Sunday 16 June 2013

Where's the science gone?

I love research. In my first year of music therapy masters I particularly fell in love with quantitative research and loved the idea of being able to conduct huge randomised controlled trials to show that music therapy is effective. In my second year, however, my love of research moved towards qualitative. So began this internal fight between numbers, logic, measurable findings - and - stories, emotion and individualised experiences of treatment. Both have a place in my world.

But - over the last few years, my experiences, conversations and reading have started me questioning the research that is thrusted into our lives whether we like it or not (yes - we are all effected by research even if we are not aware of it!).

During my music therapy life, I've been made aware by colleagues on the very experimental nature of psychiatric medications and that the trials are often funded by drug companies. At the 2012 Australian Music Therapy Association Conference in Sydney, I saw Dr Graham Martin reflect on his own experiences in challenging 'evidence-based practice' with 'practice-based evidence.' Then not long after, I came across this TED talk by Ben Goldacre: "What doctors don't know about the drugs they prescribe." For anyone passionate about mental health care, I strongly recommend you watch it.


This topic always makes me question why do we trust this research? Why is it that this poor quality research becomes the 'evidence base' of medicine and treatment? But then I also think. If I conducted a trial on music therapy and the results were negative - would I publish it? My initial thought was - of course not! Now, I feel like I would have an ethical need to do so. But I'm also aware now that other professions have studies that 'fail' - of course it's inevitable that all therapy and treatment trials will fail before they succeed. In failure there is a risk of being shunned and disconnected - so I worry that we are in a place where we try so hard to succeed, that we are missing the very point of research.

When I was at uni, we were told that scientific research should be empirical, sceptical, critical, tentative and open for the public. So my question is - where has the science gone?

The government tend to fund therapies and treatments that have a strong 'evidence-base.' Research is considered an ethical risk if an 'evidence-based' treatment was to be taken away from a participant. So what do we do? How can we prove ourselves, when the most trusted medical research has lost its scientific purpose? Do we keep trying to prove ourselves with quantitative research - and hope that they are positive and that we'll get noticed - or do we use the individualised stories of qualitative research because individuals respond differently to treatments anyway - with the chances that we don't get noticed?

For now - I'm just glad that I'm a clinician not a researcher. I will use the 'evidence base' to inform my 'practice-based' evidence in order to provide the treatment that I believe (and continue to observe) to be quality. Though I know I need to get my own knowledge out beyond the four walls of my own mind - so I will explore my research with the curious, scientific, sceptical and critical mind that research deserves.