Scoping Review of Naturalistic Decision Making Studies Among Mental Health Professionals: Coverage of Characteristics and Contexts

Ahuna, J. K., & Becker, K. D. (2025).

Journal of Cognitive Engineering and

Decision Making, 19(1), 96–129.

https://doi.org/10.1177/15553434241303806

Abstract

The Naturalistic Decision Making (NDM) paradigm is an emerging shift in how researchers study decision making in complex, real-world situations and design decision supports. The purpose of this scoping review was to describe how the NDM paradigm was applied in studies of mental health professionals. Six bibliographic databases were searched to identify NDM studies. Each study was charted for study features, participant demographics, decision contexts, and the essential characteristics of NDM research. The search identified 26 studies published from 1989 to June 2023. Approximately 35% of studies were published in a peer-reviewed journal. Quantitative (30.8%), qualitative (34.6%), and mixed (34.6%) methods were utilized in similar percentages of studies, with social workers (61.5%) most frequently represented in these studies. Approximately 69% of studies examined assessment decisions (versus diagnosis or treatment) and roughly 96% of studies examined individuals (versus teams). Most studies explored professionals’ decision making process (73.1%) and how proficient decision makers utilized their experience to make decisions (38.5%). The NDM literature among mental health professionals is growing, with many opportunities to understand clinical decision making using well-established NDM concepts and methods. The review concludes with recommendations for both NDM and mental health services researchers. 

Here are some thoughts:

This scoping review reveals a significant underutilization and misalignment of Naturalistic Decision-Making (NDM) principles in research on mental health professionals' decision-making. Despite the complex, high-stakes, and information-rich environments in which mental health clinicians operate—conditions that align well with NDM's focus on real-world expertise—few studies meaningfully engage with core NDM characteristics. The authors conclude that the NDM paradigm remains underdeveloped in mental health research, limiting our understanding of how clinicians make effective decisions in practice. They call for more authentic NDM-based research to capture expert reasoning, support training innovations like decision-centered design and scenario-based learning, and ultimately improve clinical outcomes by bridging the gap between theory, practice, and real-world decision demands.

What Thomas Kuhn Really Thought about Scientific "Truth"

John Horgan

Scientific American

Originally posted 23 May 12

Here are two excerpts:

Denying the view of science as a continual building process, Kuhn held that a revolution is a destructive as well as a creative act. The proposer of a new paradigm stands on the shoulders of giants (to borrow Newton's phrase) and then bashes them over the head. He or she is often young or new to the field, that is, not fully indoctrinated. Most scientists yield to a new paradigm reluctantly. They often do not understand it, and they have no objective rules by which to judge it. Different paradigms have no common standard for comparison; they are "incommensurable," to use Kuhn's term. Proponents of different paradigms can argue forever without resolving their basic differences because they invest basic terms—motion, particle, space, time—with different meanings. The conversion of scientists is thus both a subjective and political process. It may involve sudden, intuitive understanding—like that finally achieved by Kuhn as he pondered Aristotle. Yet scientists often adopt a paradigm simply because it is backed by others with strong reputations or by a majority of the community.

Kuhn's view diverged in several important respects from the philosophy of Karl Popper, who held that theories can never be proved but only disproved, or "falsified." Like other critics of Popper, Kuhn argued that falsification is no more possible than verification; each process wrongly implies the existence of absolute standards of evidence, which transcend any individual paradigm. A new paradigm may solve puzzles better than the old one does, and it may yield more practical applications. "But you cannot simply describe the other science as false," Kuhn said. Just because modern physics has spawned computers, nuclear power and CD players, he suggested, does not mean it is truer, in an absolute sense, than Aristotle's physics. Similarly, Kuhn denied that science is constantly approaching the truth. At the end of Structure he asserted that science, like life on earth, does not evolve toward anything but only away from something.

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Kuhn declared that, although his book was not intended to be pro-science, he is pro-science. It is the rigidity and discipline of science, Kuhn said, that makes it so effective at problem-solving. Moreover, science produces "the greatest and most original bursts of creativity" of any human enterprise. Kuhn conceded that he was partly to blame for some of the anti-science interpretations of his model. After all, in Structure he did call scientists committed to a paradigm "addicts"; he also compared them to the brainwashed characters in Orwell's 1984. Kuhn insisted that he did not mean to be condescending by using terms such as "mopping up" or "puzzle-solving" to describe what most scientists do. "It was meant to be descriptive." He ruminated a bit. "Maybe I should have said more about the glories that result from puzzle solving, but I thought I was doing that."

As for the word "paradigm," Kuhn conceded that it had become "hopelessly overused" and is "out of control." Like a virus, the word spread beyond the history and philosophy of science and infected the intellectual community at large, where it came to signify virtually any dominant idea. A 1974 New Yorker cartoon captured the phenomena. "Dynamite, Mr. Gerston!" gushed a woman to a smug-looking man. "You're the first person I ever heard use 'paradigm' in real life." The low point came during the Bush administration, when White House officials introduced an economic plan called "the New Paradigm" (which was really just trickle-down economics).

The article is here.

Is There Such a Thing as Truth?

Errol Morris
Boston Review
Originally posted April 30, 2018

Here is an excerpt:

In fiction, we are often given an imaginary world with seemingly real objects—horses, a coach, a three-cornered hat and wig. But what about the objects of science—positrons, neutrinos, quarks, gravity waves, Higgs bosons? How do we reckon with their reality?

And truth. Is there such a thing? Can we speak of things as unambiguously true or false? In history, for example, are there things that actually happened? Louis XVI guillotined on January 21, 1793, at what has become known as the Place de la Concorde. True or false? Details may be disputed—a more recent example: how large, comparatively, was Donald Trump’s victory in the electoral college in 2016, or the crowd at his inauguration the following January? 
But do we really doubt that Louis’s bloody head was held up before the assembled crowd? Or doubt the existence of the curved path of a positron in a bubble chamber? Even though we might not know the answers to some questions—“Was Louis XVI decapitated?” or “Are there positrons?”—we accept that there are answers.

And yet, we read about endless varieties of truth. Coherence theories of truth. Pragmatic, relative truths. Truths for me, truths for you. Dog truths, cat truths. Whatever. I find these discussions extremely distasteful and unsatisfying. To say that a philosophical system is “coherent” tells me nothing about whether it is true. Truth is not hermetic. I cannot hide out in a system and assert its truth. For me, truth is about the relation between language and the world. A correspondence idea of truth. Coherence theories of truth are of little or no interest to me. Here is the reason: they are about coherence, not truth. We are talking about whether a sentence or a paragraph
 or group of paragraphs is true when set up against the world. Thackeray, introducing the fictional world of Vanity Fair, evokes the objects of a world he is familiar with—“a large family coach, with two fat horses in blazing harnesses, driven by a fat coachman in a three-cornered hat and wig, at the rate of four miles an hour.”

The information is here.

Rebooting Philosophy

By Luciano Floridi
Oxford University Press's Blog
Originally published July 12, 2014

Here is an excerpt:

Philosophy is a bit like a computer with a memory leak. It starts well, dealing with significant and serious issues that matter to anyone. Yet, in time, its very success slows it down. Philosophy begins to care more about philosophers’ questions than philosophical ones, consuming increasing amount of intellectual attention. Scholasticism is the ultimate freezing of the system, the equivalent of Windows’ “blue screen of death”; so many resources are devoted to internal issues that no external input can be processed anymore, and the system stops. The world may be undergoing a revolution, but the philosophical discourse remains detached and utterly oblivious. Time to reboot the system.

Philosophical “rebooting” moments are rare. They are usually prompted by major transformations in the surrounding reality.

The entire article is here.