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Posted: Sep 13, 2006 22:03

THE FALLACY OF PRECISION

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By: Lon Woodbury

We live in a scientific world. Every day we learn of accomplishments by scientists that would have been considered miracles just a few decades ago. The speed of travel and communication is steadily increasing and the explosion of the Internet has allowed a person to find and instantly communicate with almost any other person on the globe. All of this, and much more, were made possible by scientists' abilities to gradually increase their capacity to conquer and control the physical world. These accomplishments depend largely on their skills in measuring and categorizing physical matter in a way that reflects reality very well. This ability was so astoundingly successful that comparable systems of precise measurement and categorization were developed for other disciplines.

This system of categorization and measurement was transferred in the early part of the Twentieth Century to what is called the life sciences. In the last century medical doctors expanded their capabilities to treat and cure many diseases that had been the scourge of mankind for ages. The progress in the treatment of disease has fostered better overall health and life expectancy for our whole society. Because emotions and social environment are intangibles that affect our physical health in unpredictable ways, the measurement and categorization of physical health and diseases are not as precise as in the physical sciences. For example, if you are building an airplane, you never have to consider if the airplane is depressed. However, a doctor treating a physical disease in a depressed patient has unpredictable intangibles to deal with that can have considerable influence over the outcome. Thus, it is very true that the practice of medicine is as much an art as it is a science.

The next step in the early Twentieth Century was to apply scientific systems of categorization and measurement to the social sciences arena, which includes education and mental health. Although the vocabulary of precision, scientific measurement and systems of categorization are used extensively in these fields, in truth, all practitioners have learned early on that the appearance of precise measurement is only that--an appearance. For example, the main system of categorization in the mental health field is the Diagnostic and Statistical Manual of Mental Disorders - Version Four (DSM-IV). A layperson looking at the DSM-IV sees a precise description of each disorder with a list of specific symptoms and recommended treatments. This appearance of precision does not reflect reality very well, however, because instead of the popular image that the DSM-IV is based on exhaustive scientific research through tests and measurements, it is really just a consensus of the view of leading practitioners at the time the manual was revised. It is developed more as a democratic exercise than a scientific one. This is a valid and useful approach, but when therapists talk as if they are basing their recommendations on precise scientific measurements, the client needs to remember this kind of precision does not exist in the mental health field. There are immeasurable variables. Although the DSM-IV is very helpful as a guide and starting point for trying to understand a client's problems, it is also susceptible to fads and political correctness creeping into the definitions. In addition, practitioners have learned that pending further information, any specific diagnosis is largely a judgment call because many of the categories bleed into each other. Therefore, many diagnoses have been totally overturned after a patient does not respond to the recommended treatment. The process is repeated until a treatment and diagnosis that seems to work is found.

We see the same thing in education. For years we have been told that the national high school dropout rate is about 15 percent, yet recent studies have concluded the real dropout rate is double that estimate. This assertion is based partly on the perspective that states and school districts have political and financial motivations to underestimate their dropout rates, and have thus found ways to "not count" certain groups of struggling teens, or maybe "just assume" that most of the students that leave a school have enrolled in another school and are not really dropouts. The debate continues on this issue of dropout rates, but it makes the point that even something as simple as measuring education dropout rates is not as precise as educators would like us to think.

My main point is parents must remember that when it comes to behavior, claims of precision tend to be an illusion. We have been spoiled by the fantastic scientific accomplishments of the physical sciences which are based largely on their ability to precisely measure and categorize in a way that fairly accurately reflects the world in which we live. The equivalent talk of measurement and precision in the behavioral sciences like mental health and education needs to be taken with a grain of salt. A good therapist and a good educator will get good results. When they claim they are working with the type of precision that exists in the physical sciences they are really just marketing themselves. Their success comes more from their basic intuitive insight, which comes from internal wisdom and experience rather than from some external system of precise measurement and categorization.




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