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Issues in evaluation of psychotherapies

Wolpert, M; Fugard, A; Deighton, J; (2013) Issues in evaluation of psychotherapies. In: Cognitive Behaviour Therapy for Children and Families, Third Edition. (pp. 34-48).

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Abstract

© Cambridge University Press 1998, 2005, 2013. Introduction This chapter aims to help frontline CBT therapists to appreciate the key issues in the evaluation of psychotherapies including a consideration of how best to undertake routine evaluation of their own practice. The first part provides an overview of current issues in academic research and evaluation of psychotherapy. It explores how researchers have attempted to address the key challenges, namely: the inference of causality in relation to hypothesised therapeutic impact; linking change to potential underlying mechanisms; and assessing the everyday life significance of impact. The second part focuses on issues faced by those who wish to undertake routine evaluation of their own clinical practice, in particular: how to choose what, how, when and whom to evaluate, as well as how practitioners might make use of any information derived from such endeavours to inform their own practice. The chapter concludes by considering possible ways forward whereby academic and practitioner evaluation can combine in helpful ways to improve our understanding of this complex but vital area. Research questions To combine and paraphrase the wisdom of many authors in this area, the aim of academic evaluation of psychotherapy is to determine ‘what works for whom and why?’. Building on Kazdin (2008, p. 151) the following list can be seen to be amongst the key questions researchers are seeking to address: What is the impact of treatment relative to (a) no treatment and (b) other treatments for a given problem? What components contribute to change and what parameters can be varied to improve outcome? What patient, therapist, treatment and contextual factors moderate or mediate outcomes? What processes within or during treatment are responsible for mechanisms of therapeutic change? To what extent are treatment effects generalisable across populations, problem areas and contexts? What are the costs, risks and benefits of intervention or lack of intervention (including economic costs but also risks of iatrogenic effects of treatment or risks of harm by lack of treatment)? What processes outside treatment are responsible for change? Thanks to a range of impressive research over the last few decades we now have important research findings particularly in relation to question 1 above (the detail of which in relation to CBT for children is covered in individual chapters in this book), but without a comparable increase in our knowledge regarding questions 2–7.

Type: Book chapter
Title: Issues in evaluation of psychotherapies
ISBN-13: 9781107689855
DOI: 10.1017/CBO9781139344456.006
UCL classification: UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Clinical, Edu and Hlth Psychology
URI: http://discovery.ucl.ac.uk/id/eprint/1395209
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