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Expert: A Meaningless PR Term used by Emperors with No Clothes

September 20, 2010

Clarification: Since this posting is being distorted, I want to clarify that I am not maintaining that no one should ever be able to call themselves an “expert”. There are legitimate experts. The problem I am drawing attention to here is the frequent use of the term “expert” by self-proclaimed and anonymously claimed “experts” who have neglected to provide evidence for the field they claim to be an “expert” in. This frequent usage has made the term a meaningless PR term, but that doesn’t mean that there are no legitimate experts. My only point is the assertion that someone is an “expert” should not, in and of itself be taken to mean that the person is legitimate. In this posting, I suggest some ways people can tell the difference.

Surf the internet on any given day and you will see the term “expert” being bandied about by various people who claim to be an expert in various different fields and areas.I have been accused of claiming to be an “expert” when, in fact, like my reputable role models, I have not used that term in relation to all of the multiple topics I have published on although I do believe that my rigorous doctoral level training at a Research I University, multiple publications in peer reviewed journals that evaluates therapy/research claims, and knowledge are sufficient to qualify me as an expert in outcome research and evaluating mental health practices and their evidence or lack thereof and my esteemed colleagues who peer reviewed my work and found my writings acceptable for publication in reputable journals tend to agree with me. In response to that other WordPress blogger who is now trying to toss me a red herring by pulling a tu quoque fallacy on me and equate this with the sort of “experts” I am criticizing, here’s a newsflash for you:  This is not the same as people I criticize who have multiple blogs with anonymous people proclaiming them to be internally renowned “experts” who promote therapies from self-published books that have no peer reviewed published outcome studies to support their safety and efficacy. I do not offer unsupported interventions to children and their families while proclaiming myself to be an “expert.” The other difference being evaded is that  I do not use “I am an expert” as an argument. I give substantive information and facts to support my arguments regarding particular interventions [e.g. literature reviews that show the dangers of prone restraints]. I don’t use “I am an expert” as a rebuttal as the self-proclaimed experts have done to me instead of offering any kind of substantive rebuttal to my arguments.

Instead, I describe the facts and let people draw their own conclusions. Practitioners of pseudoscience, of course, like to focus on the negatives and the fact they are taking so much time to malign me with false statements shows that at least they must believe I am having some kind of impact in effectively debunking them. It doesn’t take an “expert” to point out that the emperor has no clothes. In the original tale about the emperor, it was an innocent, naive child who pointed that out to the adults who had been bamboozled.

Disclaimer: I am not intending to say here that everyone and anyone who calls themselves an “expert” is not legit. Some legit people do call themselves experts. The issue here, though, is that anyone can call themselves an expert and the use of that term means virtually nothing.

Whatever the case may be, the term, “expert” is frequently used and has become a rather meaningless PR buzzword. For example, when I challenge unsupported claims being made, the response I get is the person is an “expert”. What does that mean? That “experts” do not have to provide real evidence and people should just blindly accept their claims and treatment recommendations from self-published books even though they have not been independently evaluated with peer reviewed research? Should you trust your mental health or worse, that of your child’s, to anyone who has multiple websites making the claim that he/she is an “expert”? That’s what the responses I have been getting seem to imply.

With the exception of specific contexts, such as the court system which has specific requirements for qualifying people as expert witnesses, the term expert means virtually whatever a person wants it to mean. There are no legal restrictions on calling ones self an expert, nor are there any specified criteria. That’s why PR people and reputation management companies love it so much. Anyone can proclaim him or herself to be an expert, a leading expert or better yet, an internationally renowned expert or perhaps even the leading expert. Additionally, in this day and age, anyone can start multiple  anonymous blogs and/or put up multiple websites claiming that so-and-s0 is an expert in such-and-such. It’s that easy and completely legal unless the person intrudes upon a legally protected title that he or she does not have.

Just what does it mean to be considered an expert? Often, people accompany claims of being an expert with statements of the years of experience they have in a particular field, but does years of experience make one an expert? Roger Callahan has been a psychologist since the 1950s. Does that make him more of an expert than people who on became psychologists in the mid-1980s? Of course not. Years and years of experience could mean nothing more than years and years of self aggrandizement and confirmation bias. There is actually quite a large body of literature showing that novice therapists get therapy results that are just as good as experience therapists — see Robyn Dawes’ book, House of Cards for details on such studies.

What else do people use as a basis to claim expertise? A common one is to see claims of expertise accompanied by client testimonials stating that the person is an “expert”. But testimonials are very easy to produce. Since most do not give a verifiable name and contact info, they can be completely made up. Just look at all the late night infomercials that are full of testimonials for worthless products advertised often by paid actors. Even if someone does feel they genuinely benefited from someone’s expertise, that still is not good evidence that the reader will benefit. For all we know, for every positive testimonial, there could be 10 people who feel very negatively about a product or service. Most people who have bad experiences usually just go away and move on and even if they wanted to complain, their negative comments would not be put on the website being promoted.

Another basis people use for promoting themselves as “experts” is association with celebrities. If a celebrity went to them they must be an “expert”? Right? Better rethink that one. Just look at all the things celebrities have gotten taken in by, showing that they can be just as gullible if not more so than the average person.

How about media appearances? Again, no guarantee of anything. Just look at all the people Oprah has had on her show. Sure, she has had some good, legitimate guests but she was also taken in by people like James Frey and James Arthur Ray, the “Secret” expert whose sweat lodge experience resulted in death for some of his followers. Roger Callahan has been on all kinds of shows promoting TFT. Just because someone has appeared on a TV show does not mean that what they have to offer is valid. Even being quoted in reputable news publications is no guarantee.

Does licensure make someone an expert? Not necessarily. Licensure only means that they have met some basic educational and supervision requirements and passed an exam to practice under their professional title.  It does not make them an expert in any particular specialty.

There are some valid certifications, such as being board certified as a behavior analyst, a BCBA. What makes the BCBA valid is that it is based on practices that have a very high degree of empirical (research) support. That doesn’t mean that everyone with a BCBA is automatically a therapist that can be completely trusted (depending on what else they are using — combining it with dangerous restraints would not be so good), but it does mean that at least they are well qualified to practice behavioral analysis. This is very different from having a certificate in a scientifically unvalidated practice such as Thought Field Therapy. Being an “expert” in a practice that lacks scientific validation is meaningless. For instance, there were a number of self-proclaimed trauma experts who obtained various forms of certifications who did recovered memory and DID (multiple personalities) therapy in the 1980s and 1990s who ended up making their clients worse and were sued.

How about personal experience?  Some people feel their personal experience with having had a certain disorder themselves, having been in a cult, being an adoptive parent, being adopted themselves, or whatever, makes them an expert. While it might indeed be a valuable experience for people to talk to others who have been through what they have, that does not mean that the person is an expert in that area. A common mistake such people make if they do not have other training and qualifications is that they may tend to think that the other person’s experience will be like their own when that is not necessarily the case.

So just what does determine if a person is truly an “expert”? Since anyone can call themselves an expert, I would suggest that instead of getting hung up on whether someone is truly an “expert”, instead, do your homework and be a good consumer. Ask good questions that will get past the superficial usage of terminology. Many actual experts do not even use that term to describe themselves. Instead, they simply describe their background, give a good, detailed description of what they do and the actual evidence that supports what they do.

Here are a few questions I would recommend people asking a mental health professional they are considering consulting [note: these apply to clinicians who are offering therapy to people, which I am not currently doing so no, they do not have to apply to me because I do not currently offer such services].

First, ask about credentials. While credentials alone are no guarantee, they make a good starting point:

What degrees do you hold? If they say they hold a doctoral degree, ask what kind. A PhD? A PsyD? An MD? An EdD? I’m not saying any of these degrees are in and of themselves bad, but it helps to have that knowledge. For example, PsyD’s tend to be less research oriented than PhD’s. That doesn’t mean that the PsyD will necessarily not be knowledgeable of research (some are), but it’s something to keep in mind regarding their training and ask them about. What was the doctorate in and from what institution? You need to be careful with this one because some therapists advertise they have PhDs that turn out to be in an unrelated field such as English Literature or they may have gotten a PhD from an unaccredited distance learning institution. Are they licensed? [Note: This applies only to people who are practicing as clinicians. It does not apply to scholarly writings or teaching, where licensure is neither expected nor required] What is the license in? Check the person out and make sure they have the credentials they say they do and check out to make sure the institution they attended was properly accredited.

Again, this alone will not make them an expert and licensure is no guarantee that what the person has to offer is valid, but the advantage to hiring a licensed therapist is, that if someone is licensed, you can usually go to the state’s website and see if there have been any complaints lodged against the individual and what the result was. It will also give you recourse to complain, should you find it necessary. You would not have that recourse with an unlicensed person, unless that person broke the law.

Next, ask them to describe in detail what kind of interventions/therapy methods they use. What is the evidence to support them? Does the person offer you anecdotes, testimonials and self-published books or are there actual studies published in reputable peer reviewed journals? If there are studies, what kind of studies are they and who performed them? Were they performed by people with a vested financial interest in the intervention or were they independently conducted? You can also check out certain reputable websites that post systematic reviews of interventions, to see what independently conducted reviews have concluded about an intervention. Here are a few you can try:

The California Evidence-Based Clearinghouse (this one is good for children’s therapies — CEBC has a rating system for degree of evidence for the various therapies they list, or lack thereof):

The Cochrane Collaboration Library (this one is good for mental health and also evidence for medical treatments)

The Campbell Collaboration Library

It is likely that the intervention, if it is empirically supported, will be listed on one of these websites and if it is not recommended, it might have been reviewed and deemed to be without basis.

If you cannot find peer reviewed published studies published in reputable journals (what you are ideally looking for are randomized controlled clinical trials with favorable results) and if the only evidence offered are through testimonials, anecdotes and assertions that the therapist is a world renowned expert and you should just listen to him or her, that is a red flag.

You can also ask what other interventions are available and what is their degree of research support. If someone is claiming that their intervention will work when established interventions fail and there is no published evidence for this, buyer beware.  If someone presents “talk therapy” as the only alternative — again, buyer beware. “Talk therapy” could mean just about anything and there are many examples of therapies that lack support claiming they are better than “talk therapy” neglecting to mention that there are specific, empirically supported therapies that are effective.

Also, I would highly recommend observing the professional to see how he or she responds to being asked questions? Is the person open to discuss your questions and concerns with you or does the person become defensive and have the attitude that you should accept his or her authority without question. If you are phoning, does the person try to rush you off the phone and into a paid session or is the person willing to take time to speak with you and address all of your questions?

These are a few basic questions you can ask. Remember, that there is no substitute for doing your own homework as a consumer. In this day and age of the internet, there are many self-proclaimed experts and only by asking careful questions and carefully considering the responses you get, can a consumer make a wise, fully informed decision.

  1. Hi Margaret

    Happy to see you here! I have the “Walk Away from Bad Therapy” page on FB.

    Good Article!

  2. Sorry Monica…it’s early and I re named you Margaret…my apologies

    • No problem. Thanks for your comment! I see you are having your own battle trying to get the state of Connecticut to do the right thing. Unfortunately this is all too common, not only with social workers but also psychologists and in states that do have boards. It is very difficult to get most of these boards to take any kind of action, but I do hope you hang in there and don’t give up.

  3. I am getting battle-weary, and I push on!

    Unfortunately I am directly battling the State of Ct DPH….Ct. is the only State without a Licensing or advisory board for LCSW’s….(and others)…there is one fpr psychologists.

    I don’t know who said it….but it’s the quote ” fall 7 times, get up 8!

  4. Hi Monica

    “you can usually go to the state’s website and see if there have been any complaints lodged against the individual and what the result was”

    Most states (if not all) only list disciplinary actions…..not “complaints filed”. In my view a therapist even with a single complaint filed should not be called or hired. Licensing Boards rarely take action against therapist ( I’ve read only 2% of all complaints against mental health practitioners end in disciplinary action). A client can call the state licensing board and find out if complaints have been filed, but it is not reportable information.
    As a license doesn’t indicate competance, a dismissed complaint doesn’t mean nothing “really wrong” happened, only that it couldn’t be proved, or that the licensing authority just didn’t take it seriously

  5. While I would agree that a dismissed complaint doesn’t necessarily mean that nothing happened, it also doesn’t mean that the person was automatically guilty. It is entirely possible for completely bogus complaints to be filed and there are cases where they have been, so I would have to disagree that the mere filing of a complaint should be grounds to not hire someone. Just to give one example, Scientology once filed a complaint about a therapist who had been involved in speaking out against Scientology. The board investigated and found it to be baseless and justifiably it was expunged from her record. Should that therapist have her life ruined because of that? I don’t think so. One solution might be to post the complaints that were filed and by whom (unless the person was a client), as well as a full report on the evidence or lack thereof to support the complaints and why they were dismissed. Even with that, though, the problem is that many people do not understand that completely innocent people can be falsely accused of things and it could ruin a perfectly good person’s reputation. There are two possible ways injustices can occur: One is to let a guilty person off and the other is the conviction and condemnation of a completely innocent person.

    Remember that literally anyone can file a complaint against anyone for any reason and it is not justice to presume a person guilty by the mere fact of a complaint being filed. Ironically, it is sometimes the quack therapists who file baseless complaints against other therapists who dare to speak out against their practices. If the system worked the way you suggested and banned people from being hired who had any complaints being filed against them, this would give any vindictive person the power to completely ruin another person’s career. Completely innocent people would have their lives ruined. That is why in our criminal justice system and on state boards as well, a person has to be presumed innocent until proven guilty — the key word here being proven. The problem is that in some cases state boards have not adequately considered the evidence being offered and that is the problem.

    A more effective solution would be for the boards to actually do the job they are supposed to do and conduct full and serious investigations of any complaints and accept evidence that is offered to them. Also a vetting and disqualification of any board members who have a connection with a therapist in any particular case for voting on that particular case would be helpful. Perhaps a voir dire to qualify board members who vote on a verdict, as is done with potential jurors in a court case, would be a good idea.

  6. It’s not just, or even fair to presume a therapist guilty based on the filing of a singular complaint, and it’s not just, or even fair when therapists “do harm” and walk away unscathed….so….
    until Licensing Boards and regulatory angencies can “do the job they are supposed to do” and a better system of checks and balances is put into place, in my opinion, a consumer of mental health services must do all they can to protect themselves upfront, and that means not hiring a therapist with a complaint on their record.
    I also am an advocate of continual (carrer long) peer consultation and or individual therapy for mental health professional, and wouldn’t hire one who did do one of those two options. “Once bitten,twice shy:!

    fyi…Connecticut does not have a Licensing Board for LCSW’s, LPC’s. LADC’s ot MFT’s. Those professions are regulated by the Dept. of Public Health, and they base 100% of their decision of a complaint on the opinion of one unpaid peer consultant (ie. LCSW consultant). You can read more on their process on my blog

    btw…from what you’re saying, the industry sounds relatively “cannibalistic”!

  7. from my comment above,,,”I also am an advocate of continual (career long) peer consultation and or individual therapy for mental health professionals, and wouldn’t hire one who did do one of those two options. “Once bitten,twice shy:!”

    that should read “I wouldn’t hire one who did not do one of those two options”
    It’s been a long chiily day at work in the NorthEast!

  8. I’m very skeptical that the person constantly being in individual therapy is any kind of protective factor at all. It would have to depend on what kind of individual therapy and given that there are so many types of therapy that do not have good research support, a person’s being in therapy really could mean that they are receiving as well as doling out quackery. Sorry if that sounds jaded, but that’s just the reality of the situation.

    If someone lacks the capacity for empathy, there is no real evidence that “therapy” can help someone who is a poor therapist be a better therapist on one hand and on the other hand, there are therapists who have no real need to be in therapy who can nevertheless be compassionate, effective therapists. The whole premise to that notion sounds to me like what Sally Satel and Christina Hoff-Sommers call therapism, the use of therapy where it is not necessarily appropriate. I highly recommend their book, One Nation Under Therapy. The fact is that there is no evidence that people need to constantly be “working on” themselves or constantly be in therapy. While I do think it is a good idea for someone who is going to be a therapist to have gone through personal therapy at some point in their lives, to expect that person to remain in it for years and years is only perpetuating the myth that clients need to be in therapy for years and years. It’s good for the therapist’s pocketbook but not so much for the client.

    As for peer consultation, again, it depends on who the peers are. I would have to challenge the person who advised that to show me actual evidence that peer consultation makes a difference. What if the peers are also into dangerous practices? They would only be reinforcing one another in those practices.

    What would be more of a protective factor is to find out what actual evidence the therapist can offer the client that the interventions, the type of therapy they use is effective. Then and only then would peer consultation have any meaning at all. There is loads of “peer consultation” happening amongst dangerous “attachment” therapists.

    Really what needs to happen is for boards to do their job and thoroughly investigate complaints. Injustices do occur on both sides of the fence and it is sometimes the most ethical mental health professionals that get unjustly accused by vindictive mental health professionals who they blew the whistle on. I think it’s a good idea to ask a person if they’ve had a complaint filed against them but the problem is that the really dishonest, bad therapists can just lie and say no whereas the honest ones who were unjustly accused would probably be honest about it. So again, I think these need to be evaluated on a case by case basis. If someone had a complaint filed against them by a vindictive quack therapist or a cult member, I wouldn’t hold that against them at all. If boards are not doing their job, I don’t think that just walking out of the offices of therapists who say they had a complaint against them is really any protection at all because the really bad therapists can and probably will lie about it and like you say, boards usually don’t report that on their websites so there is no way to learn the truth.

  9. I so appreciate your scrutiny of the “expert” concept. The bountiful authoritarian advice from Life Experts on everything from finding love, to finding our true selves to finding our spiritual path, whatever that really is, could fill an ocean or two. I rarely see anyone ponder who appointed that advise-giver our oracle. As a public, we still believe in the Wizard of Oz, yet there’s no Toto dog around to pull back the curtain.

Trackbacks & Pingbacks

  1. Tu Quoque Fallacy: A Classic Example « Potentially Harmful and Other Questionable Therapies
  2. Can Tapping Therapies Be Harmful? « Potentially Harmful and Other Questionable Therapies
  3. Two Forms of Harmful Therapy « Potentially Harmful and Other Questionable Therapies
  4. In Memory of Robyn Dawes: 1936-December 14, 2010 « Potentially Harmful and Other Questionable Therapies

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