Therapeutic Doubt: Enhancing Clinical Effectiveness Through Critical Thinking

• Published in: PsycCritiques Vol. 51; no. 24; p. No Pagination Specified
• Main Author: Knight, Tracy A.
• Format: Journal Article
• Language: English
• Published: American Psychological Association 14.06.2006
• Subjects: Clinical Judgment (Not Diagnosis); Clinical Psychology Graduate Training; Decision Making; Evidence Based Practice; Human; Psychodiagnosis; Skepticism; Thinking
• ISSN: 1554-0138; 1554-0138
• DOI: 10.1037/a0002735

Reviews the book, Critical Thinking in Clinical Practice: Improving the Quality of Judgments and Decisions (2nd ed.) by Eileen Gambrill (see record 2006-02275-000). In this second edition of Critical Thinking in Clinical Practice: Improving the Quality of Judgments and Decisions, Eileen Gambrill invites clinicians to engage in a fresh, frequently neglected enterprise: critical self-examination. In doing so, she has produced an ambitious and impressively comprehensive book that belongs in the library of every clinician and in the backpack of every clinical graduate student. This book is filled with useful perspectives and ideas that cannot help but enhance one's clinical practice. But be forewarned: To benefit from this book, the reader has to relinquish any illusion of certainty and replace it with attributes such as humility and persistently unfulfilled curiosity. The author discusses many other influences on clinician decisions, including agency cultures and psychological factors. The psychological factors influencing clinicians' decisions--including the clinicians' goals, their information-processing strategies, and their faulty self-assessments--also contribute to frequent and sometimes enduring errors, ones that can be easily addressed merely by acknowledging those tendencies within us all. Part 2 of the book explores "Common Sources of Error," expertly exploring the influences wielded by language (the clinician's, the client's, and the field's). Given the field's current commitment to evidence-based practice (EBP), it was fitting for the author to include a pertinent chapter in this second edition. In it, she deftly argues for the active exploration and use of research evidence as an alternative to authority-based practice. She details the philosophies, models, and steps in EBP and then enumerates 28 objections to it and her counterarguments. In doing so, she emphasizes the flexibility and respect for experience inherent in EBP that are not always apparent and is persuasive in her respect for the potential of EBP. At the same time, her commitment to the process, although clear, did not include many of the objections I often encounter. The final chapters of this book concern how organizational cultures (including staffing and team meetings) can be enhanced to better embrace the potentials of all involved and, fittingly, how we all can discover our personal barriers to critical thinking and maintain the gains we achieve. Rarely have I found a clinical book so uniformly valuable. Critical Thinking in Clinical Practice deserves to be read, cover to cover, by all practicing clinicians, clinical graduate students, and trainees. (PsycINFO Database Record (c) 2017 APA, all rights reserved)