Critical Thinking in Clinical Practice: Improving the Quality of Judgments and Decisions

Praise for Critical Thinking in Clinical Practice , Third Edition "Eileen Gambrill is unparalleled in her ability to describe common flaws and biases in clinical decision making. The result in this revised edition is a steadfast call for change that also acknowledges the demands of practice. A must–read for clinicians and researchers alike." — Elizabeth K. Anthony , PhD, Assistant Professor, School of Social Work, Arizona State University "This Third Edition builds upon the impressive strengths of Gambrill′s prior treatments of the topic to support the notion that critical thinking is a teachable skill and one essential for contemporary practice in the human services. This book should be the default authority on the topic of critical thinking for human service professionals and would be an excellent textbook." — Bruce A. Thyer , PhD, LCSW, Professor and former Dean, Florida State University College of Social Work "I was skeptical about how Critical Thinking in Clinical Practice could be improved, but Eileen Gambrill has succeeded! Her articulation of critical thinking skills for clinical decisions ultimately will benefit the people we serve." — Joanne Yaffe , PhD, ACSW, Associate Professor of Social Work and Adjunct Associate Professor of Psychiatry, University of Utah A balanced and illustrative guide to incorporating critical–thinking values, knowledge, and skills into clinical education and practice Now in a third edition, Critical Thinking in Clinical Practice is written for helping professionals who want to think more clearly about the decisions they make and the context in which they make them. It is a practical volume for clinicians who would like to expand their knowledge of common pitfalls and fallacies in clinical reasoning. As in earlier editions, this Third Edition draws on research related to problem solving and decision making, illustrating the relevance of research findings to everyday clinical practice and policy. Revised throughout, the new edition includes discussion of: The influence of pharmaceutical companies on the helping professions, including disease mongering—the creation of bogus risks, problems, and needless worries Different kinds of propaganda in the helping professions that compromise informed consent Additional coverage of classification, pathology, reliance on authority, and hazards in data collection The development of decision aids of value to both professionals and clients The relative contribution of specific interventions compared to nonspecific factors to positive outcome Factors related to decision making in multidisciplinary teams New developments regarding intuitive and analytic reasoning The pragmatic theory of fallacies Designed to enhance the quality of services offered to clients, Critical Thinking in Clinical Practice, Third Edition is filled with insightful examples, useful lists, websites, and guidelines, presenting an essential resource for all helping professionals and students in the helping professions.

Preface ix Part I: Lay of the Land 1 The Need for Critical Thinking in Clinical Practice 3 2 Sources of Influence on Clinical Decisions 29 3 R easons and Reasoning: The Heart of Making Decisions 57 4 Different Views of Knowledge and How to Get It: Exploring Your Personal Epistemology 87 Part II: Common Sources of Error 5 The Influence of Language and Persuasion Strategies 131 6 Formal and Informal Fallacies: Mistakes in Thinking and How to Avoid Them 155 7 Classification, Authority, and Focusing on Pathology 181 Part III: Decision Aids 8 Content and Procedural Knowledge 209 9 Taking Advantage of Research on Judgment, Problem Solving, and Decision Making 239 10 Evidence–Based Practice: A Philosophy and Process for Making Informed Decisions 275 11 Posing Questions and Searching for Answers 297 12 Critical Appraisal of Practice– and Policy–Related Research: The Need for Skepticism 335 Part IV: Applying Critical Thinking Skills to Clinical Decisions 13 Making Decisions About Data Collection 377 14 Discovering Causes of Clients’ Problems: Common Biases 409 15 Making Predictions: Improving the Odds 453 16 Enhancing the Quality of Case Conferences, Team Meetings, and Organizational Culture 481 Part V: The Future 17 Overcoming Personal Obstacles to Critical Thinking 509 18 Maintaining Critical Thinking Skills 533 References 549 About the Author 623 Author Index 625 Subject Index 641

Eileen Gambrill is the Hutto Patterson Professor of Child and Family Studies at the School of Social Welfare, University of California, Berkeley, where she teaches both research and practice. Her research and writing cover professional decision making, evidence–informed practice, the role of critical thinking, propaganda in the helping professions and its harmful effects, and the ethics of helping. She presents nationally and internationally on the topics of critical thinking, evidence–informed practice, and the ethics of helping.

"...she has produced an ambitious and impressively comprehensive book that belongs in the library of every clinician and in the backpack of every graduate student." ( PsycCRITIQUES ) "The book does work best as a reference: each topic is a separate research area in its own right" ( Evidence Based Medicine ) "Anyone seeking a succinct, well–written, easy–to–read survey of faculty reasoning and how to cure it should look no further. Gambrill′s book should be the required text for any course in critical thinking for psychotherapists, a course urgently needed by every psychiatric, clinical psychology, and social work training program in existence today." ( Skeptical Inquirer ) "Clinical training programs cannot discount the importance of critical thinking or the knowledge and skills that it requires. It is hard to justify the absence of a course focusing on the wide–ranging material woven together in Critical Thinking in Clinical Practice. By supplying a model textbook for such a course, Gambrill has made a valuable contribution." ( Contemporary Psychology ) "[ Critical Thinking in Clinical Practice ] is essential reading for all who aspire to improve the quality of clinical practice. In some respects, this book might be called "the thinking social worker′s guide to improved practice." The very questions that are raised by Gambrill are as important as the answers that she proposes." ( Research in Social Work Practice ) "For the research instructor, this volume presents a potential bridge for the gap between research and practice. It would be an ideal text for a course that would focus on how critical thinking that employs research concepts and methods can improve clinical decision making. In addition, readers are provided with a variety of approaches to monitor and improve their decision making skills." ( Social Work in Health Care )