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November 9, 1994

House of Cards: Psychology and Psychotherapy Built on Myth

Author Affiliations

Boyd, Mont

JAMA. 1994;272(18):1465. doi:10.1001/jama.1994.03520180095045

The disorders called mental illnesses afflict many persons with distress and disability and, in aggregate, constitute substantial social, personal, and economic problems in our culture. Psychotherapists assert the skills to provide alleviation and solutions, and often do. Professor Dawes' book is not a derisory exposé, as the title might suggest, but a thoughtful scrutiny of the present state of scientific thinking and the lack of it in clinical practice.

Up to about 1950 most professional therapists were physicians. Since then, attracted by status and salaries, professing therapists without medical training have increased exponentially in number. The clinical practice of psychology has increasingly divorced itself from its research base, while the rigor of training in scientific method has diminished. There are now more clinical psychologists than psychiatrists and more psychiatric social workers than clinical psychologists. Treatment is provided in the main by nonphysicians. Almost anyone can open an office and solicit

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