Building a Rigorous and Relevant Knowledge Base for the Psychological Therapies

Barkham, Michael; Stiles, William B.; Lambert, Michael J.; Mellor‐Clark, John

doi:10.1002/9780470687994.ch2

Cited by 68 publications

(58 citation statements)

References 84 publications

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“…To consider whether any psychotherapy is useful and safe requires the critical integration of evidence from each stage of the hourglass. This means adopting position of equipoise regarding externally valid practice‐based evidence (PBE) from effectiveness studies situated in routine clinical services, to that of internally valid evidence‐based practice (EBP) style research trials (Barkham et al ., ). No systematic review has been previously conducted to explore the state of the outcome evidence base for CAT.…”

Section: Introductionmentioning

confidence: 97%

“…In the language of CAT, this has been termed the ‘uptake versus credibility’ dilemma (Marriott & Kellett, ). The consideration of the evidence base for any psychotherapy is a complex endeavour, as it requires the critical evaluation and assimilation of a typically diverse range of evidence across a range of outcome methodologies (Barkham, Stiles, Lambert, & Mellor‐Clark, ).…”

Section: Introductionmentioning

confidence: 99%

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Cognitive analytic therapy: A review of the outcome evidence base for treatment

Calvert

Kellett

2014

Psychol Psychother

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Purpose This study reviews the quality of the extant outcome evidence for cognitive analytic therapy (CAT) to inform clinical practice and to stimulate a future CAT research strategy. Method An electronic search identified CAT efficacy and effectiveness studies and these were subject to systematic review. The methodological quality of studies meeting inclusion criteria were appraised using two validated research study quality checklists and studies were fitted to an established model of psychotherapy evaluation. Results Twenty‐five outcome studies met the inclusion criteria, including five randomized controlled trials. The CAT evidence base is predominated by small‐scale practice‐based studies, in typically complex and severe clinical populations – 44% were focal to the treatment of personality disorder. Although the quality of extant CAT evidence is generally sound (52% of studies were high quality), the depth and breadth of the evidence base is currently limited. Where comparisons with other modalities are available, CAT appears largely equivocal. Conclusions Cognitive analytic therapy is a popular and promising intervention for complex presentations. However, the evidence base currently lacks wider credibility due to having largely bypassed the rigours of the controlled phase of the hourglass model of psychotherapy evaluation. There is a particular need for further CAT outcome research with common mental health problems. Practitioner points CAT can be an effective intervention across a range of mental health difficulties. Consider a 24‐session CAT contract for those patients presenting with complex and severe difficulties. Practice research networks could make a significant contribution to the CAT evidence base.

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Section: Introductionmentioning

confidence: 97%

Section: Introductionmentioning

confidence: 99%

Cognitive analytic therapy: A review of the outcome evidence base for treatment

Calvert

Kellett

2014

Psychol Psychother

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“…For instance, Barkham, Stiles, Lambert, and Mellor-Clark (2010) suggested that regular institutional use of repeated measures of distress can provide opportunities for assessment of therapy quality and have important implications both for individual cases and for larger entities such as mental health agencies. Other authors (e.g., Howard, Moras, Brill, Martinovich, & Lutz, 1996) have suggested that routine assessment in clinical practice can help address the research question, "What particular treatment may work most efficiently for a particular patient?"…”

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confidence: 99%

Clinical validity of the Counseling Center Assessment of Psychological Symptoms-62 (CCAPS-62): Further evaluation and clinical applications.

McAleavey¹,

Nordberg²,

Hayes³

et al. 2012

Journal of Counseling Psychology

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Self-report instruments of psychological symptoms are increasingly used in counseling centers but rely on rigorous evaluation of their clinical validity. Three studies reported here (total N = 26,886) investigated the validity of the Counseling Center Assessment of Psychological Symptoms-62 (CCAPS-62; Locke et al., 2011) as an assessment and screening instrument. In Study 1, initial evidence regarding the concurrent validity of the CCAPS-62 was replicated and extended in a naturalistic clinical sample of clients from 16 counseling centers. Using this sample, convergent validity of the subscales was examined in counseling center clients, the range of sensitivity of the subscales was investigated using item-response theory, and the presence of 2nd-order factors was preliminarily examined. In Study 2, 7 of the 8 CCAPS-62 subscales statistically significantly differentiated between students in counseling and those who were not, using data collected from a large national survey, although most differences were small and the groups' distributions overlapped considerably. Cut scores based on the differences between these clinical and nonclinical populations showed limited utility due to overall similarities between these broadly defined groups. In Study 3, therapist-rated diagnoses collected from 5 university counseling centers were used to further examine the validity of subscale scores. In addition, cut points for diagnostic screening using receiver operating characteristic curves were evaluated. Overall, these studies support the use of the CCAPS-62 as an initial measure of psychological symptoms in college counseling settings, provide additional information about its psychometric performance, develop cut scores, and illustrate the potential for collaboration between practitioners and researchers on a large scale.

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“…In this sense, 'evidence' is the basis for beliefs about what will work in supervision. However, there is a recognised hierarchy of trustworthiness or plausibility under-pinning these various forms of evidence, from the 'gold standard' of the randomized controlled trial to formally-developed expert consensus (Barkham et al 2010b;Bower and Gilbody 2010;Elliott 2002).…”

Section: Why Do We Need Ebp In Clinical Supervision?mentioning

confidence: 99%

A Rationale for Evidence-Based Clinical Supervision

Milne

Reiser

2011

J Contemp Psychother

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Although modern mental health systems increasingly require evidence-based practice (EBP), clinicians continue to object to restrictions on their professional independence, which they may perceive as counterproductive, divisive and even demeaning. In the face of such deep-seated objections, do we really need to strive for an evidence-based approach to supervision? We believe so, and begin our argument by noting a colourful illustration of the problems that can exist in the absence of EBP, those of poor training, therapist drift and weak professional regulation. Next, we present EBP as a mechanism to reduce such unacceptable variability in the way that treatments are delivered. We then apply the lessons from this divisive situation to the practice of clinical supervision, outlining a rationale for an inclusive, synergistic way forward. A number of fundamental psychological motives for this integration are noted, including supervisor training that is informed by practice-based research, corrective feedback on supervision, and a supportive professional system. Illustrative examples are provided in each of these areas. It is concluded that the traditional gulf between research and practice can and should be bridged in relation to supervision.

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Building a Rigorous and Relevant Knowledge Base for the Psychological Therapies

Cited by 68 publications

References 84 publications

Cognitive analytic therapy: A review of the outcome evidence base for treatment

Cognitive analytic therapy: A review of the outcome evidence base for treatment

Clinical validity of the Counseling Center Assessment of Psychological Symptoms-62 (CCAPS-62): Further evaluation and clinical applications.

A Rationale for Evidence-Based Clinical Supervision

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