0000,0000,,to give you the answer.
Dialogue: 0,0:05:32.48,0:05:33.90,Default,,0000,0000,0000,,That's clearly wrong.\N
Dialogue: 0,0:05:33.99,0:05:35.10,Default,,0000,0000,0000,,>> Not an empirically \Nsupported technique.
Dialogue: 0,0:05:35.10,0:05:37.24,Default,,0000,0000,0000,,>> It's not an empirically \Nsupported technique, no.
Dialogue: 0,0:05:37.24,0:05:41.69,Default,,0000,0000,0000,,And there would be a variety \Nof other sort of techniques,
Dialogue: 0,0:05:41.69,0:05:44.51,Default,,0000,0000,0000,,even mathematical techniques\Nthat would be more or less
Dialogue: 0,0:05:44.51,0:05:48.86,Default,,0000,0000,0000,,the equivalent of the Ouija board\Nkind of thing.
Dialogue: 0,0:05:49.78,0:05:51.76,Default,,0000,0000,0000,,And there are some things that\Neverybody would accept
Dialogue: 0,0:05:51.76,0:05:54.85,Default,,0000,0000,0000,,would be within the range \Nof reasonable things to do.
Dialogue: 0,0:05:55.06,0:06:00.23,Default,,0000,0000,0000,,So when somebody comes\Nto you with their presenting problem,
Dialogue: 0,0:06:00.23,0:06:01.48,Default,,0000,0000,0000,,and what not.
Dialogue: 0,0:06:04.36,0:06:08.42,Default,,0000,0000,0000,,Whatever it is that they're \Ntalking about,
Dialogue: 0,0:06:08.42,0:06:13.47,Default,,0000,0000,0000,,you've got a choice, I presume\Nof probably an even wider array
Dialogue: 0,0:06:13.47,0:06:18.63,Default,,0000,0000,0000,,of reasonable techniques that\Nyou could use, some of which
Dialogue: 0,0:06:18.63,0:06:21.60,Default,,0000,0000,0000,,probably most of the time \Nhas some research associated
Dialogue: 0,0:06:21.60,0:06:22.52,Default,,0000,0000,0000,,with them.
Dialogue: 0,0:06:22.68,0:06:25.78,Default,,0000,0000,0000,,Some of them maybe not.
Dialogue: 0,0:06:25.78,0:06:29.12,Default,,0000,0000,0000,,Maybe something occurs\Nto you that's the product
Dialogue: 0,0:06:29.12,0:06:33.07,Default,,0000,0000,0000,,of your own intuition about\Nthe circumstances or what not
Dialogue: 0,0:06:33.07,0:06:37.00,Default,,0000,0000,0000,,maybe not quite as far\Nafield as the Ouija board example
Dialogue: 0,0:06:37.00,0:06:39.16,Default,,0000,0000,0000,,you know if you kind of \Nextend that analogy.
Dialogue: 0,0:06:39.16,0:06:40.93,Default,,0000,0000,0000,,But something that's fairly\Nfar afield,
Dialogue: 0,0:06:40.93,0:06:44.95,Default,,0000,0000,0000,,are there sort of ethical\Nconsiderations--
Dialogue: 0,0:06:44.95,0:06:49.28,Default,,0000,0000,0000,,again in my world if I\Npick some kind of really
Dialogue: 0,0:06:49.28,0:06:54.30,Default,,0000,0000,0000,,super obscure technique \Nand I get my client the answer
Dialogue: 0,0:06:54.30,0:06:58.58,Default,,0000,0000,0000,,using that technique,\Nmy client may or may not
Dialogue: 0,0:06:58.58,0:07:04.64,Default,,0000,0000,0000,,know in that particular moment\Nwhether I've done them well,
Dialogue: 0,0:07:04.64,0:07:06.71,Default,,0000,0000,0000,,done them not so well \Nwhatever--
Dialogue: 0,0:07:06.97,0:07:07.83,Default,,0000,0000,0000,,they may or may not know.
Dialogue: 0,0:07:07.83,0:07:09.58,Default,,0000,0000,0000,,They may later find out.
Dialogue: 0,0:07:09.58,0:07:12.96,Default,,0000,0000,0000,,Then there might-- I suppose\Nthere might be repercussions
Dialogue: 0,0:07:12.96,0:07:16.43,Default,,0000,0000,0000,,for me, I guess I could get\Nessentially sued or something
Dialogue: 0,0:07:16.43,0:07:18.24,Default,,0000,0000,0000,,like that if I do something \Nthat's too screwy.
Dialogue: 0,0:07:18.24,0:07:19.24,Default,,0000,0000,0000,,>> I guess.
Dialogue: 0,0:07:19.31,0:07:23.84,Default,,0000,0000,0000,,>> But the fact of the\Nmatter is in that moment
Dialogue: 0,0:07:23.84,0:07:27.44,Default,,0000,0000,0000,,I can make that choice and\Nwhatnot and I'm probably
Dialogue: 0,0:07:27.44,0:07:29.73,Default,,0000,0000,0000,,on safer ground if I choose\Nsomething that's emprically
Dialogue: 0,0:07:29.73,0:07:32.44,Default,,0000,0000,0000,,supported but then in \Nyour world,
Dialogue: 0,0:07:32.44,0:07:36.05,Default,,0000,0000,0000,,there's not necessarily going\Nto be you know if you pick
Dialogue: 0,0:07:36.05,0:07:40.15,Default,,0000,0000,0000,,something that's pretty far \Nafield, who knows whether
Dialogue: 0,0:07:40.15,0:07:42.12,Default,,0000,0000,0000,,there's going to be any\Nrepercussions ever
Dialogue: 0,0:07:42.12,0:07:45.70,Default,,0000,0000,0000,,so how do you make\Nthat choice between things
Dialogue: 0,0:07:45.70,0:07:49.52,Default,,0000,0000,0000,,that are empirically supported\Nversus not.
Dialogue: 0,0:07:50.02,0:07:53.91,Default,,0000,0000,0000,,Are there some ethical\Nconsiderations kind of along
Dialogue: 0,0:07:53.91,0:07:58.42,Default,,0000,0000,0000,,those lines and so how do\Nyou kind of make that choice,
Dialogue: 0,0:07:58.42,0:08:01.75,Default,,0000,0000,0000,,what are the ethical considerations\Nand kind of what does that
Dialogue: 0,0:08:01.75,0:08:04.11,Default,,0000,0000,0000,,all imply about what you do?
Dialogue: 0,0:08:04.41,0:08:06.10,Default,,0000,0000,0000,,>> Well there's a lot there right.
Dialogue: 0,0:08:06.82,0:08:09.22,Default,,0000,0000,0000,,The first thing that we have to\Nthink about is that you're right.
Dialogue: 0,0:08:09.22,0:08:11.61,Default,,0000,0000,0000,,There's a zone here that we\Nwould say there are some
Dialogue: 0,0:08:11.61,0:08:15.91,Default,,0000,0000,0000,,techniques and some procedures\Nand some ways of thinking about
Dialogue: 0,0:08:15.91,0:08:18.22,Default,,0000,0000,0000,,client problems that would\Nbe considered sort of
Dialogue: 0,0:08:18.22,0:08:21.02,Default,,0000,0000,0000,,centrally standard that would\Nbe like this is very professionally
Dialogue: 0,0:08:21.02,0:08:23.61,Default,,0000,0000,0000,,accepted, there's lots and \Nlots of agreement
Dialogue: 0,0:08:23.61,0:08:25.53,Default,,0000,0000,0000,,that this is a very sort of\Nregular and accepted
Dialogue: 0,0:08:25.53,0:08:26.81,Default,,0000,0000,0000,,way to approach this.
Dialogue: 0,0:08:26.93,0:08:28.86,Default,,0000,0000,0000,,And there would be variablity\Nthere but it would be
Dialogue: 0,0:08:28.86,0:08:30.98,Default,,0000,0000,0000,,bounded variablity in much\Nthe same way that it would
Dialogue: 0,0:08:30.98,0:08:33.48,Default,,0000,0000,0000,,be for a statistical choice\Nthat you would be able
Dialogue: 0,0:08:33.48,0:08:34.17,Default,,0000,0000,0000,,to make.
Dialogue: 0,0:08:34.29,0:08:36.34,Default,,0000,0000,0000,,There would also be things\Nthat are clearly outside
Dialogue: 0,0:08:36.34,0:08:38.16,Default,,0000,0000,0000,,of those boundaries and\Na lot of times those are
Dialogue: 0,0:08:38.16,0:08:39.94,Default,,0000,0000,0000,,things that have to do \Nwith safety,
Dialogue: 0,0:08:40.41,0:08:42.78,Default,,0000,0000,0000,,not just with efficacy \Nbecause of course therapy,
Dialogue: 0,0:08:42.78,0:08:45.99,Default,,0000,0000,0000,,one of the I think the most\Ndangerous fallacies
Dialogue: 0,0:08:45.99,0:08:48.18,Default,,0000,0000,0000,,about therapy actually\Nis that either will help
Dialogue: 0,0:08:48.18,0:08:49.48,Default,,0000,0000,0000,,you or do nothing at all.
Dialogue: 0,0:08:49.76,0:08:52.13,Default,,0000,0000,0000,,It's either neutral or beneficial\Nand that it actually can't be
Dialogue: 0,0:08:52.13,0:08:54.77,Default,,0000,0000,0000,,damaging when we have \Npretty good evidence
Dialogue: 0,0:08:54.77,0:08:56.63,Default,,0000,0000,0000,,actually that there's some\Ntypes of therapy techniques
Dialogue: 0,0:08:56.63,0:08:58.05,Default,,0000,0000,0000,,that can be damaging
Dialogue: 0,0:08:58.05,0:09:01.47,Default,,0000,0000,0000,,and these can have even \Niatrogenic effects right.
Dialogue: 0,0:09:01.47,0:09:03.52,Default,,0000,0000,0000,,An iatrogenic effect would\Nbe when you're trying to
Dialogue: 0,0:09:03.52,0:09:04.51,Default,,0000,0000,0000,,help somebody with something
Dialogue: 0,0:09:04.51,0:09:06.53,Default,,0000,0000,0000,,but you hurt them in the \Nprocess of trying to help them.
Dialogue: 0,0:09:06.53,0:09:09.36,Default,,0000,0000,0000,,An iatrogenic infection would\Nbe one that you kind of
Dialogue: 0,0:09:09.36,0:09:11.64,Default,,0000,0000,0000,,obtain during surgery\Nor something along that line.
Dialogue: 0,0:09:11.64,0:09:14.11,Default,,0000,0000,0000,,So an example of a technique\Nthat would have
Dialogue: 0,0:09:14.11,0:09:16.71,Default,,0000,0000,0000,,iatrogenic effects and very\Nwell demonstrated would be
Dialogue: 0,0:09:16.71,0:09:20.43,Default,,0000,0000,0000,,using hypnosis for particular\Npurposes so especially
Dialogue: 0,0:09:20.43,0:09:23.97,Default,,0000,0000,0000,,trying to retrieve memories.\N>> I've heard of that.
Dialogue: 0,0:09:23.97,0:09:26.34,Default,,0000,0000,0000,,>> Of course and trying to\Nhelp people get a better
Dialogue: 0,0:09:26.34,0:09:28.10,Default,,0000,0000,0000,,understanding of something\Nthat's happened to them
Dialogue: 0,0:09:28.10,0:09:30.04,Default,,0000,0000,0000,,in a distant past that they\Ndon't remember well.
Dialogue: 0,0:09:30.25,0:09:32.99,Default,,0000,0000,0000,,That particular technique \Neven though it used to
Dialogue: 0,0:09:32.99,0:09:34.88,Default,,0000,0000,0000,,be much more popular than\Nit is now,
Dialogue: 0,0:09:34.88,0:09:37.12,Default,,0000,0000,0000,,has now been very well \Ndemonstrated to be
Dialogue: 0,0:09:37.12,0:09:40.58,Default,,0000,0000,0000,,too dangerous for us\Nto be allowed to use it
Dialogue: 0,0:09:40.58,0:09:45.03,Default,,0000,0000,0000,,and in most licensing contexts\Nthat would be something that
Dialogue: 0,0:09:45.03,0:09:47.02,Default,,0000,0000,0000,,would be considered\Nin appropriate.
Dialogue: 0,0:09:47.50,0:09:49.53,Default,,0000,0000,0000,,>> Dangerous how?\NDangerous in the sense of
Dialogue: 0,0:09:49.53,0:09:54.07,Default,,0000,0000,0000,,it may be generating her\Nwrong insights or dangerous
Dialogue: 0,0:09:54.07,0:09:57.18,Default,,0000,0000,0000,,actually literally to the \Nclient/patient.
Dialogue: 0,0:09:57.18,0:09:59.21,Default,,0000,0000,0000,,>> Well it depends on what \Nyou mean I guess by
Dialogue: 0,0:09:59.21,0:10:00.92,Default,,0000,0000,0000,,just dangerous to the patient.
Dialogue: 0,0:10:00.92,0:10:03.21,Default,,0000,0000,0000,,I think it's both psychological\Nand physically dangerous.
Dialogue: 0,0:10:03.21,0:10:05.45,Default,,0000,0000,0000,,That's the type of distinction\Nthat you're trying to make.
Dialogue: 0,0:10:05.45,0:10:08.19,Default,,0000,0000,0000,,It's clearly psychologically\Ndangerous to the patient
Dialogue: 0,0:10:08.19,0:10:11.36,Default,,0000,0000,0000,,and obviously you could \Nconstruct memories for
Dialogue: 0,0:10:11.36,0:10:13.97,Default,,0000,0000,0000,,example of having been \Nterribly abused by a family
Dialogue: 0,0:10:13.97,0:10:15.85,Default,,0000,0000,0000,,member when actually \Nthat never happened and
Dialogue: 0,0:10:15.85,0:10:18.10,Default,,0000,0000,0000,,the family member\Nactually never abused you.
Dialogue: 0,0:10:18.10,0:10:19.62,Default,,0000,0000,0000,,Obviously that would be \Nsomething that would be
Dialogue: 0,0:10:19.62,0:10:22.45,Default,,0000,0000,0000,,detrimental in a psychological \Nway but it could also be
Dialogue: 0,0:10:22.45,0:10:25.02,Default,,0000,0000,0000,,detrimental in a much more\Npractical or physical way
Dialogue: 0,0:10:25.02,0:10:26.96,Default,,0000,0000,0000,,not just to the patient \Nbut to their of course
Dialogue: 0,0:10:26.96,0:10:28.22,Default,,0000,0000,0000,,entire context.
Dialogue: 0,0:10:28.22,0:10:30.72,Default,,0000,0000,0000,,Let's extend that example\Nand let's say that family
Dialogue: 0,0:10:30.72,0:10:32.96,Default,,0000,0000,0000,,member is still alive and\Nis still somebody that
Dialogue: 0,0:10:32.96,0:10:34.07,Default,,0000,0000,0000,,you see and all of that.
Dialogue: 0,0:10:34.07,0:10:36.04,Default,,0000,0000,0000,,It could even be that\Nthat could effect
Dialogue: 0,0:10:36.04,0:10:38.67,Default,,0000,0000,0000,,that person's life in a \Nvery negative way also.
Dialogue: 0,0:10:38.67,0:10:40.31,Default,,0000,0000,0000,,Even to the point where \Nwe would say are there
Dialogue: 0,0:10:40.31,0:10:42.20,Default,,0000,0000,0000,,legal actions that are\Ninvolved here,
Dialogue: 0,0:10:42.20,0:10:43.64,Default,,0000,0000,0000,,that type of thing.
Dialogue: 0,0:10:43.64,0:10:47.53,Default,,0000,0000,0000,,So (inaudible) among\Nmany other researchers
Dialogue: 0,0:10:47.53,0:10:50.66,Default,,0000,0000,0000,,have done an amazing job\Nof putting out there
Dialogue: 0,0:10:50.66,0:10:52.87,Default,,0000,0000,0000,,lots of really imporant\Nwork that then clinicians
Dialogue: 0,0:10:52.87,0:10:55.79,Default,,0000,0000,0000,,like me and are licensing\Nboards and the associations
Dialogue: 0,0:10:55.79,0:10:57.40,Default,,0000,0000,0000,,that help us to know\Nwhat we're supposed to
Dialogue: 0,0:10:57.40,0:10:59.53,Default,,0000,0000,0000,,be doing have to be\Nable to pay attention to
Dialogue: 0,0:10:59.53,0:11:01.65,Default,,0000,0000,0000,,this data that comes\Nin that says oh wait
Dialogue: 0,0:11:01.65,0:11:04.27,Default,,0000,0000,0000,,this is not that this is \Nefficacious
Dialogue: 0,0:11:04.27,0:11:06.41,Default,,0000,0000,0000,,that it could also be\Ndamaging to people
Dialogue: 0,0:11:06.41,0:11:07.28,Default,,0000,0000,0000,,in this way.
Dialogue: 0,0:11:07.48,0:11:08.59,Default,,0000,0000,0000,,So there are always\Ngoing to be things
Dialogue: 0,0:11:08.59,0:11:09.78,Default,,0000,0000,0000,,that are outside the\Nrange right
Dialogue: 0,0:11:09.78,0:11:13.65,Default,,0000,0000,0000,,conversion therapy having\Nto do with sexual identity
Dialogue: 0,0:11:13.65,0:11:14.96,Default,,0000,0000,0000,,is another good example.
Dialogue: 0,0:11:14.96,0:11:17.68,Default,,0000,0000,0000,,Something that's been \Nunfortunately quite controversial
Dialogue: 0,0:11:17.68,0:11:18.77,Default,,0000,0000,0000,,here in Texas.
Dialogue: 0,0:11:18.77,0:11:21.15,Default,,0000,0000,0000,,Why on Earth this should be\Nsomething controversial,
Dialogue: 0,0:11:21.15,0:11:23.13,Default,,0000,0000,0000,,don't even get me started\Non that, soap box.
Dialogue: 0,0:11:23.13,0:11:25.36,Default,,0000,0000,0000,,I'm going to climb right up\Non that and go ahh!
Dialogue: 0,0:11:25.36,0:11:26.67,Default,,0000,0000,0000,,>> Maybe that's another hour.\N
Dialogue: 0,0:11:26.67,0:11:28.71,Default,,0000,0000,0000,,>> That's right? We've got\Na whole other episode on
Dialogue: 0,0:11:28.71,0:11:31.75,Default,,0000,0000,0000,,conversion therapy for \Nsexual identity.
Dialogue: 0,0:11:31.75,0:11:34.57,Default,,0000,0000,0000,,You know but sexual orientation\Nis something that we don't
Dialogue: 0,0:11:34.57,0:11:37.14,Default,,0000,0000,0000,,actually believe that it's in\Nthe client's best interest
Dialogue: 0,0:11:37.14,0:11:39.24,Default,,0000,0000,0000,,when the client comes in\Nand would say something
Dialogue: 0,0:11:39.24,0:11:42.15,Default,,0000,0000,0000,,like I don't want to have\Nthe sexual orientation that
Dialogue: 0,0:11:42.15,0:11:44.04,Default,,0000,0000,0000,,I feel like I have, \NI want to change that.
Dialogue: 0,0:11:44.04,0:11:46.96,Default,,0000,0000,0000,,That's not considered an\Nappropriate therapeutic goal
Dialogue: 0,0:11:46.96,0:11:49.07,Default,,0000,0000,0000,,even if I am capable of\Nthat and there's--
Dialogue: 0,0:11:49.07,0:11:52.80,Default,,0000,0000,0000,,very unlikely to be the \Nfact that I would even be
Dialogue: 0,0:11:52.80,0:11:53.75,Default,,0000,0000,0000,,capable of that.
Dialogue: 0,0:11:53.75,0:11:55.34,Default,,0000,0000,0000,,I don't know of any\Ntreatment that would
Dialogue: 0,0:11:55.34,0:11:57.48,Default,,0000,0000,0000,,successfully actually \Nproduce that effect
Dialogue: 0,0:11:57.48,0:11:59.51,Default,,0000,0000,0000,,but even if were to \Ncome up with such a
Dialogue: 0,0:11:59.51,0:12:01.69,Default,,0000,0000,0000,,treatment we would say\Nethically that's not an
Dialogue: 0,0:12:01.69,0:12:04.04,Default,,0000,0000,0000,,appropriate goal and it's\None that you actually
Dialogue: 0,0:12:04.04,0:12:07.38,Default,,0000,0000,0000,,have to say what underlies\Nthe fact that this client
Dialogue: 0,0:12:07.38,0:12:09.61,Default,,0000,0000,0000,,feels like that and it\Nneeds to be the goal.
Dialogue: 0,0:12:09.83,0:12:11.34,Default,,0000,0000,0000,,That they need to try\Nto change that aspect
Dialogue: 0,0:12:11.34,0:12:12.90,Default,,0000,0000,0000,,of themselves,\Nthere's some kind of stigma
Dialogue: 0,0:12:12.90,0:12:14.68,Default,,0000,0000,0000,,some kind of horrible\Nthings that are happening to
Dialogue: 0,0:12:14.68,0:12:17.67,Default,,0000,0000,0000,,this person because of that\Nidentity and let's see if
Dialogue: 0,0:12:17.67,0:12:18.82,Default,,0000,0000,0000,,we can work with that.
Dialogue: 0,0:12:18.82,0:12:20.30,Default,,0000,0000,0000,,Let's see what we can \Ndo help them to adjust
Dialogue: 0,0:12:20.30,0:12:21.26,Default,,0000,0000,0000,,to what's going on.
Dialogue: 0,0:12:21.42,0:12:22.100,Default,,0000,0000,0000,,I think there are lots \Nof things that we would
Dialogue: 0,0:12:22.100,0:12:24.45,Default,,0000,0000,0000,,say like in any moment\Nwhen somebody brings
Dialogue: 0,0:12:24.45,0:12:25.55,Default,,0000,0000,0000,,a presenting problem.
Dialogue: 0,0:12:25.55,0:12:28.49,Default,,0000,0000,0000,,There are limits to letting\Nthe client determine
Dialogue: 0,0:12:28.49,0:12:29.63,Default,,0000,0000,0000,,the presenting problem.
Dialogue: 0,0:12:29.63,0:12:32.96,Default,,0000,0000,0000,,There are times when we\Nwould say yeah,
Dialogue: 0,0:12:32.96,0:12:36.11,Default,,0000,0000,0000,,I can't treat that.\NI can't address that even
Dialogue: 0,0:12:36.11,0:12:37.45,Default,,0000,0000,0000,,though you're saying\Nthat's the problem
Dialogue: 0,0:12:37.45,0:12:39.89,Default,,0000,0000,0000,,we have to reframe this\Nproblem before I can even
Dialogue: 0,0:12:39.89,0:12:41.46,Default,,0000,0000,0000,,try to help you with it.
Dialogue: 0,0:12:41.46,0:12:43.60,Default,,0000,0000,0000,,But then there are also \Nlots of other times when
Dialogue: 0,0:12:43.60,0:12:46.05,Default,,0000,0000,0000,,we would say you have\Nto take something more standard.
Dialogue: 0,0:12:46.05,0:12:47.57,Default,,0000,0000,0000,,Somebody comes in and\Nthey're depressed.
Dialogue: 0,0:12:48.62,0:12:52.61,Default,,0000,0000,0000,,Okay there are many different\Napproaches that are
Dialogue: 0,0:12:52.61,0:12:55.30,Default,,0000,0000,0000,,potentially appropriate for\Ntreating depression.
Dialogue: 0,0:12:55.45,0:12:57.31,Default,,0000,0000,0000,,It's not the case that we \Nwould just say oh there's
Dialogue: 0,0:12:57.31,0:12:58.93,Default,,0000,0000,0000,,one that's good and there's\None that's bad.
Dialogue: 0,0:12:58.93,0:13:00.86,Default,,0000,0000,0000,,Which I think when we\Nhave to start to get into
Dialogue: 0,0:13:00.86,0:13:03.30,Default,,0000,0000,0000,,a conversation really about\Ntheory right that there's
Dialogue: 0,0:13:03.30,0:13:06.42,Default,,0000,0000,0000,,a theoretical basis for a lot\Nof these different choices
Dialogue: 0,0:13:06.42,0:13:08.93,Default,,0000,0000,0000,,that clinicians make and \Nthat you have a theoretical
Dialogue: 0,0:13:08.93,0:13:12.64,Default,,0000,0000,0000,,identity--you identify as some\Nkind of theoretician in this way.
Dialogue: 0,0:13:12.64,0:13:15.36,Default,,0000,0000,0000,,Something that you kind of\Nagree with and so for me,
Dialogue: 0,0:13:15.36,0:13:18.74,Default,,0000,0000,0000,,a lot of the work that I do,\Nis a combination of two theories.
Dialogue: 0,0:13:18.74,0:13:20.98,Default,,0000,0000,0000,,So I work with cognitive \Nbehavioral theory
Dialogue: 0,0:13:20.98,0:13:23.11,Default,,0000,0000,0000,,quite a lot. \NI do a lot of CBT.
Dialogue: 0,0:13:23.11,0:13:25.14,Default,,0000,0000,0000,,And then I use a lot of \Nhumanism also.
Dialogue: 0,0:13:25.14,0:13:27.30,Default,,0000,0000,0000,,I use a lot of humanistic\Ntheory in trying to determine
Dialogue: 0,0:13:27.30,0:13:29.62,Default,,0000,0000,0000,,the types of interventions\Nthat I'm going to use.
Dialogue: 0,0:13:29.65,0:13:31.30,Default,,0000,0000,0000,,The types of relationships\Nthat I'm going to have with
Dialogue: 0,0:13:31.30,0:13:33.23,Default,,0000,0000,0000,,my clients, the types of \Nethical choices I make
Dialogue: 0,0:13:33.23,0:13:34.64,Default,,0000,0000,0000,,and that kind of thing.
Dialogue: 0,0:13:34.64,0:13:37.17,Default,,0000,0000,0000,,It helps to provide a \Ncoherent set right of ways
Dialogue: 0,0:13:37.17,0:13:38.55,Default,,0000,0000,0000,,you would make those decisions.
Dialogue: 0,0:13:38.55,0:13:42.73,Default,,0000,0000,0000,,Is there some equivalent to\Nthat in statistical world?
Dialogue: 0,0:13:42.73,0:13:46.29,Default,,0000,0000,0000,,Do you have different theories\Nof the way that stats should
Dialogue: 0,0:13:46.29,0:13:47.95,Default,,0000,0000,0000,,be interpreted in that sense?
Dialogue: 0,0:13:47.95,0:13:49.56,Default,,0000,0000,0000,,>> To be completely honest \Nwith you,
Dialogue: 0,0:13:49.56,0:13:52.08,Default,,0000,0000,0000,,no, I don't think--\NI really actually don't think
Dialogue: 0,0:13:52.08,0:13:54.17,Default,,0000,0000,0000,,there is an analog there.
Dialogue: 0,0:13:54.17,0:13:59.96,Default,,0000,0000,0000,,You know my field is a much\Nmore cut and dry
Dialogue: 0,0:13:59.96,0:14:01.45,Default,,0000,0000,0000,,in that respect.
Dialogue: 0,0:14:01.45,0:14:10.30,Default,,0000,0000,0000,,Math is math and there really\Nis kind of correct math
Dialogue: 0,0:14:10.30,0:14:14.53,Default,,0000,0000,0000,,in certain circumstances\Nand there's incorrect math.
Dialogue: 0,0:14:16.86,0:14:19.43,Default,,0000,0000,0000,,Even though the sort of \Ntechniques that one might
Dialogue: 0,0:14:19.43,0:14:23.42,Default,,0000,0000,0000,,select from there are good\Ntechniques and there
Dialogue: 0,0:14:23.42,0:14:24.72,Default,,0000,0000,0000,,are less good techniques.
Dialogue: 0,0:14:24.83,0:14:27.57,Default,,0000,0000,0000,,The dividing line between\Nthe good ones and the
Dialogue: 0,0:14:27.57,0:14:30.32,Default,,0000,0000,0000,,bad ones is a lot sharper\NI think than it is in
Dialogue: 0,0:14:30.32,0:14:33.66,Default,,0000,0000,0000,,psychologists so my life\Nin that regard anyway
Dialogue: 0,0:14:33.66,0:14:36.96,Default,,0000,0000,0000,,is actually a lot easier.\NYeah it really is,
Dialogue: 0,0:14:36.96,0:14:40.83,Default,,0000,0000,0000,,it's a lot easier so I mean\Nyou have those sort of
Dialogue: 0,0:14:40.83,0:14:43.50,Default,,0000,0000,0000,,theoretical perspectives that\Nshape what you do.
Dialogue: 0,0:14:44.01,0:14:46.93,Default,,0000,0000,0000,,Along the way a few minutes\Nago you mentioned some
Dialogue: 0,0:14:46.93,0:14:50.42,Default,,0000,0000,0000,,other things, some other \Ntypes of therapy that
Dialogue: 0,0:14:50.42,0:14:54.48,Default,,0000,0000,0000,,you know I guess maybe\Naren't all that common
Dialogue: 0,0:14:54.48,0:14:56.100,Default,,0000,0000,0000,,and would generally \Nmaybe be frowned upon.
Dialogue: 0,0:14:56.100,0:15:01.56,Default,,0000,0000,0000,,But sort of the dividing\Nline to me doesn't
Dialogue: 0,0:15:01.56,0:15:04.46,Default,,0000,0000,0000,,strike me as nearly \Nas sharp.
Dialogue: 0,0:15:04.46,0:15:09.50,Default,,0000,0000,0000,,What if somebody has some--\Nwhat if there are clincians
Dialogue: 0,0:15:09.50,0:15:13.58,Default,,0000,0000,0000,,out there who have unusual\Ntheoretical perspectives on
Dialogue: 0,0:15:13.58,0:15:19.19,Default,,0000,0000,0000,,things so it leaves them to \Nengage in some unusual
Dialogue: 0,0:15:19.19,0:15:23.53,Default,,0000,0000,0000,,practices with the aim \Nof trying to genuinely
Dialogue: 0,0:15:23.53,0:15:24.43,Default,,0000,0000,0000,,help their clients.
Dialogue: 0,0:15:24.43,0:15:26.46,Default,,0000,0000,0000,,But maybe some things\Nfor which there's really
Dialogue: 0,0:15:26.46,0:15:28.78,Default,,0000,0000,0000,,no empirical support.
Dialogue: 0,0:15:28.78,0:15:30.58,Default,,0000,0000,0000,,>> Okay now we're\Ngetting down to it.
Dialogue: 0,0:15:30.58,0:15:33.04,Default,,0000,0000,0000,,>> Really kind of maybe \Nthings, their theoretical
Dialogue: 0,0:15:33.04,0:15:36.51,Default,,0000,0000,0000,,perspective is driven\Nmore by their own intuitions
Dialogue: 0,0:15:36.51,0:15:39.61,Default,,0000,0000,0000,,about things than it is by \Nsort of a research base.
Dialogue: 0,0:15:39.61,0:15:44.10,Default,,0000,0000,0000,,Is that number one,\Ndo such people exist,
Dialogue: 0,0:15:44.10,0:15:45.44,Default,,0000,0000,0000,,I suspect they do.
Dialogue: 0,0:15:45.44,0:15:50.57,Default,,0000,0000,0000,,But I guess mire importantly\Nthen is that in itself an
Dialogue: 0,0:15:50.57,0:15:53.15,Default,,0000,0000,0000,,ethical problem?
Dialogue: 0,0:15:53.15,0:15:55.75,Default,,0000,0000,0000,,>> Yeah it's at least an \Nethical question.
Dialogue: 0,0:15:55.75,0:15:58.63,Default,,0000,0000,0000,,>> And how does it get\Nresolved then?
Dialogue: 0,0:15:58.63,0:16:00.38,Default,,0000,0000,0000,,I honestly don't know.
Dialogue: 0,0:16:00.38,0:16:05.40,Default,,0000,0000,0000,,Is there I mean if the \Npeople--if there's a
Dialogue: 0,0:16:05.40,0:16:07.18,Default,,0000,0000,0000,,therapist out there that's\Nengaging in these sort of
Dialogue: 0,0:16:07.18,0:16:10.46,Default,,0000,0000,0000,,more intuitively based\Nkind of things
Dialogue: 0,0:16:10.46,0:16:15.92,Default,,0000,0000,0000,,and their clients are happy.
Dialogue: 0,0:16:16.81,0:16:18.49,Default,,0000,0000,0000,,>> Well this point kind of\Ngets down to the cracks
Dialogue: 0,0:16:18.49,0:16:20.99,Default,,0000,0000,0000,,actually of I think where \Nour perspectives kind of
Dialogue: 0,0:16:20.99,0:16:22.89,Default,,0000,0000,0000,,come in as clinician,\Nstatistian is just sort
Dialogue: 0,0:16:22.89,0:16:25.66,Default,,0000,0000,0000,,of think about what\Nrole do you think
Dialogue: 0,0:16:25.66,0:16:28.68,Default,,0000,0000,0000,,actually that empirical \Ndata should play
Dialogue: 0,0:16:28.68,0:16:31.17,Default,,0000,0000,0000,,in terms of determining \Nwhat kinds of things
Dialogue: 0,0:16:31.17,0:16:32.35,Default,,0000,0000,0000,,clinicians do.
Dialogue: 0,0:16:32.35,0:16:35.10,Default,,0000,0000,0000,,They're going to be many\Nsituations in which we
Dialogue: 0,0:16:35.10,0:16:37.82,Default,,0000,0000,0000,,don't actually have access\Nto a clear cut set of
Dialogue: 0,0:16:37.82,0:16:40.28,Default,,0000,0000,0000,,treatments that have \Nbeen perfectly well
Dialogue: 0,0:16:40.28,0:16:42.26,Default,,0000,0000,0000,,demonstrated to be\Nefficacious.
Dialogue: 0,0:16:42.26,0:16:43.79,Default,,0000,0000,0000,,Certainly there are going\Nto be lots of times
Dialogue: 0,0:16:43.79,0:16:46.12,Default,,0000,0000,0000,,when that's not available\Nto us but I would also
Dialogue: 0,0:16:46.12,0:16:48.93,Default,,0000,0000,0000,,say that if it is available\Nto us we have some
Dialogue: 0,0:16:48.93,0:16:51.26,Default,,0000,0000,0000,,ethical obligation to\Ngo toward that.
Dialogue: 0,0:16:51.26,0:16:52.91,Default,,0000,0000,0000,,And that's one of the\Nthings that's so difficult
Dialogue: 0,0:16:52.91,0:16:55.21,Default,,0000,0000,0000,,about the situation of\Npsychology now I think
Dialogue: 0,0:16:55.21,0:16:57.18,Default,,0000,0000,0000,,that there are some \Ntheoretical orientations
Dialogue: 0,0:16:57.18,0:17:00.53,Default,,0000,0000,0000,,that pull for more research\Nsupport than others.
Dialogue: 0,0:17:00.53,0:17:04.66,Default,,0000,0000,0000,,So being trained as a \Nprimarily cognitive behavioral
Dialogue: 0,0:17:04.66,0:17:08.78,Default,,0000,0000,0000,,technician in those ways\Nthat's an approach that's
Dialogue: 0,0:17:08.78,0:17:09.94,Default,,0000,0000,0000,,been very looked at.
Dialogue: 0,0:17:09.94,0:17:11.49,Default,,0000,0000,0000,,It's been investigated a bunch.
Dialogue: 0,0:17:11.49,0:17:13.80,Default,,0000,0000,0000,,You know tons and tons of\Nresearch has been done on it.
Dialogue: 0,0:17:14.06,0:17:15.68,Default,,0000,0000,0000,,Certain things have\Nbeen very well demonstrated,
Dialogue: 0,0:17:15.68,0:17:17.86,Default,,0000,0000,0000,,other things are mushier\Nand haven't been as well
Dialogue: 0,0:17:17.86,0:17:19.46,Default,,0000,0000,0000,,demonstrated that kind of thing.
Dialogue: 0,0:17:19.46,0:17:22.44,Default,,0000,0000,0000,,Just because we have the \Ndata on that theoretical approach
Dialogue: 0,0:17:22.44,0:17:25.23,Default,,0000,0000,0000,,doesn't necessarily mean that\Nwe've ruled out efficacy on
Dialogue: 0,0:17:25.23,0:17:27.30,Default,,0000,0000,0000,,all of the other approaches.
Dialogue: 0,0:17:27.30,0:17:30.43,Default,,0000,0000,0000,,Like their could actually be\Nequivalently efficacious
Dialogue: 0,0:17:30.43,0:17:33.67,Default,,0000,0000,0000,,approaches that just haven't\Nbeen tested in the same way.
Dialogue: 0,0:17:33.67,0:17:36.93,Default,,0000,0000,0000,,The way that I tend to \Ncome down on this ethically
Dialogue: 0,0:17:36.93,0:17:41.31,Default,,0000,0000,0000,,is that if empirical support\Nfor a treatment is availbe
Dialogue: 0,0:17:41.31,0:17:44.66,Default,,0000,0000,0000,,and appears to apply\Nappropriately to the
Dialogue: 0,0:17:44.66,0:17:46.29,Default,,0000,0000,0000,,particular client that \Nyou're talking about and
Dialogue: 0,0:17:46.29,0:17:47.78,Default,,0000,0000,0000,,of course you've got a lot\Nof things with socio
Dialogue: 0,0:17:47.78,0:17:49.99,Default,,0000,0000,0000,,demographics and all \Nkinds of issues that might
Dialogue: 0,0:17:49.99,0:17:52.42,Default,,0000,0000,0000,,apply there right in terms\Nof where was the research
Dialogue: 0,0:17:52.42,0:17:54.33,Default,,0000,0000,0000,,done and with whom \Nand does this actually
Dialogue: 0,0:17:54.33,0:17:56.52,Default,,0000,0000,0000,,apply to the person I'm\Nlooking at right now
Dialogue: 0,0:17:56.52,0:17:57.70,Default,,0000,0000,0000,,across from me right.
Dialogue: 0,0:17:57.70,0:18:00.50,Default,,0000,0000,0000,,But that if empirical \Nsupport is available and
Dialogue: 0,0:18:00.50,0:18:03.11,Default,,0000,0000,0000,,certainly if empirical \Ndata is available suggesting
Dialogue: 0,0:18:03.11,0:18:06.41,Default,,0000,0000,0000,,that something is dangerous \Nthen we definitely need to
Dialogue: 0,0:18:06.41,0:18:09.81,Default,,0000,0000,0000,,avoid that. That can rule\Nthings out for us as an
Dialogue: 0,0:18:09.81,0:18:12.40,Default,,0000,0000,0000,,approach but then when\Nwe don't have those data,
Dialogue: 0,0:18:12.40,0:18:14.52,Default,,0000,0000,0000,,when we have no indication\Nthat something is dangerous,
Dialogue: 0,0:18:14.52,0:18:17.38,Default,,0000,0000,0000,,instead we have indication\Nthat it's probably efficacious
Dialogue: 0,0:18:17.38,0:18:20.44,Default,,0000,0000,0000,,in this situation okay,\Nwell then that makes sense
Dialogue: 0,0:18:20.44,0:18:22.76,Default,,0000,0000,0000,,to me that that would drive\Nsome of my decision making
Dialogue: 0,0:18:22.76,0:18:25.79,Default,,0000,0000,0000,,as a clinician that I would\Nsay why look cognitive behavioral
Dialogue: 0,0:18:25.79,0:18:27.88,Default,,0000,0000,0000,,therapy or an even better\Nexample would probably be
Dialogue: 0,0:18:27.88,0:18:30.86,Default,,0000,0000,0000,,dialectical behavior therapy\Nfor certain types of
Dialogue: 0,0:18:30.86,0:18:32.22,Default,,0000,0000,0000,,emotional problems.
Dialogue: 0,0:18:32.22,0:18:34.79,Default,,0000,0000,0000,,Marsha Linehan is the person \Nwho came up with
Dialogue: 0,0:18:34.79,0:18:37.80,Default,,0000,0000,0000,,dialectal behavioral therapy,\None of my great heroes.
Dialogue: 0,0:18:38.06,0:18:40.98,Default,,0000,0000,0000,,And I use the work that \Nshe has done and
Dialogue: 0,0:18:40.98,0:18:43.40,Default,,0000,0000,0000,,come up with her whole\Nresearch team for many years.
Dialogue: 0,0:18:43.40,0:18:46.38,Default,,0000,0000,0000,,I've used that work\Na great deal in clinical practice.
Dialogue: 0,0:18:46.38,0:18:49.03,Default,,0000,0000,0000,,The fact that it's so well\Ndemonstrated to work
Dialogue: 0,0:18:49.03,0:18:51.49,Default,,0000,0000,0000,,with particular types of \Nproblems means that
Dialogue: 0,0:18:51.49,0:18:54.51,Default,,0000,0000,0000,,I can very easily say oh \NI have very strong justification
Dialogue: 0,0:18:54.51,0:18:57.71,Default,,0000,0000,0000,,for why I would choose\NDBT as a way to approach
Dialogue: 0,0:18:57.71,0:19:01.29,Default,,0000,0000,0000,,an eating disorder, \Na self harm behavior,
Dialogue: 0,0:19:01.29,0:19:04.97,Default,,0000,0000,0000,,suicidality with a lot of \Nrelationship chaos.
Dialogue: 0,0:19:04.97,0:19:06.74,Default,,0000,0000,0000,,Various kinds of things\Nthat sort of all approach
Dialogue: 0,0:19:06.74,0:19:09.39,Default,,0000,0000,0000,,something like borderline\Npersonality disorder
Dialogue: 0,0:19:09.39,0:19:12.31,Default,,0000,0000,0000,,which was the core problem that\Nit was originally, treatment was
Dialogue: 0,0:19:12.31,0:19:13.97,Default,,0000,0000,0000,,originally developed on.
Dialogue: 0,0:19:13.97,0:19:19.06,Default,,0000,0000,0000,,So in those situations I feel \Nlike it is an ethical obligation
Dialogue: 0,0:19:19.06,0:19:21.07,Default,,0000,0000,0000,,I would say this to me \Nin terms of my interpretation
Dialogue: 0,0:19:21.07,0:19:24.49,Default,,0000,0000,0000,,of what ethics are telling me\Nto choose that over
Dialogue: 0,0:19:24.49,0:19:27.41,Default,,0000,0000,0000,,a treatment I don't know\Nif it's going to work.
Dialogue: 0,0:19:27.41,0:19:29.87,Default,,0000,0000,0000,,I have no data on it \Nat all, much less a
Dialogue: 0,0:19:29.87,0:19:31.83,Default,,0000,0000,0000,,treatment that I actually\Nhave data that suggests
Dialogue: 0,0:19:31.83,0:19:33.85,Default,,0000,0000,0000,,that it would be counter\Nproductive right.
Dialogue: 0,0:19:33.85,0:19:38.42,Default,,0000,0000,0000,,That's a relatively \Nsmall subset of the type
Dialogue: 0,0:19:38.42,0:19:39.53,Default,,0000,0000,0000,,of work that we do I think.
Dialogue: 0,0:19:39.53,0:19:42.39,Default,,0000,0000,0000,,>> Do the ethical guidelines,
Dialogue: 0,0:19:42.39,0:19:48.96,Default,,0000,0000,0000,,the APA's ethical guidelines\Ncompel you to use those
Dialogue: 0,0:19:48.96,0:19:52.76,Default,,0000,0000,0000,,kinds of treatments.
Dialogue: 0,0:19:53.01,0:19:54.18,Default,,0000,0000,0000,,You're not required to?
Dialogue: 0,0:19:54.18,0:19:55.49,Default,,0000,0000,0000,,>> No, you're not required to.
Dialogue: 0,0:19:55.49,0:19:59.58,Default,,0000,0000,0000,,Instead, you're certainly required\Nto not use treatments that
Dialogue: 0,0:19:59.58,0:20:01.57,Default,,0000,0000,0000,,have been demonstrated \Nto be dangerous.
Dialogue: 0,0:20:01.57,0:20:05.35,Default,,0000,0000,0000,,You're required to take \Ninto account that type of--
Dialogue: 0,0:20:05.35,0:20:08.35,Default,,0000,0000,0000,,>> This is kind of an analogous\Nthing in those guidelines
Dialogue: 0,0:20:08.71,0:20:11.40,Default,,0000,0000,0000,,of the kind of do no \Nharm kind of thing
Dialogue: 0,0:20:11.40,0:20:14.35,Default,,0000,0000,0000,,that's in the medical.
Dialogue: 0,0:20:14.35,0:20:15.93,Default,,0000,0000,0000,,>> Not just kind of it's\Nspecifically in there.
Dialogue: 0,0:20:15.93,0:20:17.07,Default,,0000,0000,0000,,>> It really is in there?
Dialogue: 0,0:20:17.07,0:20:19.57,Default,,0000,0000,0000,,>> Yep malfeasance is \Nthe word that we use for that.
Dialogue: 0,0:20:19.57,0:20:22.31,Default,,0000,0000,0000,,So non-malfeasance \Nis the number one guideline
Dialogue: 0,0:20:22.31,0:20:23.99,Default,,0000,0000,0000,,where you would say \Nfirst do no harm
Dialogue: 0,0:20:23.99,0:20:26.14,Default,,0000,0000,0000,,and then of course\Nbeneficence
Dialogue: 0,0:20:26.14,0:20:27.54,Default,,0000,0000,0000,,comes in very shortly \Nafter that.
Dialogue: 0,0:20:27.54,0:20:30.15,Default,,0000,0000,0000,,Beneficence is to do\Nactive good for someone else
Dialogue: 0,0:20:30.15,0:20:32.66,Default,,0000,0000,0000,,and all of your decisions\Nfor a client are supposed to be
Dialogue: 0,0:20:32.66,0:20:34.88,Default,,0000,0000,0000,,beneficent decisions right.
Dialogue: 0,0:20:34.88,0:20:37.31,Default,,0000,0000,0000,,But then you also have \Nto protect client autonomy
Dialogue: 0,0:20:37.31,0:20:39.53,Default,,0000,0000,0000,,and client autonomy of\Ncourse is the ability to
Dialogue: 0,0:20:39.53,0:20:41.66,Default,,0000,0000,0000,,self determine and make\Nyour own decisions for
Dialogue: 0,0:20:41.66,0:20:43.29,Default,,0000,0000,0000,,yourself as a person.
Dialogue: 0,0:20:43.29,0:20:47.32,Default,,0000,0000,0000,,It's also my requirement\Nas a clinician to really
Dialogue: 0,0:20:47.32,0:20:49.81,Default,,0000,0000,0000,,respect your autonomy\Nand try to encourage it.
Dialogue: 0,0:20:49.81,0:20:52.24,Default,,0000,0000,0000,,So you can see that \Nwe can kind of get into
Dialogue: 0,0:20:52.24,0:20:53.40,Default,,0000,0000,0000,,some messes there \Nsometimes.
Dialogue: 0,0:20:53.40,0:20:55.37,Default,,0000,0000,0000,,>> There's some serious\Nbalancing acts there yes.
Dialogue: 0,0:20:55.37,0:20:57.52,Default,,0000,0000,0000,,>> Yes, absolutely and those\Nconflicts very often come
Dialogue: 0,0:20:57.52,0:21:00.35,Default,,0000,0000,0000,,around things like is it \Nbeneficent to protect autonomy.
Dialogue: 0,0:21:00.35,0:21:04.83,Default,,0000,0000,0000,,Which of those--classic example\Nthere comes in--
Dialogue: 0,0:21:04.83,0:21:08.65,Default,,0000,0000,0000,,the classic example comes in \Nwhen we talk about
Dialogue: 0,0:21:08.65,0:21:12.45,Default,,0000,0000,0000,,in patient hospitalization,\Ninvoluntary in patient
Dialogue: 0,0:21:12.45,0:21:13.60,Default,,0000,0000,0000,,hospitalization right.
Dialogue: 0,0:21:13.60,0:21:15.56,Default,,0000,0000,0000,,If your decision is that \Nyou don't want to be
Dialogue: 0,0:21:15.56,0:21:16.64,Default,,0000,0000,0000,,in the hospital.\N>> I don't.
Dialogue: 0,0:21:16.64,0:21:20.66,Default,,0000,0000,0000,,>> Me neither. Who does? \NSo often so few people do.
Dialogue: 0,0:21:20.66,0:21:23.31,Default,,0000,0000,0000,,But if your decision is that\Nyou don't think you don't
Dialogue: 0,0:21:23.31,0:21:24.54,Default,,0000,0000,0000,,need to be in the hospital \Nand you don't want to be there
Dialogue: 0,0:21:24.54,0:21:27.89,Default,,0000,0000,0000,,but my perspective as your\Nclinician is that you're
Dialogue: 0,0:21:27.89,0:21:30.23,Default,,0000,0000,0000,,going to be dead if I don't\Nput you in the hospital.
Dialogue: 0,0:21:30.23,0:21:32.84,Default,,0000,0000,0000,,And therefore it's actually\Nbeneficent for me to
Dialogue: 0,0:21:32.84,0:21:36.45,Default,,0000,0000,0000,,put you there even though\Nthis is not what you want.
Dialogue: 0,0:21:36.45,0:21:39.44,Default,,0000,0000,0000,,That's a very common \Nkind of place where we say
Dialogue: 0,0:21:39.44,0:21:42.25,Default,,0000,0000,0000,,okay are you going to prioritize\Nthe clients autonomy,
Dialogue: 0,0:21:42.25,0:21:44.53,Default,,0000,0000,0000,,where they're getting to choose\Nto make their own mistakes
Dialogue: 0,0:21:44.53,0:21:46.94,Default,,0000,0000,0000,,so to speak because \Nby the way those of us
Dialogue: 0,0:21:46.94,0:21:48.76,Default,,0000,0000,0000,,who are not mental patients\Nwe get to make our own
Dialogue: 0,0:21:48.76,0:21:50.32,Default,,0000,0000,0000,,mistakes all the time.
Dialogue: 0,0:21:50.32,0:21:52.93,Default,,0000,0000,0000,,(inaudible) It does happen\Nof course, all the time.
Dialogue: 0,0:21:52.93,0:21:55.06,Default,,0000,0000,0000,,Or are you going to try\Nto figure out how do
Dialogue: 0,0:21:55.06,0:21:58.28,Default,,0000,0000,0000,,you know what is beneficent \Nfor this person.
Dialogue: 0,0:21:58.28,0:22:00.59,Default,,0000,0000,0000,,I think that's one of the \Nthings that's most dicy
Dialogue: 0,0:22:00.59,0:22:03.13,Default,,0000,0000,0000,,about the concept of \Nelevating benefience
Dialogue: 0,0:22:03.13,0:22:06.05,Default,,0000,0000,0000,,to the top is that it\Ndoes then kind of give
Dialogue: 0,0:22:06.05,0:22:07.86,Default,,0000,0000,0000,,you this assumption that\Nyou can figure out what
Dialogue: 0,0:22:07.86,0:22:09.69,Default,,0000,0000,0000,,the right thing is for \Nanother person
Dialogue: 0,0:22:09.69,0:22:11.72,Default,,0000,0000,0000,,and maybe even better\Nthan they do what's
Dialogue: 0,0:22:11.72,0:22:12.54,Default,,0000,0000,0000,,right for them.
Dialogue: 0,0:22:12.54,0:22:14.00,Default,,0000,0000,0000,,That's one of those \Nfundamental ethical
Dialogue: 0,0:22:14.66,0:22:17.01,Default,,0000,0000,0000,,assumptions that's sometimes\Na little dicy for me.
Dialogue: 0,0:22:17.01,0:22:20.82,Default,,0000,0000,0000,,>> The cool thing is that you\Nare not required to use research.
Dialogue: 0,0:22:20.82,0:22:23.76,Default,,0000,0000,0000,,You're not required to use\Ndatabase kind of techniques
Dialogue: 0,0:22:23.76,0:22:24.82,Default,,0000,0000,0000,,or anything like that?
Dialogue: 0,0:22:24.96,0:22:26.25,Default,,0000,0000,0000,,>> (inaudible) because \Notherwise we wouldn't be
Dialogue: 0,0:22:26.25,0:22:28.25,Default,,0000,0000,0000,,allowed to do anything at all\Nin so many situations.
Dialogue: 0,0:22:28.25,0:22:32.03,Default,,0000,0000,0000,,If I were required to use \Nresearch to tell me what
Dialogue: 0,0:22:32.03,0:22:34.73,Default,,0000,0000,0000,,I'm allowed to do,\Nthen we would be required
Dialogue: 0,0:22:34.73,0:22:37.34,Default,,0000,0000,0000,,to have the research in place\Nbefore we were allowed
Dialogue: 0,0:22:37.34,0:22:38.30,Default,,0000,0000,0000,,to do anything.
Dialogue: 0,0:22:38.30,0:22:41.70,Default,,0000,0000,0000,,What if you come in and\Nyou say, okay I've got
Dialogue: 0,0:22:41.70,0:22:43.12,Default,,0000,0000,0000,,this particular problem\Nand I say,
Dialogue: 0,0:22:43.12,0:22:45.44,Default,,0000,0000,0000,,oh that's never been\Nresearched,
Dialogue: 0,0:22:45.44,0:22:46.94,Default,,0000,0000,0000,,>> We've never heard of this.
Dialogue: 0,0:22:46.94,0:22:48.50,Default,,0000,0000,0000,,>> Well or if even we've\Nheard of it,
Dialogue: 0,0:22:48.50,0:22:51.79,Default,,0000,0000,0000,,but the money hasn't been \Nthere to set up an NH study
Dialogue: 0,0:22:51.79,0:22:53.65,Default,,0000,0000,0000,,and nobody is actually
Dialogue: 0,0:22:53.65,0:22:55.17,Default,,0000,0000,0000,,investigated whether\Nthis is something that
Dialogue: 0,0:22:55.17,0:22:58.14,Default,,0000,0000,0000,,this problem could be treated\Nwith this therapy or
Dialogue: 0,0:22:58.14,0:22:59.18,Default,,0000,0000,0000,,that therapy.
Dialogue: 0,0:22:59.18,0:23:02.33,Default,,0000,0000,0000,,Maybe we don't have \Ngood outcome studies on that.
Dialogue: 0,0:23:02.33,0:23:04.35,Default,,0000,0000,0000,,Maybe there are only 15\Npeople that have
Dialogue: 0,0:23:04.35,0:23:06.71,Default,,0000,0000,0000,,been demonstrated to\Nhave this problem or whatever.
Dialogue: 0,0:23:07.22,0:23:08.80,Default,,0000,0000,0000,,In those kinds of situations,
Dialogue: 0,0:23:08.80,0:23:12.90,Default,,0000,0000,0000,,if in fact the ethical guidelines\Nrequired me to use research
Dialogue: 0,0:23:12.90,0:23:16.40,Default,,0000,0000,0000,,I would be stuck and unable\Nto do anything at all.
Dialogue: 0,0:23:16.40,0:23:19.80,Default,,0000,0000,0000,,So instead what they weigh\Nin on is the idea that you
Dialogue: 0,0:23:19.80,0:23:23.77,Default,,0000,0000,0000,,want to be able to use\Nrational theoretical
Dialogue: 0,0:23:23.77,0:23:26.83,Default,,0000,0000,0000,,and hopefully at times\Nempirical guidelines for
Dialogue: 0,0:23:26.83,0:23:29.02,Default,,0000,0000,0000,,determining what's \Nbest for the client,
Dialogue: 0,0:23:29.02,0:23:32.14,Default,,0000,0000,0000,,but that overall it's the\Nsort of Gestalt thing.
Dialogue: 0,0:23:32.14,0:23:35.33,Default,,0000,0000,0000,,Like you got this overall\Nprofessional perspective
Dialogue: 0,0:23:35.33,0:23:37.43,Default,,0000,0000,0000,,and you have to use your\Nown professional judgment
Dialogue: 0,0:23:37.43,0:23:39.68,Default,,0000,0000,0000,,in trying to determine \Nwhat is actually going to
Dialogue: 0,0:23:39.68,0:23:41.86,Default,,0000,0000,0000,,be in the best interest\Nof the client.
Dialogue: 0,0:23:41.86,0:23:46.37,Default,,0000,0000,0000,,That takes us like full circle\Nback to the subjectivity question
Dialogue: 0,0:23:46.37,0:23:48.75,Default,,0000,0000,0000,,right where we're like \Nthere it is.
Dialogue: 0,0:23:48.75,0:23:52.05,Default,,0000,0000,0000,,My job definitely has a \Nlot of subjectivity to it.
Dialogue: 0,0:23:52.05,0:23:54.38,Default,,0000,0000,0000,,And yours it sounds like\Nhas a lot more subjectivity
Dialogue: 0,0:23:54.38,0:23:57.97,Default,,0000,0000,0000,,in the interpretation \Nthat it's like in sort of the
Dialogue: 0,0:23:57.97,0:24:00.00,Default,,0000,0000,0000,,same way that I would talk \Nabout assessment right.
Dialogue: 0,0:24:00.00,0:24:04.34,Default,,0000,0000,0000,,So when we do assessment,\Nwe get concrete very often
Dialogue: 0,0:24:04.34,0:24:07.66,Default,,0000,0000,0000,,quite objective data\Non what a person's behavior
Dialogue: 0,0:24:07.66,0:24:09.46,Default,,0000,0000,0000,,is looking like what they're doing.
Dialogue: 0,0:24:09.46,0:24:12.64,Default,,0000,0000,0000,,And it's a matter of how to actually\Ninterpret those results.
Dialogue: 0,0:24:12.64,0:24:17.92,Default,,0000,0000,0000,,Does this level of vigilant \Nattending on a particular
Dialogue: 0,0:24:17.92,0:24:21.29,Default,,0000,0000,0000,,computer task indicate to me\Nthat ADHD is a likely
Dialogue: 0,0:24:21.29,0:24:23.32,Default,,0000,0000,0000,,explanation for this behavior.
Dialogue: 0,0:24:23.32,0:24:26.02,Default,,0000,0000,0000,,And it's not in whether\Nto like how do I actually
Dialogue: 0,0:24:26.02,0:24:27.10,Default,,0000,0000,0000,,get the data.
Dialogue: 0,0:24:27.10,0:24:29.89,Default,,0000,0000,0000,,It's in what do the data mean\Nthat would be the real
Dialogue: 0,0:24:29.89,0:24:30.81,Default,,0000,0000,0000,,subjective part.
Dialogue: 0,0:24:30.81,0:24:33.49,Default,,0000,0000,0000,,>> Yeah, yeah I mean \Nin my world yeah.
Dialogue: 0,0:24:33.49,0:24:35.89,Default,,0000,0000,0000,,The analogous is actually\Nfairly well cut and dry,
Dialogue: 0,0:24:35.89,0:24:38.11,Default,,0000,0000,0000,,we've talked about before.\NThere's good techniques
Dialogue: 0,0:24:38.11,0:24:41.14,Default,,0000,0000,0000,,and we usually try to focus \Non those.
Dialogue: 0,0:24:41.14,0:24:43.36,Default,,0000,0000,0000,,And the question of what \Nis the meaning and then
Dialogue: 0,0:24:43.36,0:24:45.47,Default,,0000,0000,0000,,what is the action that then\Nbuilds upon that.
Dialogue: 0,0:24:45.47,0:24:49.14,Default,,0000,0000,0000,,Those are all the places that \Nyou know and again
Dialogue: 0,0:24:49.14,0:24:54.96,Default,,0000,0000,0000,,good news for me frankly,\Npersonally is
Dialogue: 0,0:24:54.96,0:24:58.45,Default,,0000,0000,0000,,>> It's all about you, Greg.\N>> Well those of us who
Dialogue: 0,0:24:58.45,0:25:02.78,Default,,0000,0000,0000,,do the things that I do,\Nand a real difference between
Dialogue: 0,0:25:02.78,0:25:06.21,Default,,0000,0000,0000,,my world and yours is that\Nfor the most part
Dialogue: 0,0:25:06.21,0:25:08.83,Default,,0000,0000,0000,,the decisions about what to \Ndo with the information
Dialogue: 0,0:25:08.83,0:25:09.81,Default,,0000,0000,0000,,are not mine.
Dialogue: 0,0:25:10.32,0:25:14.67,Default,,0000,0000,0000,,I'm simply responsible \Nfor crunching the numbers,
Dialogue: 0,0:25:14.67,0:25:18.80,Default,,0000,0000,0000,,telling the people who are\Npaying me or are otherwise
Dialogue: 0,0:25:18.80,0:25:21.97,Default,,0000,0000,0000,,working with me telling\Nthem what the numbers say,
Dialogue: 0,0:25:21.97,0:25:23.49,Default,,0000,0000,0000,,what's the knowledge \Nthat we just extracted
Dialogue: 0,0:25:23.49,0:25:27.34,Default,,0000,0000,0000,,from the data but then\Nthe actions upon that knowledge
Dialogue: 0,0:25:27.34,0:25:29.67,Default,,0000,0000,0000,,where to go from there\Nare usually--
Dialogue: 0,0:25:29.67,0:25:32.72,Default,,0000,0000,0000,,that's usually not what\NI'm involved in.
Dialogue: 0,0:25:32.72,0:25:36.76,Default,,0000,0000,0000,,It's not the situation that\Nyou have where having
Dialogue: 0,0:25:36.76,0:25:39.18,Default,,0000,0000,0000,,established what's going on
Dialogue: 0,0:25:39.18,0:25:44.66,Default,,0000,0000,0000,,you work with your patients,\Nyour clients to then devise
Dialogue: 0,0:25:44.66,0:25:48.02,Default,,0000,0000,0000,,a course of action that's \Nultimately hopefully
Dialogue: 0,0:25:48.02,0:25:50.48,Default,,0000,0000,0000,,going to be helpful and \Nsensable and all that.
Dialogue: 0,0:25:50.48,0:25:52.20,Default,,0000,0000,0000,,In my case, most of the time,
Dialogue: 0,0:25:52.20,0:25:56.80,Default,,0000,0000,0000,,frankly the actions to be taken \NI don't really--
Dialogue: 0,0:25:56.80,0:26:00.26,Default,,0000,0000,0000,,I don't really have to be involved\Nin them so again
Dialogue: 0,0:26:00.26,0:26:01.96,Default,,0000,0000,0000,,I really have a much,\NI have a much simpler life.
Dialogue: 0,0:26:01.96,0:26:05.50,Default,,0000,0000,0000,,I have a great deal of envy\Nfor or not envy--
Dialogue: 0,0:26:05.50,0:26:06.97,Default,,0000,0000,0000,,>> Reverse envy?
Dialogue: 0,0:26:06.97,0:26:10.84,Default,,0000,0000,0000,,>> Right I'm not envious \Nof the situation that y'all
Dialogue: 0,0:26:10.84,0:26:11.74,Default,,0000,0000,0000,,find yourselves in.
Dialogue: 0,0:26:11.74,0:26:15.61,Default,,0000,0000,0000,,I don't know how you stop\Nfrom thinking about
Dialogue: 0,0:26:15.61,0:26:17.04,Default,,0000,0000,0000,,this stuff.
Dialogue: 0,0:26:17.04,0:26:24.89,Default,,0000,0000,0000,,You see your clients and \Nyou're confronted with all
Dialogue: 0,0:26:24.89,0:26:29.12,Default,,0000,0000,0000,,of these different circumstances\Nthat pose this variety of ethical
Dialogue: 0,0:26:29.12,0:26:30.27,Default,,0000,0000,0000,,dilemmas and what not.
Dialogue: 0,0:26:30.27,0:26:31.100,Default,,0000,0000,0000,,I don't know how you\Nstop from thinking about it
Dialogue: 0,0:26:31.100,0:26:34.64,Default,,0000,0000,0000,,at nighttime, \Njust constantly cycling over it
Dialogue: 0,0:26:34.64,0:26:35.60,Default,,0000,0000,0000,,and all of that.
Dialogue: 0,0:26:35.60,0:26:39.50,Default,,0000,0000,0000,,>> I'm going to talk about that\Nfor a second, how we do that.
Dialogue: 0,0:26:39.50,0:26:40.96,Default,,0000,0000,0000,,But first I want us to just \Nreally notice
Dialogue: 0,0:26:40.96,0:26:44.66,Default,,0000,0000,0000,,how much validation we're\Ngetting. Like look at this guy.
Dialogue: 0,0:26:44.66,0:26:46.69,Default,,0000,0000,0000,,This is a statistician. \N
Dialogue: 0,0:26:46.69,0:26:49.27,Default,,0000,0000,0000,,He's absolutely saying like\Nphew that's a tough job,
Dialogue: 0,0:26:49.27,0:26:51.21,Default,,0000,0000,0000,,I don't know how you guys\Ndo that.
Dialogue: 0,0:26:51.21,0:26:54.59,Default,,0000,0000,0000,,Yeah it turns out there's \Nlike this huge extensive amount
Dialogue: 0,0:26:54.59,0:26:56.79,Default,,0000,0000,0000,,of training that teaches\Nus how to do things
Dialogue: 0,0:26:56.79,0:26:58.27,Default,,0000,0000,0000,,like compartmentalize.
Dialogue: 0,0:26:58.27,0:27:01.28,Default,,0000,0000,0000,,So I compartmentalize my\Nclients and that's how I stop
Dialogue: 0,0:27:01.28,0:27:03.83,Default,,0000,0000,0000,,thinking about them \Nat night otherwise of course
Dialogue: 0,0:27:03.83,0:27:06.46,Default,,0000,0000,0000,,I wouldn't be available \Nto my clients
Dialogue: 0,0:27:06.46,0:27:09.19,Default,,0000,0000,0000,,because I would be such a\Nmess myself.
Dialogue: 0,0:27:09.19,0:27:11.22,Default,,0000,0000,0000,,So in order to be an \Neffective clinician
Dialogue: 0,0:27:11.22,0:27:13.33,Default,,0000,0000,0000,,you have to be trained in\Nand have to practice
Dialogue: 0,0:27:13.33,0:27:15.98,Default,,0000,0000,0000,,and usually this is a big\Npart of the whole graduate
Dialogue: 0,0:27:15.98,0:27:17.26,Default,,0000,0000,0000,,school process and everything
Dialogue: 0,0:27:17.26,0:27:18.67,Default,,0000,0000,0000,,is that you're supervised\Nby people who will
Dialogue: 0,0:27:18.67,0:27:21.71,Default,,0000,0000,0000,,also encourage you to \Nlearn how to put those
Dialogue: 0,0:27:21.71,0:27:23.98,Default,,0000,0000,0000,,things away so that it\Ndoesn't pervade through
Dialogue: 0,0:27:23.98,0:27:27.20,Default,,0000,0000,0000,,your entire existence \Nthat way.
Dialogue: 0,0:27:27.20,0:27:30.78,Default,,0000,0000,0000,,So as most of you know\Nit can sometimes be
Dialogue: 0,0:27:30.78,0:27:32.41,Default,,0000,0000,0000,,challenging to do that.
Dialogue: 0,0:27:32.41,0:27:34.22,Default,,0000,0000,0000,,There are times when \Nwe still do bring them home
Dialogue: 0,0:27:34.22,0:27:37.20,Default,,0000,0000,0000,,and I still remember that\Nfrom the beginning of my training
Dialogue: 0,0:27:37.20,0:27:39.28,Default,,0000,0000,0000,,when I was a new clinician\Nthat there was definitely
Dialogue: 0,0:27:39.28,0:27:40.33,Default,,0000,0000,0000,,much more of that.
Dialogue: 0,0:27:40.33,0:27:42.18,Default,,0000,0000,0000,,It was much more of a\Nchallenged to not bring the
Dialogue: 0,0:27:42.18,0:27:44.90,Default,,0000,0000,0000,,emotional aspects of\Nmy work home with me.
Dialogue: 0,0:27:44.90,0:27:47.89,Default,,0000,0000,0000,,And then over time you\Nget better and better
Dialogue: 0,0:27:47.89,0:27:49.96,Default,,0000,0000,0000,,at being able to not \Ndo that and just kind
Dialogue: 0,0:27:49.96,0:27:52.20,Default,,0000,0000,0000,,of show up everyday ready\Nto deal with the problem.
Dialogue: 0,0:27:52.20,0:27:55.23,Default,,0000,0000,0000,,>> In this complex maze \Nof stuff that you deal with
Dialogue: 0,0:27:55.23,0:27:57.65,Default,,0000,0000,0000,,then and all of the different\Nethical dilemmas that
Dialogue: 0,0:27:57.65,0:28:00.14,Default,,0000,0000,0000,,your day to day life poses\Nfor you,
Dialogue: 0,0:28:00.14,0:28:03.21,Default,,0000,0000,0000,,if you cannot solve them\Nfor yourself,
Dialogue: 0,0:28:03.21,0:28:06.55,Default,,0000,0000,0000,,and you don't want to\Npercolate over them at night,
Dialogue: 0,0:28:06.55,0:28:07.88,Default,,0000,0000,0000,,what do you do?
Dialogue: 0,0:28:07.88,0:28:11.19,Default,,0000,0000,0000,,Do you talk to other people,\NI mean how does that resolved?
Dialogue: 0,0:28:11.19,0:28:13.65,Default,,0000,0000,0000,,>> This is part of our ethical \Nguidelines too, is
Dialogue: 0,0:28:13.65,0:28:16.08,Default,,0000,0000,0000,,how to deal with this so\Nas most of the people
Dialogue: 0,0:28:16.08,0:28:18.15,Default,,0000,0000,0000,,listening to us will probably know,
Dialogue: 0,0:28:18.15,0:28:21.24,Default,,0000,0000,0000,,if in fact you find yourself \Nin an ethical quandary
Dialogue: 0,0:28:21.24,0:28:23.19,Default,,0000,0000,0000,,and you're really not sure \Nwhat to do about it,
Dialogue: 0,0:28:23.19,0:28:26.37,Default,,0000,0000,0000,,there are of course resources\Nthat you can use to
Dialogue: 0,0:28:26.37,0:28:29.12,Default,,0000,0000,0000,,try to weigh, get information\Nand try to get help with that.
Dialogue: 0,0:28:29.12,0:28:31.73,Default,,0000,0000,0000,,One of the ways that of\Ncourse we do that
Dialogue: 0,0:28:31.73,0:28:33.84,Default,,0000,0000,0000,,is by talking to fellow\Nclinicians so anybody in your
Dialogue: 0,0:28:33.84,0:28:36.06,Default,,0000,0000,0000,,same licensing category.
Dialogue: 0,0:28:36.06,0:28:37.98,Default,,0000,0000,0000,,Most of us choose a\Ncouple of people that
Dialogue: 0,0:28:37.98,0:28:40.53,Default,,0000,0000,0000,,we're really close to and\Nwe'll actually talk through cases.
Dialogue: 0,0:28:40.53,0:28:45.34,Default,,0000,0000,0000,,We tend to of course try to\Nbe as subtle and careful
Dialogue: 0,0:28:45.34,0:28:46.63,Default,,0000,0000,0000,,about that as we can.
Dialogue: 0,0:28:46.63,0:28:48.01,Default,,0000,0000,0000,,We don't want to share \Nmore information than
Dialogue: 0,0:28:48.01,0:28:49.22,Default,,0000,0000,0000,,you have to that kind\Nof thing.
Dialogue: 0,0:28:49.22,0:28:51.49,Default,,0000,0000,0000,,But you're absolutely \Nallowed to do that.
Dialogue: 0,0:28:51.49,0:28:53.79,Default,,0000,0000,0000,,Then the other thing you're\Nallowed to do is of course
Dialogue: 0,0:28:53.79,0:28:55.58,Default,,0000,0000,0000,,look up, you know a lot\Nof the times there's actually
Dialogue: 0,0:28:55.58,0:28:58.90,Default,,0000,0000,0000,,lots of writing that's been\Ndone on these ethical questions
Dialogue: 0,0:28:58.90,0:29:01.34,Default,,0000,0000,0000,,and lots of weighing in has\Nhappened as far as all of
Dialogue: 0,0:29:01.34,0:29:03.18,Default,,0000,0000,0000,,these decisions go.
Dialogue: 0,0:29:03.18,0:29:04.15,Default,,0000,0000,0000,,>> The internet has an answer?
Dialogue: 0,0:29:04.15,0:29:05.36,Default,,0000,0000,0000,,>> The internet may have\Nan answer,
Dialogue: 0,0:29:05.36,0:29:07.21,Default,,0000,0000,0000,,be careful about the answer.
Dialogue: 0,0:29:07.21,0:29:09.33,Default,,0000,0000,0000,,The internet may have the\Nwrong answer,
Dialogue: 0,0:29:09.33,0:29:11.28,Default,,0000,0000,0000,,but yeah there's lots of \Npublished stuff about
Dialogue: 0,0:29:11.28,0:29:14.80,Default,,0000,0000,0000,,different ethical guidelines,\Ndifferent ethical quandaries
Dialogue: 0,0:29:14.80,0:29:16.36,Default,,0000,0000,0000,,and that kind of thing that \Npeople get into.
Dialogue: 0,0:29:16.36,0:29:17.81,Default,,0000,0000,0000,,That's a lot of how you do it.
Dialogue: 0,0:29:17.81,0:29:23.56,Default,,0000,0000,0000,,Now, believe it or not,\Nyou have survived an hour
Dialogue: 0,0:29:23.56,0:29:26.49,Default,,0000,0000,0000,,of the clinician and\Nthe statistician.
Dialogue: 0,0:29:26.49,0:29:28.51,Default,,0000,0000,0000,,That has happened. \NYou have managed to make
Dialogue: 0,0:29:28.51,0:29:32.13,Default,,0000,0000,0000,,your way through this process.\N>> Congratulations.
Dialogue: 0,0:29:32.13,0:29:34.92,Default,,0000,0000,0000,,>> Congratulations, and we have\Nmanaged to make our way
Dialogue: 0,0:29:34.92,0:29:36.26,Default,,0000,0000,0000,,through an hour of this.
Dialogue: 0,0:29:36.26,0:29:38.52,Default,,0000,0000,0000,,I feel like it's always the case\Nthat in our conversations
Dialogue: 0,0:29:38.52,0:29:40.97,Default,,0000,0000,0000,,I'm like cutting us off in\Nthis process
Dialogue: 0,0:29:40.97,0:29:43.05,Default,,0000,0000,0000,,because we could talk for hours.
Dialogue: 0,0:29:43.05,0:29:44.100,Default,,0000,0000,0000,,>> We have other things \Nsometimes that we have to get to.
Dialogue: 0,0:29:44.100,0:29:46.80,Default,,0000,0000,0000,,>> We do. (laughter)
Dialogue: 0,0:29:46.80,0:29:48.55,Default,,0000,0000,0000,,>> We have to terminate.
Dialogue: 0,0:29:48.55,0:29:52.84,Default,,0000,0000,0000,,>> Terminate? Oh my goodness,\Nno no. Instead this is is more
Dialogue: 0,0:29:52.84,0:29:55.73,Default,,0000,0000,0000,,analogous to the end of a session\Nrather than the end of a relationship
Dialogue: 0,0:29:55.73,0:30:00.35,Default,,0000,0000,0000,,therapeutically and so I would\Nsay instead tune in next time
Dialogue: 0,0:30:00.35,0:30:04.59,Default,,0000,0000,0000,,to see what crazy stuff \NDr. Hixon and I are talking about.
Dialogue: 0,0:30:04.59,0:30:08.12,Default,,0000,0000,0000,,I think we've been bouncing\Naround lots of different possibilities
Dialogue: 0,0:30:08.12,0:30:10.20,Default,,0000,0000,0000,,for the kinds of things that\Nwe'll talk about next time.
Dialogue: 0,0:30:10.20,0:30:12.38,Default,,0000,0000,0000,,So I'm just going to leave\Nthat mysterious and say
Dialogue: 0,0:30:12.38,0:30:16.20,Default,,0000,0000,0000,,tune in and we hope we\Nget to see you again soon.
Dialogue: 0,0:30:16.20,0:30:17.44,Default,,0000,0000,0000,,>> Absolutely.
Dialogue: 0,0:30:17.44,0:30:19.20,Default,,0000,0000,0000,,>> Thanks for being here.\N>> All right bye bye.