scholarly journals What Research Evidence Is Valid for Psychotherapy Research?

2021 ◽  
Vol 11 ◽  
Author(s):  
Björn Philips ◽  
Fredrik Falkenström
Keyword(s):  
Research Evidence ◽  
Controlled Trial ◽  
Psychotherapy Research ◽  
Experimental Methodology ◽  
Psychotherapy Process Research ◽  
Complex Disorders ◽  
Causal Connections ◽  
Life Saving ◽  
Change Mechanisms ◽  
Based Medicine

Evidence-Based Medicine (EBM) have contributed to improved clinical practice with increased use of effective and life-saving treatments for severe diseases. However, the EBM model is less suitable for psychotherapy research than for pharmacological research and somatic medicine. The randomized controlled trial (RCT) design is an example of experimental methodology, which inevitably has more imperfections in psychotherapy research because psychotherapy RCTs cannot use double-blinding and the treatments tested are composite treatment packages. Long-term psychotherapy for severe and complex mental disorders is especially difficult to study with an RCT design. During the last decades, advanced analytic methods have been developed in psychotherapy process research, which enables investigation of causal connections regarding change mechanisms in psychotherapy. Therefore, we propose that the top of the research evidence hierarchy for psychotherapy should encompass: (1) RCT for circumscribed disorders, (2) cohort studies for complex disorders, and (3) advanced process studies for change mechanisms.

Themes and Lessons Learned

2016 ◽  
pp. 337-361
Keyword(s):  
Clinical Trial ◽  
Mixed Methods ◽  
Case Studies ◽  
Quantitative Methods ◽  
Psychotherapy Research ◽  
Positive Outcome ◽  
Lessons Learned ◽  
Qualitative And Quantitative Methods ◽  
Change Mechanisms

Case Studies Within Psychotherapy Trials: Integrating Qualitative and Quantitative Methods presents a specific, mixed-methods approach, called the “Cases Within Trials” (CWT) model, to psychotherapy research, combining the results from a randomized clinical trial (RCT) with systematic case studies involving contrasting outcomes drawn from the experimental condition of the RCT; and a synthesis of the two types of knowledge. Chapters 3–6 of the book present four specific and diverse projects that concretely illustrate the CWT method. In Chapter 8 the editors analyze the four chapters and explore emergent themes in the knowledge gained from them. In the process, the editors systematically compare the positive-outcome and negative-outcome cases across the four projects, highlighting, for example, (a) the importance of contextual variables in creating the conditions for change mechanisms to be activated; (b) the multidimensional, reciprocally interactional nature of the therapy process; and (c) the particular role of therapist responsiveness.

scholarly journals Challenges Facing New Educators: Expanding Teaching Strategies for Clinical Reasoning and Evidence-Based Medicine

2018 ◽  
Vol 13 (4) ◽  
pp. 359-366 ◽  
Author(s):  
Jessica L. Barrett ◽  
Craig R. Denegar ◽  
Stephanie M. Mazerolle
Keyword(s):  
Adult Learning ◽  
Learning Theory ◽  
Clinical Reasoning ◽  
Evidence Based Medicine ◽  
Research Evidence ◽  
Faculty Members ◽  
Evidence Based ◽  
New Faculty ◽  
Constructivist Learning Theory ◽  
Based Medicine

Context: It is the educator's responsibility to prepare the students to be clinicians who think and reason critically while integrating research evidence into practice. Those new to the role of faculty member, who lack clinical and teaching experience, face challenges in the classroom application of those concepts. Objective: To discuss the challenges facing new faculty members and present strategies for addressing them. Specific faculty challenges addressed include learning their roles as educators and teaching multifaceted concepts, such as clinical reasoning and evidence-based medicine. Background: Experience provides a framework for a professional to balance multiple demands, whether as a new instructor teaching or a clinician synthesizing information to determine a course of action. Many new educators do not have extensive experience either clinically or in the classroom. This can cause anxiety as educators are confounded by their roles and responsibilities. Students likewise lack experience and may not possess the ability to systematically analyze patient encounters or research evidence. Constructivist learning theory paired with adult learning principles can address the learning needs of faculty members and students alike. Recommendation(s): Programs must provide assistance for new faculty and implement strategies for students to learn reasoning skills. Use of constructivist learning theory and application of the adult learning model are ways to address these deficiencies. Integrating concepts of active learning and self-direction while aligning expectations and creating overlap between classroom and clinical domains can assist in addressing the challenges faced by new faculty and students. Conclusion(s): The systematic process of evidence-based decision making is grounded in utilizing evidence. Strategies must be identified and implemented throughout curricula to target and enhance students' abilities to organize and synthesize information. Educators must use new methods in their own learning and teaching to enhance their students' abilities. New faculty members in particular require assistance in negotiating their roles.

The research evidence base for homeopathy: a fresh assessment of the literature

Homeopathy ◽  
2003 ◽  
Vol 92 (02) ◽  
pp. 84-91
Author(s):  
RT Mathie
Keyword(s):  
Clinical Trials ◽  
Research Evidence ◽  
Controlled Trial ◽  
Relative Number ◽  
Evidence Base ◽  
Weight Of Evidence ◽  
Clinical Effects ◽  
Upper Respiratory Tract ◽  
Medical Conditions ◽  
Double Blind

Abstract Background. The claims made for the clinical effects of homeopathy are controversial. The results of several meta-analyses of clinical trials are positive, but they fail in general to highlight specific medical conditions that respond well to homeopathy. Aims. This review examines the cumulative research from randomised and/or double-blind clinical trials (RCTs) in homeopathy for individual medical conditions reported since 1975, and asks the question: What is the weight of the original evidence from published RCTs that homeopathy has an effect that is statistically significantly different from that in a comparative group? Method. Analysis of the 93 substantive RCTs that compare homeopathy either with placebo or another treatment. Results. 50 papers report a significant benefit of homeopathy in at least one clinical outcome measure, 41 that fail to discern any inter-group differences, and two that describe an inferior response with homeopathy. Considering the relative number of research articles on the 35 different medical conditions in which such research has been carried out, the weight of evidence currently favours a positive treatment effect in eight: childhood diarrhoea, fibrositis, hayfever, influenza, pain (miscellaneous), side-effects of radio- or chemotherapy, sprains and upper respiratory tract infection. Based on published research to date, it seems unlikely that homeopathy is efficacious for headache, stroke or warts. Insufficient research prevents conclusions from being drawn about any other medical conditions. Conclusions. The available research evidence emphasises the need for much more and better-directed research in homeopathy. A fresh agenda of enquiry should consider beyond (but include) the placebo-controlled trial. Each study should adopt research methods and outcome measurements linked to a question addressing the clinical significance of homeopathy's effects.

Person-Centered Research: A novel approach to Randomized Controlled Trials

2018 ◽  
Vol 6 (2) ◽  
pp. 209
Author(s):  
Reza A Badian ◽  
Brendan McCormack ◽  
Vibeke Sundling
Keyword(s):  
Randomized Controlled Trial ◽  
Randomized Controlled Trials ◽  
Study Design ◽  
Controlled Trial ◽  
Controlled Trials ◽  
Evidence Based ◽  
Randomized Controlled ◽  
Centered Care ◽  
Based Medicine ◽  
Novel Design

Introduction: Integrating person-centered values with randomized controlled trials methodology is a novel idea. Person-centeredness is gaining steadily more prominence and attention in healthcare and health-related policy and research. Randomized controlled trials are considered as the gold standard in evidence-based medicine for evaluating the effects of treatment or determining the causal effect. A wide array of study designs is available, but there is a lack of designs with both strong person-centered principles and a strong position with respect to the level of evidence. In this paper we intend to introduce a novel design to fill such a gap.Aims and objectives: The aim of this paper is to introduce a novel study design where essential values of person-centered care (PCC) are integrated with randomized controlled trial (RCT) methodology into a novel study design termed a person-centered randomized controlled trial (PC-RCT).Methods: In this paper we discuss the importance and role of evidence in clinical research, levels of evidence, as well as the significance of study design in evidence-based medicine. Moreover, we discuss randomized controlled trials that are considered the gold standard to achieve high quality evidence. In this paper we will explain what the concept of person-centered care is and discuss the values associated with person-centeredness.The theoretical and methodological considerations that are relevant in applying this concept will be discussed before presenting how we intend to incorporate person-centered values into a randomized controlled trial in a novel study design that is both person-centered and randomized controlled (PC-RCT). Different aspects of this proposed novel study design will be discussed, including the theory and methods underlying this new proposed design, its novelty, different stages and practical steps involved in this proposed design. Challenges, drawbacks and possible solutions for addressing challenges of this novel design will be explored, focusing on the construct, dynamics, advantages, disadvantages and novelty of PC-RCT design.Conclusion: This paper presents how person-centered values and traditional randomised controlled trial principal values are integrated into one study design where the strengths of both concepts are merged into one. The proposed novel study design has stronger person-centered characteristics and is solid in its RCT features. This design ensures that participants have much more active participation in decision-making and gain more choice in their treatment. The proposed novel study design in this paper has clearly an important role to play in satisfying the need for a study design that can address both the need for rendering higher levels of evidence as well as simultaneously securing greater integration of person-centered values in the same study design.

Patient Information on Evidence and Clinical Effectiveness of Psychotherapy

2020 ◽  
Author(s):  
Charlotte Blease ◽  
John M. Kelley ◽  
Manuel Trachsel
Keyword(s):  
Research Evidence ◽  
Treatment Options ◽  
Common Factors ◽  
Psychotherapy Research ◽  
Clinical Effectiveness ◽  
Evidence Base ◽  
Relative Importance ◽  
Considerable Controversy ◽  
Specific Factors ◽  
The Common

This chapter focuses on what information should be provided to patients about the evidence base supporting the clinical effectiveness of psychotherapy. In particular, the authors consider whether research on the relative efficacy of different forms of psychotherapy should be provided to patients, as well as whether patients should be provided with information on the relative importance of common factors versus specific factors as the causal agents of clinical improvement. After a critical review and discussion of the relatively few scholarly papers that have previously addressed this question, the authors conclude that patients should be provided with an honest, transparent, and impartial summary of the evidence related to their treatment options including information about the common factors. The authors offer this conclusion even while acknowledging that considerable controversy persists about how to interpret the psychotherapy research evidence base. Finally, the authors strongly support continued research into these questions, especially given the relatively limited scholarly attention they have received to date.

scholarly journals Evidence-Based Medicine as a Tool for Undergraduate Probability and Statistics Education

2015 ◽  
Vol 14 (4) ◽  
pp. ar42 ◽  
Author(s):  
J. Masel ◽  
P. T. Humphrey ◽  
B. Blackburn ◽  
J. A. Levine
Keyword(s):  
Scientific Method ◽  
Statistics Education ◽  
Controlled Trial ◽  
General Interest ◽  
Chance Events ◽  
Exploratory Data ◽  
Attitudes Toward Statistics ◽  
Probability And Statistics ◽  
Based Medicine ◽  
Biology Curriculum

Most students have difficulty reasoning about chance events, and misconceptions regarding probability can persist or even strengthen following traditional instruction. Many biostatistics classes sidestep this problem by prioritizing exploratory data analysis over probability. However, probability itself, in addition to statistics, is essential both to the biology curriculum and to informed decision making in daily life. One area in which probability is particularly important is medicine. Given the preponderance of pre health students, in addition to more general interest in medicine, we capitalized on students’ intrinsic motivation in this area to teach both probability and statistics. We use the randomized controlled trial as the centerpiece of the course, because it exemplifies the most salient features of the scientific method, and the application of critical thinking to medicine. The other two pillars of the course are biomedical applications of Bayes’ theorem and science and society content. Backward design from these three overarching aims was used to select appropriate probability and statistics content, with a focus on eliciting and countering previously documented misconceptions in their medical context. Pretest/posttest assessments using the Quantitative Reasoning Quotient and Attitudes Toward Statistics instruments are positive, bucking several negative trends previously reported in statistics education.

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