Saturday, November 14, 2009

Monica Pignotti Refutes the Disinformation Campaign

If you Google "Monica Pignotti" you will find postings filled with false statements and distortions. An all out internet smear campaign over the past six months has been initiated against some of my colleagues and me because we criticized what we consider to be abusive, dangerous interventions. My name originally got pulled into this because I published scholarly criticism of these interventions.

I am really not usually one to toot my own horn in this way, but given the situation, I find it necessary to refute this misinformation. Some of the smears have gotten so personal, juvenile, misogynist and nasty (e.g. calling me "Miss Piggy" and "Fat Cow" although even that is false, since my weight is pretty average for a woman my age) they are hardly worth responding to. However, others are false allegations (for example, the lie that I was fired from FSU, easily refutable by my transcripts and references and the lie that I am selling quack devices in Central America) and distortions of my background [e.g. lying that most of my clinical experience was with TFT when really I have plenty of experience in many other modalities and never even made a full time living from TFT at any point in time]. Here are some endorsements of my work by top scientific people in the mental health profession, to counteract my cyberstalkers' constant repetition of ancient history and neglecting to mention the genuine respect I have worked very hard to earn within the scientific community.

The first is from Dr. Scott Lilienfeld:

I understand from Monica that Dr. [name deleted] has written a lengthy letter of complaint [to her Dean] in response to her criticisms of his therapeutic practices. I wish to offer my own perspective on these matters. By way of background, I am a Professor in the Department of Psychology at Emory University in Atlanta where I have taught since 1994 (I received my Ph.D. in psychology from the University of Minnesota in 1990, and was a faculty member at SUNY Albany from 1990 to 1994). I am past president of the Society for a Science of Clinical Psychology (Section 3 of the Clinical Psychology Division of the American Psychological Association), recipient of the David Shakow Award for Early Career Contributions to Clinical Psychology from Division 12 of the American Psychological Association, editor-in-chief of a peer reviewed journal (Scientific Review of Mental Health Practice).

I have been fortunate to get to know Ms. Pignotti through both formal and informal interactions, primarily via e-mail and phone correspondence and secondarily via academic conferences. In my experience, she is a highly intelligent and intellectually curious person with great academic integrity. She is also gutsy, and willing to speak out when she observes therapeutic practices that are potentially ineffective or harmful. But she bases her claims solidly on the best available research evidence. Monica is well respected among scientifically-oriented clinical psychologists, including some of the field’s leaders. I wanted to offer my strong support of Monica Pignotti, whom I view as a courageous scholar of considerable academic integrity.

Scott O. Lilienfeld, Ph.D., Professor
Department of Psychology, Emory University

And here is another endorsement from psychologist Steven Jay Lynn:

Monica Pignotti is a courageous champion of science in clinical practice. Her efforts to combat pseudoscience with critical thinking, scrupulous attention to "what the data say," and rigorous research are impressive and laudable.

Steven Jay Lynn, Ph.D., ABPP (Clinical, Forensic)
Professor of Psychology
Director, Psychological Clinic
Binghamton University
Binghamton, NY 13902

And this one, from Dr. Brandon Gaudiano:

I have witnessed firsthand Dr. Pignotti’s deep and abiding commitment to science and her tireless efforts to improve the health and well-being of individuals suffering from mental illness. Her promotion of evidence-based practices and her courage to speak out against controversial and potentially dangerous therapies is truly commendable and is a testament to her selfless dedication to the field.

Brandon Gaudiano, Ph.D.
Assistant Professor (Research)
Department of Psychiatry & Human Behavior
Warren Alpert Medical School of Brown University

Sunday, November 8, 2009

There is no such thing as a Pigno-o-Meter

My cyberstalker has grown more and more brazen in his libelous postings about me. Today, he posted in Live journal a blatantly false statement that I am selling a device called a "Pigno-o-Meter" in foreign countries. Of course, I have never had anything to do with any such device, which is a work of fiction. The stalker obviously has a lot of time on his hands, as he went to the trouble to photoshop a picture of this made up machine with the name on it. These things come up on Google searches on "Monica Pignotti" so I want to once again state, for the record, that there is no such device, I have no interest in inventing or marketing any sort of device. I debunk quack devices, not invent them. The evidence that I debunk such devices is in the forthcoming book chapter:

Thyer, B. A. & Pignotti, M. (in press). Science and pseudoscience in clinical assessment. In C. Jordan & C. Franklin (Eds.)Clinical assessment for social workers: Quantitative and qualitative approaches (third edition). Chicago IL: Lyceum Press.

Plus, I have a contract with an academic publisher to co-author a complete book on pseudoscience in social work where I will be including a debunking of quack devices.

The blog entry reaches the height of absurdity when it states that it simulates TFT tapping when the fact is that I completely left and repudiated TFT over 5 years ago and have not had anything to do with it since that time, other than to criticize it.

Monday, September 21, 2009

Myths about Licensure and Expertise in the Mental Health Profession

There has been a great deal of buzz on the Internet over the past several months about licensure vs. people who are not licensed and yet are critics of the mental health profession. What is being claimed, in essence, is that people who are not licensed are inferior in knowledge to those who are licensed and should not be viewed as credible. This is a myth and a completely unwarranted conclusion, so I thought I'd take these opportunity to list a few myths about licensure and so-called "expertise" in the mental health profession and outline what it does and does not entail. Here is what it means to be licensed:

  • The person has attained the level of education required for their state to be eligible for licensure (for example, in psychology, most states require a Ph.D. or PsyD in clinical psychology or an EdD from an accredited institution and for licensure in social work, most states require a Masters in SW from an accredited institution). There are exceptions -- in some states, for example, masters level people can be licensed in psychology and bachelor's level people, in SW.
  • The licensed individual has passed an exam of some sort. These also vary from state to state but usually consist of a 2-3 hour multiple choice exam and in some states, an oral examination.
  • The licensed individual has undergone a period of supervision by another licensed professional -- in most states this is around 2 years of full time, supervised work. There is no guarantee that the interventions done were evidence-based. Any licensed person can be the supervisor, and that would include people such as Roger Callahan, who as a licensed psychologist in California, would qualify to sign off on a person's supervision hours for practicing TFT, just to give one possibility.
  • The person has to subscribe to and abide by the code of ethics for the profession (the APA code of ethics for psychologists, and NASW for social workers). The person need not be a member of either of those organizations to be licensed, however.
  • Licensure provides a mechanism for people to complain to state boards if there have been ethical violations.

And that's pretty much it. Is it valid to assume that an unlicensed person is less qualified to evaluate a particular therapy and the research evidence that exists to support it? No, not necessarily. There is nothing that says that a person who is unlicensed has less education, less knowledge or less capacity for critical discernment than those who are, or even inferior interpersonal skills, since there are plenty of ways to develop such skills outside formal mental health training.

In psychology, people with non-clinical degrees (e.g. developmental, social) are often much more research-oriented. While some clinical psychology programs are also very rigorous, not all are research oriented. In fact, many of the PsyD degrees given from free-standing, non-university affiliated schools have little emphasis on research. There are, of course, exceptions and not all PsyD degrees are from free-standing schools and a few free-standing schools are better than some of the university programs, but I point this out just to give people an indication that just because someone has a PsyD, an EdD or even a PhD we cannot assume that they have received good training in research, or kept up with the latest in research evaluation. All their licensure requires is that they get continuing education credits, but usually those courses are clinical, not about how to evaluate research and claims about interventions. Moreover, many of the clinical courses are not even truly evidence-based.

Recently we have witnessed some people who claimed to be licensed mental health professionals waving their licensure around in a very unprofessional manner and trying to claim that this in some way makes their evaluation of various therapies more credible than people who are not licensed. Again, not necessarily at all. On the contrary, there are plenty of licensed individuals who have displayed very poor judgment about selecting interventions and have chosen interventions that lack research evidence over those that have research evidence. There are even licensed mental health professionals who practice interventions that have been shown to do more harm than good and there is no official prohibition against practicing such interventions.

So what is the difference between a licensed and unlicensed individual? The criteria I listed above. Licensed individuals are not necessarily superior in their critical thinking skills or ability to evaluate research. The only thing unlicensed cannot do that licensed people can do is see clients under the professionally protected title (e.g. social worker, psychologist, marriage and family therapist). A person does not have to ever have seen a client to be able to examine and evaluate research that supports or does not support a particular approach. In fact, a practicing clinician might well be more prone to bias, in that such individuals often become attached to particular interventions that they become known for and become financially and emotionally invested in their degree of acceptance.

The bottom line here is buyer beware, and that people need to examine the actual quality of the evidence, rather than assuming that because something is being endorsed by a licensed individual, it is valid. That is a highly unwarranted and dangerous assumption.

The same applies to "experts". The mental health profession is unfortunately full of examples of "expertise" that is based on nothing more than tradition and authority, not scientific evidence. In the 1950s, for example, "experts" believed that Schizophrenia and autism were caused by a person's mother. There was never any scientific basis for this assumption, but people trusted the experts when in fact they were doing great harm to their patients by assigning the wrong cause and inducing undeserved guilt and suffering in the parents.

More recently, we had the recovered memory craze of the 1990s that resulted in false memories and families that were destroyed. Today, we have other fad diagnoses, such as "attachment disorder" that go far beyond the diagnosis of Reactive Attachment Disorder in the DSM IV and even that is on very shaky ground. Just because something is in the DSM does not make it valid and it is subject to revision, as the lengthy DSM V debates are demonstrating. Again, the point is to question authority.

While sometimes people who lack relevant knowledge and education do need to trust experts, that doesn't mean they have to blindly trust. Find out not only about licensure, but ask what the basis is for their opinions. For example, here are some questions I have for one PsyD who has asserted that he is an expert but has yet to provide scientific references for the prone restraint procedure he recommends in his self-published book. These are the sorts of questions prospective clients ought to be asking rather than trusting assertions from authority.

Find out if there has been any criticism and ask proponents about this. If the proponents attack the critic as being "unlicensed" or use other appeals to authority or personal attacks, instead of giving solid evidence, be very suspicious. This has happened recently when proponents of Ronald Federici and Arthur Becker-Weidman's therapies have attacked critics as being "unlicensed" even when two widely-published critics have research-oriented PhDs and are highly qualified to determine degree of evidence. People who are on solid ground do not need to attack their critics in this way.

There is a false dichotomy proponents of unsupported therapies are trying to sell, which is that people who demand evidence and are critical are cold, uncaring people who have no interpersonal skills. We can see this right here on this blog in Jennifer Molinari's comments to me. Eileen Gambrill has called this the fallacy of hard headed, therefore hard hearted and soft headed, therefore soft hearted. In other words, people who are hard headed and rigorous about evidence are hard hearted, uncaring people when in fact this isn't necessarily so. A person can be hard headed and soft hearted, or they can be soft headed and soft hearted (the compassionate person who nevertheless is highly gullible and uncritical of therapies they practice). What is neglected by people who make this unwarranted assumption is that it is entirely possible to be hard headed and rigorous, yet still be soft hearted and compassionate, and have excellent interpersonal skills.

People who boast about their great interpersonal skills and "compassion" and yet ignore criticism of approaches they use that lack empirical support are the very people mental health consumers need to be the most careful about. Right now, as a Google search on my name will reveal, there is a very active campaign by these so-called "professionals" against people who seek to question and challenge their authority. While there are, of course, many responsible mental health professionals who are open to criticism and do not attack critics, beware of those who do.

Wednesday, July 29, 2009

Ronald Federici Writes to My University and Makes False Allegations about Me

Even though I am not in any kind of trouble with my university, I wanted to make it known that Ronald Federici has written to the Dean of my college, making a number of false allegations about me. He is also threatening to sue me even though he has no grounds to do so. The reason I want to make this known is that this sort of bullying could potentially have a chilling effect on people who wish to challenge and criticize various therapies being promoted on the internet. See my link on the first page of this blog, for information about the lawsuit in the UK against Simon Singh, for an example. These kinds of intimidation tactics could result in people being afraid to post their opinions and evidence about people who make unsupported claims about various therapies and alternative medicine practices, resulting in therapy, self-help or other gurus who have essentially abused the legal system to silence any criticism.

As a brief aside to all this, Social Work Professor Eileen Gambrill has written that Social Work is an authority-based profession and proposed evidence-based practice as an alternative. What this means is not blindly accepting people just because they are able to produce credentials, such as licensure. Licensure is no guarantee that the therapies being practiced will be effective or even safe. All licensure tells you is that the person has completed the requisite education, testing and supervision requirements for licensure and it gives the consumer a mechanism for filing complaints. It does not mean that the licencee is above criticism and questioning and one need not be licensed to criticize. What matters is the content of the criticism, not the titles held by the people doing the criticism.

This is not the first time Federici has gone to a person's university and/or written letters threatening lawsuits. In 2004, he complained to Jean Mercer's college, making completely unfounded and false allegations against her. She soundly refuted these and they had no effect on her status as a tenured professor at her college. However, this shows that I am not the first person he has made false allegations about.

After learning of the charges he made about me to my Dean, I attempted to write Federici privately to attempt to reason with him. What I got back was a letter threatening to sue me, cc'ing my Dean and also stating he would send this to the Chancellor and Florida State licensing board. He also wrote that he considered the letter a "privileged communication" as if my posting it publicly would constitute a violation of some sort. Even though I do not believe such a letter would fall into that category, as Federici is not a client of mine, nor is he discussing a client's case, I choose not to post it here, at least for the time being. I will, however, summarize and respond to some of the points in his letter and use fair use quotes, since from my point of view, I feel that the letters he has been sending to me and to my university are abusive, contain blatantly and demonstrably false statements, and in my opinion, constitute harassment. Again, that is my OPINION. Abusers often want their targets to keep the abuse secret and I feel that his letters were abusive towards me and I will not keep what I feel is abuse, a secret. Here are some of his allegations and my response:

1. Federici stated that my postings to the internet were a representation of my university, when they were never intended to be, nor have I ever stated that they represented FSU. In fact, in my e-mails, I have a disclaimer when I post to electronic list servs, that my postings do not represent FSU.

2. The allegation that I have made libelous and defamatory comments about him. Although I have been critical of therapies being practiced by Federici and others, none of what I have written would constitute libel or defamation. Any facts I have written about, I have supported with citations from the people I criticized, accompanied by my opinions. In his letter of July 26 to my Dean, Federici accused me of posting certain words about him in a subject header which in fact, I did not write. Those words and the subject header was written by another person on the internet newsgroup he referenced who, if you click on the link, will find, freely admitted to this and stands by what he posted. My post had been in response to a statement that was made by the that Federici is a psychiatrist, and had merely corrected the person that he was a psychologist. Because I responded, those words came up in the header, but I did not write them. While I do have very serious concerns about the interventions practiced by Federici and have exercised my constitutional rights to free speech in expressing my opinions about these interventions and concerns over the fact there are not published randomized clinical trials to support their efficacy or the claims made by Federici of an 80% success rate, I would never post the words misattributed to me, as it is my belief that Federici sincerely believes he is helping people. I clarified this later on that same exchange.

3. Federici mischaracterized the advocacy group I belong to, which is called Advocates for Children in Therapy as being a disreputable, fringe group when it is not. In recent months, individuals posting under pseudonyms who say they are supporters of Federici have mischaracterized this group and called it “Advocates for Child Torture” and there is a website that has misappropriated the title of the Advocates for Children in Therapy organization claimint the founder is Ronald Federici, when in fact he has nothing to do with the original organization. This has similarities to what Scientology managed to do when they took over the name, Cult Awareness Network, the main difference being that Scientology managed to legally take this organization over whereas Federici has not attempted to legally taken over ACT. For the actual purposes of this group, see . The evidence posted on that website is fair use quotations of proponents, including Federici. The claim is not, by the way, that all of these therapists practice exactly the same thing. Although there are common features, they obviously do not. It is my opinion and belief that Federici practices from an entirely different theoretical base (here, I actually agree with him) than some of the other therapists on that website who he has also been critical of, but that would be the topic for future discussion. For now, suffice it to say that although Federici is different from some of the other therapists, I have criticisms of both.

4. Federici stated that I violated my professional social work code of ethics by filing a complaint with the Virginia Board of Psychology Examiners without attempting to communicate with him directly about my concerns. I have never filed any complaints about Federici with the Virginia Board, hence I have had no need to approach him directly. He really should have checked that out with them before making this unfounded allegation.

5. Federici stated in his first letter to my Dean, “I am afraid Ms Pignotti is not of sound mind, which we feel is related to her past cult involvements.” And “Ms. Pignotti's 20+ years in a cult may have impacted her judgement and perceptions.” As he himself states, Federici has never met me, much less clinically assessed me. Hence, he is in no position to judge the my mental stability. I was not in a “cult” for 20+ years as he alleges. He referred to my past involvement with the Church of Scientology when in fact, my involvement was for less than 6 years in the 1970s, a time when experimentation with new religious movements was quite common in young people. I left this church/organization, which I joined as a teenager, 33 years ago in 1976 and have since, been quite critical of it. Since he claims to be familiar with the material that comes up on Google searches where the length and time of my involvement was clearly stated, he should have been aware of this. My current criticism of the types of interventions being promoted has nothing to do with Scienotology. I would bet that many individuals have things they did in their late teens/early 20s that they would not like to have trotted out and paraded before them 30+ years later. Young people often make foolish mistakes, some of them with quite serious consequences but thankfully most people learn from their mistakes, as I have.

6. Federici stated “Given her clear (sorrid) [sic] past and biases, her influences on students and others could be profoundly negative.” and “Ms. Pignotti has been involved with an Elden Braun, . . .A former scientologist and scammer of huge sums of money. His records is posted accurately on the web. Please carefully, review Ms Pignotti's past and present affiliations and adversarial positions with many “ Although I believe his statements about Braun to be inaccurate, as the case against him was a civil, not a criminal one, I am in no way associated or involved with Mr. Braun. He merely responded to a negative posting about me, defending me. However, I have never even met Mr. Braun. Federici further stated that Rosa and Sarner are unsavory individuals. This is not the case and their reputations are being unfairly maligned by supporters of Federici when in fact, both are respected professional individuals.

7. Federici stated “What concerns me most is that 1) you have an ulterior agenda of criticizing people when you do not know the facts; 2) you have NEVER seen or evaluated a patient in clinical practice; 3) you associate with some real low level people--your University should be concerned about this ( Sarner, Rosa, Braun/ACT ); 4) you act unprofessionally and unethically.”

In response 1) I have supported my criticism with citations to facts and when offering opinions, have stated them as such as an expression of my constitutional right to free speech; 2) His statement that I have never seen or evaluated a patient in clinical practice is false (although in social work we refer the individuals we work with as clients, not patients). I have, in fact, seen a number of clients in a psychotherapy practice I had in the state of New York between 1996 and 2001. At the time, I had passed what was the required state examination at that time (the credential CSW -- certified social worker). Although as of 2005, the laws have changed in New York the state of NY did not license social workers at the time I had my psychotherapy practice, such practice was legal and valid at that time. During that time period I saw a number of clients in my psychotherapy practice, which I would describe as eclectic in orientation and contrary to what is being alleged I did not just use TFT -- I also used exposure-based methods, family counseling methods and psychoeducational methods in much of my work. No client or any other individual ever complained about me. Although currently I obviously have rejected TFT, the practice of TFT itself is not considered unethical and in fact, I was eclectic, like the majority of people in a survey I did on LCSWs, published this year. There are no grounds to say what I did violated any professional ethical codes.

3) See my comments above. 4) I disagree that my criticism has been unprofessional and I have never claimed to be representing FSU in my writings on the internet.

8. He stated that he was going to complain to the Florida Board of Social Work. I am not currently licensed as a social worker in the state of Florida, nor am I performing any functions that would require me to be licensed. I do not have a clinical social work practice in Florida, thus, I am not under the jurisdiction of this board. My teaching duties at FSU do not require licensure and I have no plans to apply for licensure at this time, but even if I did or if I were licensed, I have not violated anything in the NASW code of ethics.

9. He stated that I was being sued for defamation. This is false. I am not being sued for defamation or anything else. Someone posted a false statement about this on the website, but this is not the case. I have never been sued for defamation. In 2001, I was the target, along with 30 other individuals, of a frivolous law suit for “racketeering” which was immediately dismissed by the judge on the case, before it ever went to trial. It involved my online criticism of an individual Hulda Clark, who wrote a book entitled The Cure for All Diseases, claiming without scientific basis, to have the cure for diseases such as cancer.

10. Federici advised my Dean to do a Google search on my name. In fact, a number of highly negative internet postings do come up on Google searches on my name and most of these were made by people who are supporters of Federici and his colleagues who are upset by the fact that I have criticized and challenged their therapies. This has included postings to, on last count, over 189 internet newsgroups and a number of ads that have been place in online publications such as Craigslist, although Craigslist removed the postings because they were considered spam and harassment. However, the numerous internet postings remain and do come up on my name, making a number of demonstrably false statements about me. Federici claims to have had no involvement in these postings and I have no definitive proof he is. However, as his communication indicates, he learned about one of them only an hour after it occurred and the way his letter is worded bears remarkable resemblance to some of the postings (e.g. the rather unusual misspelling of the word, sordid, as “sorrid”). People can look at all this if interested, and come to their own conclusions about whether they think Federici was in any way involved. They should also consider this most telling threat, made shortly before the attacks began where this blogger who is a survivor of a therapy she felt did a great deal of damage to her, posted a letter she says she received from Federici which stated the following:

"I know all of your names, and could post what I know about your personal and family issues of atheism, scientology, handicaps, depression, mental health issues, sexuality, etc. I have NOT posted a word in rebuttal. NOT ONE. And no, the other posts were not me, but people who know me and my family for 20+ years. Not transient, but real, good people. "

Some of my colleagues have opined to me that I should not even dignify all this with a response. However, I wanted to correct, for the record, the false statements that were made about me, just in case there is any doubt in anyone’s mind as to their inaccuracy.