Evidence, Theory, and Clinical Frameworks · Clinical Exercise

Say It at the Right Tier

Not everything in this module has the same amount of evidence behind it, and the difference changes what you are entitled to say out loud. Eight frameworks to place, a supervisee's case notes to audit sentence by sentence, and the pushback you will actually get.

What this exercise practises

Assigning a framework to its evidence tier, hearing the single word that promotes a framework a tier it has not earned, and holding the distinction when a supervisee tells you, correctly, that the framework is helping her clients.

Three of the eight frameworks here were developed by the author of this module. That is the point of the exercise rather than an awkwardness in it, and the hardest overclaim to catch involves one of them.

Estimated time to complete this exercise: 25 minutes

1Four tiers
2The case note
3The pushback
4Close

Before you begin

How this one works

Not everything in this module has the same amount of evidence behind it, and the difference changes what you are entitled to say out loud. That is the whole exercise.
Part 1 assigns eight frameworks to four evidence tiers. Three of the eight were developed by the author of this module, which is the point rather than an awkwardness: the frameworks you have been taught most persuasively are the ones you are most likely to over-credit.
Part 2 is a supervisee's case note, sentence by sentence. Four of the eight sentences overstate their evidence. One of them does it so subtly that the clinical content is correct and only the attribution is wrong.
Part 3 is the pushback you will actually get, which is that the framework really does help clients.
Nothing is graded and nothing is recorded. Reloading starts it again.

Treating frameworks as though they had equivalent empirical support is not merely intellectually imprecise. It is clinically misleading, and the person who carries the cost is the client, who will repeat what you told them to somebody else.

References

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  2. Basson, R. (2001). Human sex-response cycles. Journal of Sex & Marital Therapy, 27(1), 33–43. https://doi.org/10.1080/00926230152035831
  3. Brotto, L. A., & Basson, R. (2014). Group mindfulness-based therapy significantly improves sexual desire in women. Behaviour Research and Therapy, 57, 43–54. https://doi.org/10.1016/j.brat.2014.04.001
  4. Chivers, M. L., Seto, M. C., Lalumiére, M. L., Laan, E., & Sattler, S. (2010). Agreement of self-reported and genital measures of sexual arousal in men and women: A meta-analysis. Archives of Sexual Behavior, 39(1), 5–56. https://doi.org/10.1007/s10508-009-9556-9
  5. Duncan, T. (2023). Clinical framework: Automatic vs. manual transmission, sexual gears, and three types of sex [Unpublished clinical framework]. Private practice.
  6. Jaiya. (2017). Erotic blueprints: Sexual arousal style assessment and educational framework. Jaiya Inc.
  7. Janssen, E., & Bancroft, J. (2007). The dual-control model: The role of sexual inhibition and excitation in sexual arousal and behavior. In E. Janssen (Ed.), The psychophysiology of sex (pp. 197–222). Indiana University Press.
  8. Kaplan, H. S. (1979). Disorders of sexual desire and other new concepts and techniques in sex therapy. Brunner/Mazel.
  9. Masters, W. H., & Johnson, V. E. (1970). Human sexual inadequacy. Little, Brown.