Research and Representation: A Conundrum for Behavior Analysts
Bolling, Madelon Y., Behavior and Social Issues
Abstract: Historically, populations of color have been ignored in psychotherapy research. Fortunately with growing awareness of social justice issues, funding institutions require proportional ethnic diversity in research samples. However, psychotherapy itself is a highly culture-bound mainstream phenomenon that generally ignores and thereby perpetuates issues of power. Minority individuals likely to participate in psychotherapy tend to be a highly acculturated subset. Non-acculturated peoples often perceive their problems so differently that "psychotherapy" is a nonsensical solution. Funding agencies' requirements that researchers recruit representative numbers of minority subjects may inadvertently amount to a campaign for cultural colonization, which is clearly unethical. Can behavior analysts tease out the issues and ethics involved? Is behavior analysis itself irrevocably culture-bound?
CONTEXT AND BACKGROUND
Though there are those who question the relevance of such a topic to the analysis of human social behavior, this paper refers extensively to psychotherapy research. The purpose is not to debate the appropriateness, behavioral orthodoxy, or effectiveness of this kind of research, but to point out the problematic nature of some traditions of social science itself, using psychotherapy research as a case in point. Issues mentioned here need to be considered in any behavioral intervention research that requires a representative sample of subjects or that deals with non-mainstream subjects in single-subject research. Specifically, any time an intervention has an interpersonal aspect, cultural assumptions shaped by contingencies of the researchers' and the participants' respective social environments are operating. The notion of scientific research itself carries cultural assumptions with it. It may be that we ignore culture, especially our own, as a factor simply because we wish to be "impartial," but it is fallacious (one might even say unscientific) and ethically unsound to do so.
I work in a research lab developing a Functional Analytic Psychotherapy (Kohlenberg and Tsai, 1991) enhanced treatment for depression. We hope to reach "empirically-supported treatment" status in order to bring principles of behavioral analysis to the medicalized field of psychotherapy. Thus, while our background isSkinnerian, we find ourselves deeply involved in group-comparison statistical design. Although it is possible to establish empirical evidence of efficacy through the more behavioral method of multiple single subject designs, this requires therapists as well as adherence raters competent in our method to be well established in at least three different geographical locations. Our approach, especially regarding methods of effective therapist training, is still under development. Meanwhile, support for the work needed to develop such methods is available almost exclusively from government agencies, whose standard for evidence of efficacy is the group-comparison design. Single-subject research will likely be the best way to extend our research into culturally distinct populations, once our methods are recognized as efficacious by the National Institutes of Health. Even so, culture, acculturation, assumptions about the nature of the world, and the different meanings of "research" to non-mainstream populations are as pertinent to single-subject research as to group-comparison research.
There are two main issues at stake here: 1) the scientific standards and traditions of group-comparison research requiring representative sampling diversity; and 2) confusion between culture and genetic heritage when dealing with the social manifestations of distress which our culture labels "psychological disorders."
There is strong language in the Public Health Service (U. S. Department of Health and Human Services, 1998) application for grants:
Women and members of minority groups and their sub-populations must be included in all NIH supported biomedical and behavioral research projects involving human subjects, unless a clear and compelling rationale and justification establishes inclusion is inappropriate with respect to the health of the subjects or the purpose of the research . …