The pursuit of consensus in psychotherapy research and practice.

Goldfried, Marvin R.

doi:10.1093/clipsy.6.4.462

Cited by 8 publications

(9 citation statements)

References 20 publications

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“…Such skepticism may not be unreasonable given the lack of current research attention to the realities of the usual care practice context (e.g., the differences between the efficacy research treatment context and community‐based mental health clinics; Addis, Wade, & Hatgis, 1999; Burns et al., 1999; Hawley & Weisz, 2002; Hoagwood et al., 2001; Weisz et al., 1995; Weisz & Hawley, 1998). This skepticism may also partly reflect a long‐standing rift between researchers and clinicians, where clinicians feel disenfranchised by researchers, believing that research often disregards their realities and invalidates their experience as professionals (Abrahamson, 1999; Fensterheim & Raw, 1996; Goldfried, 1999; Norcross, 1999). Long implicit, this rift has become more explicit and openly debated recently, even in the lay media.…”

Section: Need For Hybrid Research On Children's Mental Health Carementioning

confidence: 99%

Examining Psychotherapy Processes in a Services Research Context.

Garland

Hurlburt

Hawley

2006

Clinical Psychology: Science and Practice

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Interdisciplinary research efforts integrating services and interventions research methodologies are needed to improve the "real-world" clinical utility and impact of youth mental health research. "Hybrid" services and interventions research efforts can capitalize on the methodologic strengths of each research tradition in order to more rigorously examine and affect therapy processes in usual care youth mental health service settings. The goals of this article are to (a) identify the need for hybrid practice research on youth mental health care; (b) present a "case example" of a hybrid study, where child and family therapy processes are being examined in a usual care, practice-based context by a team of services researchers; (c) address the potential advantages and challenges of hybrid research; and (d) suggest promising areas for future hybrid research in youth mental health care.Mounting frustration about the ubiquitous gap between the science and the practice of mental health care has prompted calls for more innovative, interdisciplinary, and collaborative research efforts. The articles in this special series highlight current interdisciplinary efforts to expand knowledge about processes of care at multiple levels in community-based practice settings, illustrating the potential benefits of integrating the disciplines of mental health services research and interventions research. In this article, we discuss how such hybrid approaches incorporating elements of both services and interventions research can capitalize on the complementary aims and methodologic strengths of both research traditions in order to more rigorously examine and affect therapy processes in youth mental health service settings. The goals of this article are to (a) identify the need for hybrid practice research on youth mental health care; (b) present a "case example" of a hybrid study, where child and family therapy processes are being examined in a usual care, practice-based context by a team of services researchers; (c) address the potential advantages and challenges of hybrid practice research; and (d) suggest promising areas for future research.

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Section: Need For Hybrid Research On Children's Mental Health Carementioning

confidence: 99%

Examining Psychotherapy Processes in a Services Research Context.

Garland

Hurlburt

Hawley

2006

Clinical Psychology: Science and Practice

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“…For example, blue-ribbon panels commissioned to examine the state of mental health services in community settings have consistently concluded that clinicians delivering community mental health services demonstrate only limited knowledge of validated treatment approaches, and even when such professionals do become informed, they find such approaches neither feasible nor relevant to their treatment settings and population (National Advisory Mental Health Council, 1999). Widely known as the "researcher-practitioner gap" (Goldfried, 1999;Greenberg, 1994), this current disconnection between psychotherapy science and mental health services might inadvertently reflect the minimization of the therapist as a significant participant in psychotherapy research, as well as the epistemological disfavor shown nonmechanistic approaches that privilege the therapy relationship (Abrahamson, 1999;Bohart, O'Hara, and Leitner, 1998). Of additional concern is the fact that impact of overall treatment quality and appropriateness are infrequently examined at policy, program, and institutional levels (Magura, 2000;Magura, Schildhaus, Rosenblum, and Gastfried, 2002), and only limited work has been produced regarding how these interact with patients' geographical, cultural, and ethnic differences (Berlin, 2002;Snowden and Yamada, 2005).…”

Section: Clarkmentioning

confidence: 99%

Contemporary Psychotherapy Research: Implications for Substance Misuse Treatment and Research

Clark¹

2009

Substance Use & Misuse

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This article provides an overview of the major findings of psychotherapy research and discusses the possible implications of these findings for substance user treatment researchers and practitioners. While the centrality of relationship for human change processes was historically understood, twentieth century research tended to see relationship and person variables as secondary to operationalized "mechanisms of action" unique to particular psychotherapies. Interestingly, recent meta-analytic investigations have uncovered the weakness of randomized controlled trials (RCT) comparison investigations that have, until recently, represented the "gold standard" for the field. There has been a resurgent interest in the "common factors" that appear to be important across many effective psychotherapies. In addition, psychiatric anthropologists have contributed important information about the problems of client noncompliance with mental health treatment that parallel quantitative investigations. Substance misuse researchers have also found that client characteristics, especially clients' readiness to engage treatment, are important to investigate. The importance of the "therapeutic alliance" and the characteristics of clients and clinicians have become central areas for study, rather than variables to be controlled or excluded. Emphasis on these factors may represent the future for research in psychotherapy and substance user treatment, especially if researchers and community practitioners can join together to overcome methodological feasibility and dissemination problems that plague effectiveness research. However, the continued attractiveness of comparative studies and treatment efficacy studies may represent longstanding epistemological assumptions and responses to economic incentives that will be difficult to challenge.

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“…75 Given the difficulties obtaining consensus even in the natural sciences, we must be scrupulous not to prematurely demand that clinicians should adhere to manuals not fully developed through all three stages. 58,59,76 Additionally, developing valid measures of competence is much easier said than done. 77,78 We also need to recognize and respect that good clinicians often combine different theoretical approaches to address the individual clinical situation.…”

Section: Palliative Care Manualized Communication Approaches Might Bementioning

confidence: 99%

Manualized Communication Interventions to Enhance Palliative Care Research and Training: Rigorous, Testable Approaches

Weiner

Arnold

Curtis

et al. 2006

Journal of Palliative Medicine

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Palliative care practice requires excellent communication between the patient, family, and clinical team. Experts in the field have proposed a variety of communication interventions that can be used in the palliative care setting. However, these interventions are at a high level of generality: the specifics of each intervention are not well codified; the individual steps in each intervention are not easily reproducible and thus not comparable between practitioners; the methods to measure adherence to these communication protocols have not been established; and there is little detail on how to adapt these general interventions to the individual patient and family. Therefore, we lack good evidence for the efficacy of these recommendations. This paper makes the case for development of structured, testable approaches to communication that will inform clinical practice and communication training. To do so, palliative care communication should be conceived as a formal medical and psychosocial intervention-a potential treatment with risks and benefits to be systematically researched and operationalized in the same manner as medication interventions. As we illustrate, psychotherapy research has faced the same challenges in the past and has utilized manualized treatments to meet its goals. Through such approaches, we can begin to address the most basic intervention questions such as protocol efficacy, dose-response, side effects, and the optimal process and content of communication with the patient and family. The advantages of manualized communication approaches; some concepts underlying manual construction; and challenges to extending manualized communication to the palliative care domain are discussed.

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The pursuit of consensus in psychotherapy research and practice.

Cited by 8 publications

References 20 publications

Examining Psychotherapy Processes in a Services Research Context.

Examining Psychotherapy Processes in a Services Research Context.

Contemporary Psychotherapy Research: Implications for Substance Misuse Treatment and Research

Manualized Communication Interventions to Enhance Palliative Care Research and Training: Rigorous, Testable Approaches

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