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In this volume, we, as editors, have endeavored to present the student and interested professional and practitioner with an understanding of the most salient issues and trends confronted by the psychotherapy researcher. Thus, many theoretical viewpoints are represented, with none having a monopoly over the others.

This is as it should be, given the data collected by clinical researchers at this time. Convert currency. Add to Basket. Condition: New.

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Language: English. Brand new Book. Psychotherapy research is undoubtedly one of the most puzzling, diverse, com- plex, controversial, and multidimensional areas tackled by clinical psycholo- gists, psychiatrists, and psychiatric social workers. In order to accomplish this task, we asked our colleagues, who are experts in their respective areas, to share their current thinking with us and with you, the read- ers. We have also attempted to capture the excite- ment that has permeated the field in the past 30 years or so.

Concerning study says psychotherapy research has a problem with undeclared researcher bias

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Scott D. Miller on Psychotherapy Research, Expertise and the use of Feedback Systems

Established seller since Seller Inventory IQ Shipped from UK. Seller Inventory APC Just as in sponsored drug studies, this number is too way high to discount the presence of a significant bias in the studies. They show that one therapy is slightly more advantageous than the other, but that the actual improvement of the subjects was so minimal as to be inconsequential. When both groups of therapists who are providing the treatment in the study are equally committed to the paradigms they are delivering, comparative psychotherapy outcome studies almost always result in a tie.

Treatment as Usual. Additionally, if the researcher were able to do so, the study might not show his or her therapy to be superior to another type. Some may see practitioners from other therapy schools, some may get medications, some may get both, and many others may get neither.

Both the TAU group and the experimental group are followed up at equal time intervals and given all the same outcome measures. The psychotherapy methodology that serves as the investigated treatment always seems to beat TAU.


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The reader should understand that within any widely-practiced therapy model, both good therapists and bad therapists can be found, just as practicing physicians can be either good or bad psychopharmacologists. For the subjects in the TAU condition who receive treatment, the average results of the good clinicians in the community are probably cancelled out by those of the bad ones.

Opinion ARTICLE

TAU subjects may also be seen less frequently. Some, as I mentioned, are getting no treatment at all. The psychotherapy that is provided is applied with rigor and consistency, and is scrutinized by other observers through the use of videotapes of the sessions. Therapists who make errors are supervised almost immediately. On top of this, research therapists often have caseloads that are very much smaller than those of folks out in practice, allowing them to spend more time deciding how to approach the clinical issues they face.

Research matters

These factors may be the real reasons their patients do better than those receiving TAU. I cannot recall a single instance of a study in which TAU beat another therapy delivered in such a manner. If it did, I would have to wonder how the experimenter could have possibly accomplished such an unlikely feat. Funding Issues. Another big issue for the field concerns which psychotherapy treatment outcome research studies get funded.

If a scientist cannot get money for a project, it will rarely get off the ground, because these types of studies are very expensive to mount. Problems with Generalizability of Study Results. This requirement means that patients who have more than one DSM disorder or psychological problem are often excluded from studies. In contrast, most patients seen in practice, at least by psychiatrists, have more than one disorder co-morbidity.

We do not know from a study using patients who have only one disorder if the treatment employed in the study would work as well with patients who have multiple problems. Because studies need subjects who will stick with the treatment until the end of the research project, some subjects who have certain characteristics that are common in clinical practice tend to be excluded.

This problem further limits the generalizability of the study. For instance, most studies of treatments for depression exclude patients who are suicidal! CBT studies, as do many others, tend to have a fairly high dropout rate. The subjects who end up completing the study are usually the most motivated to change, and would therefore be expected to do better than those who lack this motivation. This all makes the treatment method look much better than it would be if it were employed in a typical clinical practice setting. Unfortunately, a good therapist has to be flexible and employ a variety of different strategies in ways that are tailored to the proclivities and sensitivities of the patient in front of them.

Generic interventions may not only fail to work, they may backfire and make matters worse.


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Treatment and adherence manuals take away a lot of this flexibility, so that the therapy as performed in an RCT is not always similar to the way that clinicians out in the field practice it. Creating treatment manuals can itself be a daunting task. I heard a respected researcher tell a group of other researchers that his team was having trouble designing such a manual because the founder of the treatment they wanted to study was observed to perform psychotherapy completely differently than his own wife, who supposedly was a practitioner of the same model of therapy.

There are many many factual inaccuracies in your article and as a whole, it just doesnt make any sense. This is true because, in a sense, the therapist — or more correctly the relationship between the patient and the therapist — is the treatment. Also, when you open an article with language like 'purveyors of CBT who tout Your condescension is so obvious that it makes undermines the objectivity of the whole article.

Having a third party control for certain therapist behavior is certainly better than nothing, but hardly qualifies as double blinding. Human behavioral exchanges are very complex - the controls would have to not only be for what the therapists actually said but for every single voice inflection and facial expression they exhibited during the entire session.


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If you've got a study that does that, please forward the reference. I'd love to see it. Perhaps you have not run into psychology professors from all therapy schools, not just CBT'ers who "tout" their treatments as all but panaceas, but I've listened to a lot of them who would surely qualify, and have heard many other stories from psychology interns from all over the country. If you'd like to mention any other "factual inaccuracies" in my post, I'd be happy to address them, or correct them if you are right.

So why bother with psychotherapy if it cannot be easily validated reproducibly and if not, what would happen if people did not attend therapy? Would it matter? Is it just a lot of hot air? Actually, we know quite a lot about a whole bunch of different ways to influence people to change their ideas and behavior, as well as ways to reduce certain feelings and moods. The point of the blog post is that these techniques have to be individualized to specific patients and altered from moment to moment during therapy depending on the patient's response.

Because of this, the usual "empirical" ways of measuring treatment effectiveness in groups do not tell us a lot. The very same technique that works well with one patient may make matters worse in a similar patient. People can always choose to cooperate or not cooperate with the therapist, unlike with chemicals, waves, and medical procedures such as anesthesia. Most surveys of psychotherapy patients show that, while some felt it did not help, a significant majority felt that they benefited from the experience.

David M. Allen, M. Problematic marital interactions usually occur in a wider context. Many mentally ill individuals now live on the streets or are treated in jail. We often derive our meaning in life by fitting in with our groups. Back Psychology Today. Back Find a Therapist. Back Get Help.