Refutation of the disinformation about Monica Pignotti

Posts tagged ‘Restraints’

Ronald Federici, PsyD: An Open Letter

This is an open letter to Ronald Federici, PsyD, a psychologist in Virginia who I believe is one of the ring leaders in the smear campaign against me. Before I begin, here is some background Although he denies being involved in the actual postings, just before the smear campaign began, according to Wayward Radish, a survivor of abusive therapy who runs a blog blowing the whistle on those who practice such methods she claims receiving the following e-mail from him:

While I am a patient man, my limits are about done as you have done some egregious things on this internet. I know all of your names, and could post what I know about your personal and family issues of atheism, scientology, handicaps, depression, mental health issues, sexuality, etc.

The alleged letter was written after people who said they knew him had come forward on the blog and said some things about him which, suffice it to say, were not favorable. Although I had nothing to do with the blog or the postings, my past history made me an easy scapegoat and target. It was shortly after this that the attacks on me and on my colleagues began to appear and in July, 2009, he sent a letter to my Dean that was filled with lies about me, including the assertion that I was “not of sound mind” even though Dr. Federici was in no position to make that assessment of me, given he has never met, much less examined me. He tries to distance himself from the ugly postings about me, but he advised my Dean to do a Google search on my name, pointing to the libelous and defamatory postings about me, as if this were evidence. My Dean took no action whatsoever on Federici and his colleagues’ letters about me because he considered them to be completely irrelevant to my work at FSU. Contrary to the lies that are being circulated by anonymous individuals, I graduated from FSU and left in good standing in every way.

Federici’s assertion that I have many enemies and attempts to imply that maybe they are responsible for the postings simply is not credible for a number of reasons:

  • While it is true that there are other proponents of treatments I have criticized (e.g. Hulda Clark followers, TFT proponents, Scientologists) who are quite upset with me, none of them have any reason to attack my colleagues Jean Mercer, Larry Sarner, Linda Rosa, Charly Miller (who have been attacked along with me) since they have not been involved of criticism of any of these things. What they have been involved in, is criticism of the methods of Ronald Federici and his colleagues.
  • Many of the attacks on me denigrate me for my past involvements in TFT and Scientology so they are slamming TFT and Scientology. Obviously, proponents of TFT and Scientology would not be slamming their own practices.
  • Word has gotten back to me that the Callahans and other leaders in the TFT association are strongly recommending to their members that they not attack me. Although I have been critical of their claims, at least this shows that they are wise enough to recognize that personal attacks would make them look very bad and thus they are choosing to refrain. They obviously do not want to be associated with the crackpot attacks on me.
  • Although there were a few isolated attacks on me, the widespread smear campaign did not begin until after I had published scholarly criticism of one of the attachment therapists and it became known I am on the professional advisory board of Advocates for Children in Therapy.

Here is my open letter.

Dear Dr. Federici,

As a human being, in all good conscience, after seeing the methods you are recommending for children, I have to say that in my opinion, I feel they are inhumane, atrocious, and just plain wrong . [Readers can view these methods in his self-published book and form their own conclusions.]

Click on “Look Inside” and search in the book for “SEQUENCE ONE HOLDING” and go to where this phrase appears on page 111.

Fortunately, I live in a free country and I have the right to free speech, which includes expressing my opinions, whenever and wherever I deem appropriate. What free speech does not give people the right to do is libel and defame others, as you and/or your friends have done to me. At the very least I know that the attackers are your friends because the same ones who post blogs and ads attacking me, post ads and blogs praising you. I have not libeled or defamed you. I have documented every fact I have stated about you and have clearly labeled my feelings and opinions as just that. In contrast, outright fabrications are posted about me, such as saying I do sexual favors for people in exchange for endorsement, was fired from FSU for being a voyeur and other ridiculous, crazy lies.

The methods you are recommending for children are in and of themselves, problematic enough, especially given that there are no published studies to support their safety and efficacy (and I mean studies in peer reviewed journals that directly test your intervention with randomized controlled trials, not fifth author on a book chapter that did not test your intervention).

I asked you to name institutions that currently use the restraint procedures you recommended in your book and you named Cook County Hospital, an institution that as far as I have been able to determine, no longer has an inpatient psychiatric unit, which has been defunct for quite some time and you named another institution, Jasper Mountain, which it turns out is highly controversial and has been sued because children ended up with broken bones. You have not produced a rebuttal to the conclusions I have made from my own literature searches, showing that deaths have occurred from prone restraints, even when the procedures were done correctly under supervised conditions and that there is very little empirical evidence for the safety and efficacy of restraint procedures and hence, the recommendation is to do everything possible to avoid using them and when they are used, to use the least restrictive possible methods, not the face-down prone restraint methods your book recommends parents use, with no one in the immediate environment to supervise their use, as there would be in a residential facility.

Instead of addressing the issues at hand that I have raised, the anonymous outrageous, libelous and outright obscene attacks on me continue. Although you may not have noticed, with the advent of evidence-based practice in clinical psychology, the days of the therapy guru who can simply assert his authority and place himself above challenge are coming to an end. No one, is above challenge, even licensed PsyDs such as yourself .  You can puff up your chest and assert those credentials all you’d like, make all the legal threats you want and take people to small claims court, but it does not mean that you are above being challenged. It might seem that I am belaboring a point here, but the reason for that is that much is at stake. If people like you can succeed in intimidating critics from challenging you, then there is no hope for the mental health profession to become an evidence-based profession that produces interventions for people that help, rather than harm. Take away a person’s ability to criticize and what we will end up with a cult run by therapy gurus, not a profession. Obviously, I have paid the price for my criticism of having my reputation smeared with libel and defamation all over the internet, but if that’s what it takes to be an advocate for vulnerable children, so be it.

Quite frankly, I am appalled by your book and what you are recommending be done to already vulnerable children who have serious histories of neglect and in some cases, severe trauma and sexual abuse and rest assured, I will not be silenced. Additionally, the fact that you work with children does not make you immune to criticism from people who are not currently actively doing so. One does not have to be working with children to be appalled by your book and in fact, I know plenty of professionals who work with children with severe behavior problems who use evidence-based treatments to deescalate situations who have not had to resort to the methods you recommend.

If you would like to discuss the actual issues with me, feel free to respond, but what I will not tolerate are any further personal attacks. I would still like to know, for starters, on what basis you are claiming the restraint procedure you recommend in your book is safe. And no, the fact that it was used by hospitals in the past who for the most part are no longer using them, is not evidence, since more recent reviews of the evidence have shown that there is no empirical evidence for these methods safety or efficacy and that these are authority-based, not evidence-based methods. And no, co-authoring a study reported in a book chapter, especially one that was not a controlled efficacy study of your intervention, does not count. What is needed to provide evidence and meet the APA’s standards for the efficacy of interventions are replicated randomized, controlled studies published in peer reviewed journals, not book chapters.

Emotional appeals that Dr. Mercer or I would not know what to do if we were confronted with an out of control child, just do not cut it. If I were to work with this population, I would make sure I was properly trained in evidence-based deescalation methods and safe, JCAHO-approved restraint methods. The last thing I would want to use is what you are recommending and I say this is just for starters, because the emotionally harsh, boot-camp nature of your proposed intervention is also highly problematic, especially when used on a population of already vulnerable children.

You constantly try to misportray me as “fringe” due to my past long-ago repudiated associations, but your methods, as stated in the BBC production of your work, are highly controversial and strongly criticized by mainstream experts on attachment, such as Peter Fonagy, who had this to say about your methods on a BBC program featuring your work from a transcript:

PROF PETER FONAGY: I’ve major worries about this notion of knocking things down in order to build them up. The normal approach to cheating behavioural disorder of this kind is to help the parents understand the child better. What is so vulnerable in these children is their sense of themselves, their sense of who they are. Now if you are systematically undermining that very fragile, that very vulnerable sense of who that child is you could end up in the situation where the child becomes really very much more depressed and hopeless and helpless.

and this:

PETER FONAGY: I think there’s a real danger in assuming that we know what’s going on in the child’s mind. How do we know that that child is going to interpret two parents trying to restrain him physically as an act of affection?

RON FEDERICI: You understand that this is practice, but you know it’s for real under…

PETER FONAGY: It’s presumptuous of us to assume that just because it involves that close physical contact it will undoubtedly be interpreted as something that’s positive.

On the contrary, my position and the position taken by Advocates for Children in Therapy is quite mainstream and not “fringe” at all and since the APA has no certification or approval process for advocacy groups, it is meaningless to say ACT is “fringe” because it is not listed by APA. Neither are a number of other reputable organizations. You are the one who is outside of the mainstream. When I did a search on your name as author on the PsycInfo and Medline databases, I did not get any peer reviewed journal articles and no, the mere mention of your name in a journal article does not make you a mainstream expert, nor do your media appearances. The media loves controversy and you definitely fit the bill.

So how about some responses to the issues at hand, rather than calling me fringe?


Monica Pignotti, PhD

[update: My own further investigation of Federici’s claimed reference to coauthoring research is that the book chapter is actually the (6th) conference proceedings from the International Association for Human Auxology which met in Tokyo in 2007. The proper reference for the book of conference proceedings is:

Ashizawa K, Cameron N. 2009. Human Growth in a Changing Lifestyle. St. Ives, Cambridge: Smith-Gordon. ISBN 978-1-85463-233-3

so these are conference proceedings, certainly not a peer reviewed journal publication, hardly seminal research and not research that directly tested the efficacy of his intervention proposed in the self-published book]

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