Pragmatic psychology

This year’s Nobel Peace Prize was recently awarded to a pragmatist.* How perfect that some of the functional models of treatment we learned about in this week’s readings seem to represent psychology at its most pragmatic. The readings succeed in reconciling the frequent strain between theory and practice. Reading these papers, I was as satisfied with the authors’ tidy, coherent theories as I was convinced of their real-world utility.

Based on the treatments presented, I thought it would be pragmatic to come up with some principles some principles of the pragmatic psychologist. They are:


(1.) Treatment should take a global perspective—i.e., the functionalist’s view of the individual interacting with her contexts.

(2.) Treatment should be outcomes based. Outcomes must conform to what Jacobson et al. (2001) call a “pragmatic truth criterion,” based on whether what they did in therapy actually “reverses the depression. Not whether the therapist conformed to a theory, but whether the patient attained the therapeutic goal. That’s how you know you’ve “correctly identified functional relationships;” that’s how you know whether to keep working like you’ve been working or to try something new (see #3).

(3.) Treatment should be customized. Behavioral Activation Therapy (BA) and Dialectical Behavioral Therapy (DBT) are paradigms. They’re not blanket therapies, they’re designed to fit a certain set of symptoms.


(4.) Treatment should be flexible. Jacobson et al.: “we emphasize the importance of finding which behaviors and activities will be positively reinforcing and will help disrupt the spiral of depression for each individual client.” Mind the nomothetic ideographic gap!

One caveat: I laughed a bit when I read in Jacobson that “simply activating depressed people” accounts for therapeutic benefits. I buy BA as empirically supported, “parsimonious,” and potentially really helpful; but what about reversing the course of depression could be simple? This highlights a danger in pragmatism: a simplification of very complex ideas, belied by a tone of obviousness or common sense.

*What his "pragmatism" means is a fairly interesting debate.