Transaction Publishers "'What we know ...,' an awful gnomic conceit, is actually very little. This ignorance is painful ... The art of prediction in the social services has not gone much past Delphi and tout sheets" (p. 202). This is the basic message of this trenchant and pugnacious 241-page book. It is a powerful indictment of the failure of social welfare programs and the devastating failure of science and scientists. With meticulous attention to standards of accuracy, science, rigor, and objectivity, Epstein mercilessly exposes the sins and moral turpitude of scientists, particularly mental health professionals, who shape their conclusions and interpretations to fit the ephemeral political and social consensus of the moment and maintain their privileged and comfortable niche. His basic theme is that the American population is unwilling to pay the dollar costs of actually solving social problems, and scientists and science are prostituted to maintain the myth that cheap, simple interventions work to solve them. But there is no credible scientific evidence to show that any social program has worked to solve any social problem. "The conflict between the resources needed to address contemporary social problems in the United States and the political unwillingness to come up with those resources defines the current dilemma of American Social policy; solutions for social problems exist in principle but they are not politically feasible" (p. 7). If accurate, a footnote (p. 15) contains a staggering and sobering estimate: "the human services probably account for more than one trillion dollars annually and employ the largest portion of the American work force." A huge portion of our total economy is expended in ventures that do not work. This gargantuan folly is supported, justified and maintained by the pseudoscience foisted upon the public by mainly psychology and social work and also the other social sciences. Chapters 1 and 2 are the most powerful in the book. First, the standards of proof in social science research are briefly but clearly set forth. Then the research in psychotherapy, which Epstein states has been a "pillar of social care and of training for the emergent professions of the welfare state-social work, counseling, psychology) and even, home economics" (p. 14), is subjected to those standards. Epstein's judgment is that there is no evidence that psychotherapy works but its central place in the society is maintained by the collusion of scientists in "the pursuit of 'clinical' as opposed to social solutions" (p. 42). The criticism of the outcome research and meta analysis in psychotherapy is a model for the critical thinking necessary to assess the quality of research and the interpretations given to it. The wonder is that "psychotherapy and the many extensions of clinical psychology have enjoyed a prolonged popularity ... without offering any credible proof of an ability to modify dysfunctional personal behavior" (p. 60). The remainder of the book includes an analysis of social services and a cogent and meticulous criticism of the research said to support programs for negative income transfer, jobs training, juvenile delinquency, and drug addiction. The pattern is the same. Scientists, wittingly or unwittingly, continue to claim there is scientific support for programs when there is none that meets the standards of scientific proof and rigor. The book contains extensive references and ends with a short index. In the confusion that surrounds policies and procedures responding to allegations of child abuse, Epstein's powerful critique of social policy and social science is directly transferable. Everything he writes about the practice of pseudoscience, the collusion of a tainted community of scholars, and the corruption of the social policy process by the falsehoods of scientists succumbing to pressures to conform to accepted myths can be said about the research and the use of it in child abuse. Scientists, psychotherapists, particularly clinical psychologists, should read this book and hang their heads. "Quacks, charlatans, and psychotherapists may have much in common (p.57). Attorneys and judges should carefully study this book and use it to sort out pseudoscience from accurate scientific knowledge when it is presented in the courtroom. Attorneys, especially defense attorneys, should know and understand the critiques of this book in order to effectively determine trial strategy, plan the cross-examination of experts, and know when to object and what objection to make. Prosecutors who are genuinely interested in justice rather than winning cases should read this book carefully and absorb the criticism of pseudoscience. Understanding the basic principles in evaluating research is crucial in order to make the best decisions when to charge an offense and what allegations should be dismissed. At this point, the few research studies prosecutors use to support the use of the anatomically-detailed dolls, to buttress child witnesses, and to bolster allegations with behavioral indicators are subject to these criticisms. It does no good for anything, including the future career of prosecutors, to prosecute persons on the basis of falsified and erroneous pseudoscience. Judges, particularly those who make decisions about admissibility of purported scientific evidence following the U.S. Supreme Court Daubert decision, must be familiar with Epstein's analysis of science and scientific facts. Many judges are simply not prepared, not knowledgeable enough, to make that level of decision properly. Also, judges who make decisions regarding disposition and treatment of people must know this critique of the social welfare services and programs. In several instances Epstein clarifies the actual research data to show that it indicates the programs often used as treatments by judges actually harm people and exacerbate an already disastrous situation. It is clear that a casual choice to get rid of a knotty problem, clear a court calendar, or avoid a tough or controversial decision, by shifting responsibility to the mental health professions or social welfare or child protection personnel cannot be made with impunity or confidence that it is either a wise or right decision. There are no promises of easy solutions in this book. The social problems which are addressed by social welfare are intractable. The warning throughout the presentation of this sobering view is that no matter what is done it is going to be far more costly than anyone is willing to admit or accept. Politicians who make the laws and appropriate the funds for social service programs should not vote on any social service legislation until after they have read this book. I highly recommend this book. Reviewed by Ralph Underwager, Institute for Psychological Therapies, Northfield, Minnesota.
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