Of interventive doppelgangers and other barriers to evidence-based practice in psychotherapy.

Abstract

Despite a long history, psychotherapy research has been mired by sundry conflicts, the most vexing of which involves establishing the profession as an evidence-based practice. Beginning in the mid-1990s, and continuing today, psychotherapy has struggled to reach consensus regarding the meaning, methods, and implementation of evidence-based practice. Much of this struggle has centered on the overreliance on, and conflation of, random controlled trial research as the cynosure of evidence-based practice. This, in tandem with the proliferation of psychotherapy models and their manifold interventive doppelgangers (differently named interventions that are functionally equivalent), has led the profession to an evidentiary impasse. It is suggested that shifting the target of evidence-based practice to mechanisms of change serves as an antidote to random controlled trials' shortcomings while also redressing the proliferation problem. Advancing this approach, however, will require a spirit of inclusive collaboration fostered, in part, by a shift from persuasion to translation as a means to untether scholars from their intellectual anchors.

Experiential Avoidance and Hyperreflexivity as Variables Associated with Depression: A Process-Based Approach

“…This is also in alignment with the integrative approach in psychotherapy, which recognizes that much of the disagreements between different psychotherapy models stem from a linguistic issue: the use of different terms to describe the same phenomenon (Goldfried, 2019). Indeed, some intervention proposals aim to combine various techniques from different psychotherapeutic models into a single intervention (Barlow et al, 2017), but this requires clarifying which processes of change are involved, so that different terms are not used for the same process (Nuttgens, 2023). There are several proposals to base psychotherapy research on processes or mechanisms of change, including both traditional (Goldfried, 2019) and more recent approaches (Hofmann, 2020;Hofmann & Hayes, 2019).…”

Evidence-Based Treatment in Practice: PCIT Research on Addressing Individual Differences and Diversity Through the Lens of 20 Years of Service

“…When these treatments are examined closely, a high degree of content overlap and similarity in theoretical foundations and implementation can be found. [11][12][13][14] Many of these treatment programs have important core components that (a) support parents to use reinforcement through positive attention and to establish appropriate boundaries and guidelines, (b) provide information about and practice with effective parent-child interactions, and (c) assist parents and children in improving their regulation of emotions. 12,14 Programs with these components are often found to have the most robust efficacy in rigorous studies and the greatest effectiveness in real-world settings.…”