Developmental Psychology for the Helping Professions

Transcription

1 Developmental Psychology for the Helping Professions

2 Also by Brian Sheldon BEHAVIOUR MODIFICATION: Theory, Practice, and Philosophy (1982) COGNITIVE-BEHAVIOURAL THERAPY: Research and Practice (1994) EVIDENCE BASED SOCIAL CARE: A Study of Prospects and Problems (with Rupa Chilvers) (2002) RESEARCH AND PRACTICE IN SOCIAL CARE: Mind the Gap (2002) A TEXT BOOK OF SOCIAL WORK (with G.M. Macdonald) (2009) COGNITIVE-BEHAVIOURAL THERAPY: Research & Practice in Health and Social Care (2011)

3 Developmental Psychology for the Helping Professions Evidence-Based Practice in Health and Social Care Brian Sheldon Peninsular Medical School University of Exeter, UK

4 Brian Sheldon 2015 All rights reserved. No reproduction, copy or transmission of this publication may be made without written permission. No portion of this publication may be reproduced, copied or transmitted save with written permission or in accordance with the provisions of the Copyright, Designs and Patents Act 1988, or under the terms of any licence permitting limited copying issued by the Copyright Licensing Agency, Saffron House, 6 10 Kirby Street, London EC1N 8TS. Any person who does any unauthorized act in relation to this publication may be liable to criminal prosecution and civil claims for damages. The author has asserted his right to be identified as the author of this work in accordance with the Copyright, Designs and Patents Act First published 2015 by PALGRAVE MACMILLAN Palgrave Macmillan in the UK is an imprint of Macmillan Publishers Limited, registered in England, company number , of Houndmills, Basingstoke, Hampshire RG21 6XS. Palgrave Macmillan in the US is a division of St Martin s Press LLC, 175 Fifth Avenue, New York, NY Palgrave Macmillan is the global academic imprint of the above companies and has companies and representatives throughout the world. Palgrave and Macmillan are registered trademarks in the United States, the United Kingdom, Europe and other countries. ISBN ISBN (ebook) DOI / This book is printed on paper suitable for recycling and made from fully managed and sustained forest sources. Logging, pulping and manufacturing processes are expected to conform to the environmental regulations of the country of origin. A catalogue record for this book is available from the British Library. Library of Congress Cataloging-in-Publication Data Sheldon, Brian. Developmental psychology for the helping professions : evidence-based practice in health and social care / Brian Sheldon, Peninsular Medical School University of Exeter, UK. pages cm 1. Developmental psychology. I. Title. BF713.S dc

5 For Rita Malpas Sheldon, a natural in this matter of child development, and for Professor Geraldine Macdonald and Dr Jane Dennis of the Cochrane and Campbell Collaborations, who already know what I think of them.

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7 Contents List of Tables and Figures Preface Acknowledgements About the Author viii ix xii xiii 1 Principles of Evidence-Based Practice 1 2 What Comes with Us? 46 3 The Influence of Learning on Development Stages and Dimensions of Psychological Development Adolescence and Early Adulthood Middle Life and the Transition to Old Age 222 Bibiliography 273 Index 292 vii

8 Tables and Figures Tables 1.1 Levels of attributive confidence in different types of research Influences on development Five predictive dimensions of personality Main approaches used in twin studies to establish variance Kohlberg s stages of moral development Characterisations of parental styles Stages in mourning 271 Figures 1.1 Hypothetical data regarding a possible association between parental separation in childhood and later depression (Sheldon & Macdonald, 2009) Eysenck s formulation of personality dimensions Distribution model of trait dimensions Conditionability in introverts and extraverts using EPI scores (adapted from Franks, 1956) Genetic and environmental influences on personality (adapted from Riemann et al., 1997) The interaction of biological and social factors in schizophrenia (adapted from Woodcock & Davis, 1978) A diagram of classical conditioning (adapted from Hilgard et al., 1979) A desensitisation hierarchy (Sheldon, 2011) Evaluation of a school- and family-based differential reinforcement scheme Neural growth and general physical growth compared (adapted from Gerrig et al., 2012) Mean typical growth/weight patterns in young males and females Problem solving and anxiety (adapted from Hebb, 1980) Ageing in the population actual and predicted UK figures (Royal Commission on Long-Term Care, 1999) 233 viii

9 Preface The idea for this book grew out of my (rather positive) experiences of teaching multidisciplinary, postgraduate and post-qualification courses in applied developmental psychology at the universities of London, Bristol, Queen s Belfast, and as part of the Centre for Evidence-Based Social Services (CEBSS) project based at Exeter. The subject itself is surprisingly under-taught on professional training courses, having often been sidelined into modules to make room for discussions of new fix-all political initiatives. Yet without such a grounding, how are staff to make valid and reliable assessments of problems? That is, unless equipped with a template of normal/average development, how are they to know when their clients /patients position on any number of curves indicates a cause for concern? Also, since the best predictor of likely success in interventions research is a close, logical fit between the known causes of problems and what is subsequently done to attempt to ameliorate them, without a knowledge of the usual patterns of development, from where are we to get our leads on causation and the likely course of problems? Methods-led approaches and policies will fill any vacuum left behind where we have a poor understanding of aetiology: We tend to use an X approach at this clinic; this department is committed to a Y approach and so on. On what evidential basis? is the a priori question. Such concerns have led me towards a number of principles that should underwrite the design of multidisciplinary courses, and these form the manifesto for this book. They are as follows. Health and social care staff are similarly motivated and face problems that are more alike than they are different. Coordinated contributions to different aspects of complex problems are, research unsurprisingly shows, better than expert action taken against one aspect alone, and the rest regarded as context. Teaching and debating together, so that mutual respect for overlapping viewpoints and skills develops, helps to prevent the formation of silo identities and the thinking that goes with them. There is, after all, more than enough work for us all, and we need all the help we can get. Many or most of the difficulties that the helping professions face are the product of a mixture of bio-psycho-social influences, and some initial knowledge of all three ingredients helps with both assessment and treatment. Samuel Butler knew the answer to the conundrum about ix

10 x Preface specialist vs general approaches long ago: Woe to the specialist who is not a pretty fair generalist, and to the generalist who is not also a bit of a specialist (1912). That is, if you think that a little knowledge is a dangerous thing, then try complete ignorance sometime. Given the number of different theories that exist about aspects of human development and the wealth of experimental evidence that we now have, it is wise to pause when we begin to consider them and to develop some criteria for full or partial inclusion, or full or partial exclusion from the mainstream curriculum. The same caution is also due regarding what gets into, or what stays outside, our practice. The danger otherwise is that we select findings that are confirmatory, professionally flattering or simply comfortable policy-based or practice-based evidence rather than evidence-based policy or practice. Professional training courses often collude with these known biases when they teach different grand theories of human development alongside each other with little apparent tension. Such salad bar approaches choose what you like and leave the rest fail to take note of degrees of logical incompatibility. If the propositions of one are roughly correct, then those of the others often cannot be. Theories must therefore be reduced at some stage to empirically observable propositions, and thrive or perish according to how well they survive empirical tests. Such strictures do not always make for classroom harmony, but nevertheless are necessary for technical and ethical reasons. Thus What shall count as evidence in this field? is as good a starting point for a course as for a systematic review; or, for that matter, a book. We cannot divorce ourselves from theoretical speculation about the human condition, or what approach might be helpful when something goes wrong in it. Even separate experimental observations will tend to coalesce into a larger picture. Our brains are just not wired up to respond only to the specific results of individual observations. However, our brains also contain cerebral cortexes and can be schooled into a self-denying ordinance regarding what we think and do. Theories have qualities too, and can be assessed against each other. For no one is going to wait for the possible extra guidance that a systematic review update due next month might deliver before deciding what to do or not do with a family coping with the fallout from childhood autism when we see them next Tuesday. If the family are lucky, the would-be-helper will stick closely to an amalgamation of current best evidence, draw the family into a debate about what is known and not known, and create a space in which changing one s mind in the face of subsequent experience occurs without loss of face.

11 Preface xi Different research findings, theories or allegedly causal influences tend to be privileged or neglected by different professional groups. These These truths we hold to be self-evident beliefs are a bar to good interprofessional communication because they are often vague and implicit or simply wrong. So genetics does not deal much in fixed biological destinies; talking things through sometimes helps and sometimes does not; social class and what comes with it is not a vague sociological construct; and there is such a thing as society. Staff need to be aware of these concentric circles of influence and to be persuaded out of the view that only the first two or the last two are their particular concern, or that there are any sharp cut-off points at which one set of factors begins and ends and another replaces it. This book is rooted in my attempts to apply these priorities in my academic teaching, research and practice. It is an attempt to survey and integrate research on genetic and epigenetic predispositions (which is proceeding apace) with that on the experiential influences on behaviour that we somehow feel should always be predominant (which is dragging its feet a little by comparison). Nature via nurture is the theme, and the development of more concerted with the grain health and social care interventions its aim. In this regard, I have tried to write a book that is thought-provoking, but also of some practical use a contribution at least.

12 Acknowledgements Heartfelt thanks are due to Florence and Hugh Millington, Harriet Evans, Margret Scoble, Dr Rupa Chilvers, the inestimable Sally Osborn (copyeditor) and Sandra Andrews for their help in the preparation of this book. Verses 1 and 2 of Louis MacNeice s poem Prayer before Birth have been reproduced by kind permission of David Higham, literary, film and TV agents. xii

13 About the Author Brian Sheldon is Emeritus Professor of Applied Social Research in the Peninsula Medical School at the University of Exeter. Previously he was Director of the Centre for Evidence-Based Social Services there. His long standing interest has been in studies of the effectiveness of services for people with mental health problems including children and can lay a claim to establishing the matter of service effectiveness on the agenda in the professions concerned. The author holds qualifications in psychology (Phd); is a qualified Social Worker; previously a State Registered Nurse; and a Registered Cognitive-Behavioural Psychotherapist, or, as he is fond of saying, he is a little multi-disciplinary team. Brian Sheldon is the author of six books and many research articles on evidenced based practiced in health and social care. He was an early advocate of a Bio-Psycho-Social model of understanding and treating mental disorders. He was also an early advocate of the use of cognitive-behavioural approaches, and was previously President of the British Association for Behavioural & Cognitive Psychotherapies. His research interests have lain in studies of the effectiveness of social service schemes or therapeutic methods, and in the establishment of evidence-based practice as a routine approach in social care and health. He has continued to practice throughout his academic career. xiii