Psychotherapy and Research: A Relation That Needs to Be Reinvented

Abstract

In this paper I question whether the randomized controlled trial (RCT) and the evidence‐based medicine model are well suited for psychotherapy research. First I discuss general characteristics of the randomized controlled trial and argue that, given a number of incompatibilities with the discipline of psychotherapy, these trials tend to provide us with data that have limited validity. The methodological objections I raise are important as the treatment protocols produced within the context of randomized controlled trials tend to be forced upon clinical practice in uncritical ways. On the other hand, I argue that systematic research is relevant for psychotherapy. If research is designed to address concerns arising from clinical practice – in particular, the far‐reaching complexity of the therapeutic encounter – it can be a powerful tool for further developing our discipline.

Evaluation of long-term counselling at a community health service for women who are on a low income

“…Levels of satisfaction with the counselling and the counsellor were high. However, responses to satisfaction surveys tend to be positive (Edwards & Staniszewska, 2000), so, as suggested by Edwards and Staniszewska, and by Vanheule (2009), responses to open-ended questions were utilised to identify helpful and unhelpful aspects of the service and of the counselling relationship, although enquiries were not made about the counselling process in general. Gallagher et al (2005) suggested that the quality of the relationship with a counsellor is an issue considered to be of primary concern to service users.…”

“…Winter et al (2003) evaluated brief psychodynamic counselling offered by a large voluntary organisation and also found significant improvements in clients' CORE-OM scores. However, studies should also examine service users' views and experiences (Edwards & Staniszewska, 2000;Vanheule, 2009). McLeod et al (2000) found that themes that emerged from clients' experiences of brief counselling included the importance of having someone to talk to, being able to express emotion, gaining a broader perspective on a problem, and developing selfconfidence.…”

“…Bower, Rowland, & Hardy, 2003). Westen et al (2004) and Vanheule (2009) suggest that financial concerns and the attempt to compare psychotherapy to pharmaceutical treatments are what drive this emphasis on short-term therapy, rather than our knowledge about the inner dynamics of the psychotherapeutic process. Yet little research has evaluated longer-term treatment, although studies of psychoanalytic therapy over a number of years suggest that it can result in lasting changes in mental and social functioning (e.g.…”

“…For practical and ethical reasons they are arguably more suitable than Randomised Controlled Trials (cf. Vanheule, 2009;Westen, Novotny, & Thompson-Brenner, 2004). Since benchmarking on standardised measures of outcome is now available (Mullin, Barkham, Mothersole, Bewick, & Kinder, 2006), this may be used in such studies.…”

Dreaming the research process: a psychotherapeutic contribution to the culture of healthcare research

“…Mainstream research in counselling and psychotherapy, as in many other human science fields, has rather uncritically adopted the post-enlightenment exclusion of the non-rational from serious scientific thought (Vanheule, 2009). However, as Freud (1976) pointed out, neglected aspects of mental life may reappear in dreams, which may bring not only personal but social and cultural phenomena into awareness.…”