Wednesday, March 05, 2008

The Hawthorne Effect in stuttering

Have you ever heard of the Hawthorne effect in psychology? A study looked at the impact of the lightening condition on factory workers. They increased the lightening, questioned the workers, and got a positive feedback: the workers enjoyed the improvement. Then, just be on the safe side, they re-did the same experiment but now they decreased the lightening. Results? The workers gave positive feedback again! So any change provoked a positive feedback. Some speculate that workers just reacted positively because someone was finally given them some attention and they wanted to support them.
I am convinced that the same could happen in therapy. Assume that a therapy is made of 5 components A,B,C,D, and E. If you increase any of the five components in importance, you will get a positive feedback from people because they see how much you invest in improving the therapy and they do not want to disappoint you.
Another experiment that I have in mind is the following. Drop one of the five components, lets say A, and do the test but without telling them about the test, I am convinced the therapy outcome will stay stable. OK, then you can argue that A is not needed. Repeat this test with the remaining four and always drop one component. I am convinced you will always get similar results. So at the end, you can conclude that no component is crucial by itself, so what did produce the improvement? You could always first drop A, then also drop B, then drop C too, and so on. Again I would say that the results will not dramatically change. OK, maybe at the last one because you give them no therapy.


Adrian said...

I have attended several group therapies over the years and virtually everyone leaves pleased with the therapy, whether there is any improvement or not. Also, I hear PWS praising individual therapists when I see no difference in their speech. This must be due to the Hawthorne Effect.

I have learned to be suspicious of testimonials for this very reason.

Ora said...

Adrian - There's more than one factor involved in what you've observed.

Consider selection bias, in that the people who remain in therapy are self-selected to be those who are successful with it. The others drift away, and therefore there voices are less often heard.

In general, the people that are available for us to speak with are the ones who have stayed around, not the ones who have drifted away. We listen to their reports and conclude that therapy is generally effective... but another interpretation is that those who are not successful are not around anymore, and we don't hear their voices.

For most of us, the setting in which we hear these reports and make these informal judgments is the "stuttering community" - not precisely defined, of course - but basically the group of people that we meet through therapy, or in "stuttering settings" such as practice/support groups, or through intensive programs, or otherwise via our therapists or other friends or acquaintances who stutter. These tend to be the people who believe (and report) that they are being helped by their work.

Why might they report more positively than reality? Consider, for example, the simple fact that people have made a personal investment of money and time - sometimes substantial - and are uncomfortable with the notion that they have might have wasted their money and effort to little effect (the psychological phenomenon of "cognitive dissonance"), and thus tend to believe and report to others that their work has been successful. The others drift away, and we're much less likely to encounter them, and thus much less likely to consider them in our assessment of the effectiveness of the therapy

Anonymous said...

Psychological influence. The brain is a powerful tool.