Cognitive Science and Clinical Disorders

Cognitive Therapies, Clinical Science, & Basic Science Cognitive Science and Clinical Disorders Dan J. Stein and Jeffrey E. Young (Eds.). San Francisco: Academic Press, 1992, 399 pp. Cognitive Therapies, Clinical Science, & Basic Science This scholarly edited volume is divided into two parts: Part I, "Theoretical Frameworks" and Part II, "Clinical Disorders." The title of the book juxtaposes "cognitive science" and "clinical disorders." The general aim is to bring together nonclinical and clinical cognitive theory. This aim constitutes no small task, since (as Stein notes in the Preface)"... cognitive scientists have, by and large, ignored many phenomena that are well known to clinicians" (p. xiii) Indeed, Stein's remarks may represent an overly optimistic view. Historically, basic cognitive experimentalists have ignored most all clinical phenomena. [Similarly, many believe that even the psychotherapy researchers have ignored clinical phenomena (as in Raw, 1993)!]. Further, this state of affairs should not be surprising. Basic researchers do basic research. That is, after all, what makes them "basic researchers." Though it may not seem obvious on first consideration, Skinner's radical behaviorism concepts-"rule-governed" versus "contingency-shaped" behavior- may inform us about an important distinction between clinical practice and basic cognitive/clinical research. Clinicians repeatedly encounter complex, contextually situated disorders of affect, behavior, and cognition. Over time, effective clinicians learn to encounter and modify these respective complex disordered systems in positive, adaptive ways. The operations used in clinical encounters are usually labeled "clinical techniques," although a more proper label might be "clinical artistry." Research has yet to be designed in a manner to fully capture and articulate this process. Despite allegiance to the "scientist-practitioner" model of clinical practice, the effective clinician's behavior becomes (in skinner's terms) largely contingency shaped in a manner which itself shapes the patient so as (in positive outcomes) to resolve, or control, the disorder. By contrast, clinical researchers and basic cognitive scientists are more interested in establishing explicit rules or theories for the onset of clinical disorders, and for the effective resolution of such disorders. This issue of contrasting contingencies or perspectives between cognitive science and cognitive psychotherapy is central in the context of suggesting the relevance of cognitive science to clinical disorders and practice; yet, the issue is not addressed in the present volume. Cognitive Science and Clinical Disorders is said to be designed for both cognitive scientists and clinicians. …