Cognitive Behavioural Therapy and Increasing Access to the Psychological therapies

A Collection of Articles and Documents

IAPT/CBT CONTENTS
IABT/CBT Debate
IAPT/CBT articles and documents
Editorial
Guest Editorial

November 2007

Correspondence between Dr David Veale, President of BABCP
and Professor Andrew Samuels, UKCP





Author

Title

Description

Abbass, Allan

Intensive Short-term Dynamic Psychotherapy in a private Psychiatric Office: Clinical and Cost Effectiveness

'...ISTDP appears to be an effective and cost-effective form of intervention when provided by a psychiatrist in a private office. Randomized controlled studies are warranted to further examine the cost benefits and efficacy of ISTDP...'
open

Abbass, Allan et al
2007

 

Short-term psychodynamic psychotherapies for common mental disorders (Review)

 

'...Short-term psychodynamic psychotherapies have been subjected to randomised controlled trials for a range of common mental disorders, including anxiety disorders, depression, stress-related physical conditions, certain behaviour disorders and interpersonal or personality problems mixed with symptom disorders. Previous meta-analyses have yielded conflicting results...'

open

Abbass, Allan, 2003

The cost effectiveness of short-term dynamic psychotherapy

'...This review examines whether or not short-term dynamic psychotherapy is a cost-effective treatment...'
open

American Psychological Association

Evidence-Based Practice in Psychology APA Presidential Task Force on Evidence-Based Practice (in psychology)

 

 

'...The use and misuse of evidence-based principles in the practice of health care has affected the dissemination of health care funds, but not always to the benefit of the patient. Therefore, psychologists, whose training is grounded in empirical methods, have an important role to play in the continuing development of evidence-based practice and its focus on improving patient care...'
open

Besser, Avi et al

Systematic Empirical Investigation of Vulnerability to Postpartum Depression from a Psychodynamic Perspective: Commentary on Issues Raised by Blum (2007)

 

'...In a recent paper, Lawrence Blum (2007) identified emotional conflicts in three areas typical in postpartum depression: (a) dependency, (b) aggression, and (c) motherhood. In this commentary, we consider agreements and disagreements with Blum's views on the psychodynamics of postpartum depression. In contrast to Blum's assertion, a theoretically derived extensive empirical psychoanalytic data base exists which confirms and extends Blum's analysis of the core dynamics involved in this disorder...'

open

Blatt, Sidney J.

Et al

Empirical evaluation of the assumptions in identifying evidence based treatments in mental health

 

'...Extensive analyses of data from the remarkably comprehensive data set established by the Treatment of Depression Collaborative Research Program (TDCRP), initiated and conducted by the National Institute of Mental Health (NIMH), enabled us to examine the contributions of three dimensions of the treatment process (type of treatment, aspects of the therapeutic relationship, and patients' pretreatment personality characteristics) to three assessments of therapeutic change (symptom reduction, reduction of vulnerability, and development of adaptive capacities) evaluated at termination and extended follow-up...'
open

Blatt, Sidney J.

Evaluating Efficacy, Effectiveness, and Mutative Factors in Psychodynamic Psychotherapies

 

'...This paper demonstrates that therapeutic process variables contribute to outcome more significantly than the type of treatment per se. The authors also show that a psychodynamic framework defines and informs clinical work with these formative therapeutic processes, further documenting the importance of the therapeutic relationship and patient personality factors...'
open

Clark, Andrew F. et al

2005

Children with Complex Mental Health Problems: Needs, Costs and Predictors over One Year

'...A one-year prospective study of psychiatric diagnosis, psychosocial functioning, need status and service receipt in 60 children identified as most concerning. Results: Thirty-two (53%) had two or more disorders. The mean number of needs per child was five. One year later mean needs were unchanged but with considerable individual variation...'

open

Clarkin, John F.

Evaluating three treatments for borderline personality disorder:

A multiwave study

 

'...We examined three year long outpatient treatments for borderline personality disorder (BPD): dialectical behavior therapy (DBT), transference focused psychotherapy (TFP), and a dynamic supportive treatment (SPT). [...] Ninety patients diagnosed with BPD were randomized to TFP, DBT, or SPT, and, in addition, received medication when indicated. Blind raters assessed 6 domains, including suicidal behavior, aggression, impulsivity, anxiety, depression, and social adjustment in a multiwave design, prior to treatment and at four month intervals during a one-year period...'
open

Cooper, Mick

2008

Research findings in Counselling and Psychotherapy: An Essential Guide

 

'...For practitioners of a non-CBT disposition, summaries of empirically validated therapies can make for fairly disturbing reading: 'Surely,' you might ask, 'person-centred therapy can help people with anxiety or eating disorders or anger;' and 'What about gestalt therapy or transactional analysis or Jungian analysis or hypnotherapy or psychosynthesis - why aren't any of these approaches included on the list of ESTs?...'
open

Crump, Professor Bernard Chief Executive, Shropshire and Staffordshire SHA, NHS

The 'Better Metrics' Project

'...There had been a general concern that clinicians practising in the NHS, and practitioners in other agencies working closely with the NHS, had not always been engaged by the targets and other indicators used to performance manage and assess performance in the NHS. ...'
open

Dahlbender, Reiner, W.

Psychic Structure and Mental Functioning:

Current Research on the Reliable Measurement and Clinical Validity of Operationalized Psychodynamic Diagnostics (OPD) System *

'...The "psychic structure" axis of the OPD is one of four axes of a diagnostic system that defines clinically relevant psychodynamic constructs as much as possible close to observation and independent of any particular meta-psychological school in order to complement purely phenomenological diagnostics and descriptive systems like ICD or DSM. The axis, which has been in use under clinical everyday conditions in different settings as well as in research projects for more than 10 years, provides precise guidelines for the assessment of a patient's level of mental functioning and personal integration on the basis of his mental capacities and vulnerabilities...' open

De Maat, Saskia et al

Short Psychodynamic Supportive Psychotherapy, Antidepressants, and Their Combination in the Treatment of Major Depression: a Mega-analysis Based on Three Randomized Clinical Trials

'...The efficacy of Short Psychodynamic Supportive Psychotherapy (SPSP) has not yet been compared with pharmacotherapy. A mega-analysis based on three original Randomized Clinical Trials (RCTs) was performed. Patients with (mild to moderate) major depressive disorder were randomized in (24 weeks) SPSP (n597), pharmacotherapy (n545), or their combination (n5171). Efficacy was assessed by the Hamilton Depression Rating Scale (HDRS), Clinical Global Impression of Severity and of Improvement (CGI-S), the Symptom Checklist (SCL; depression subscale) and the Quality of Life Depression Scale (QLDS). Pearson v2 calculations were used to compare success rates...'
open

Dekker, Jacques

 

Short-term Psychoanalytic Supportive Psychotherapy for depressed patients

 

'...Short-term Psychoanalytic Supportive Psychotherapy (SPSP) is a face-to-face, individual psychotherapy, consisting of sixteen sessions in six months (first eight weekly, then eight fortnightly sessions). It is rooted in psychoanalytic theory. Its primary aim is to cure depression. To reduce patient's vulnerability to depression is a secondary goal. The emphasis is on supportive techniques that counter regression and foster psychological growth...'
open

Department of Health

Cognitive Behavioural Therapy and the Effective Treatment of Depression:

 Report for the Department of Health in support of the submission to the Comprehensive Spending Review

 

'...Despite the evidence for non-pharmacological interventions in mild depression including guided self-help, computerised cognitive behavioural therapy, exercise and brief psychological interventions, such as problem-solving therapy, access to such treatments remains limited (Lovell & Richards, 2000) and is matter of considerable concern. Of even greater concern is the limited access to effective treatments for people with moderate and severe depression as the burden of disease is much greater for depression of this severity...'
open

Department of Health

Effective Psychological Treatments for Anxiety Disorders:

A Report for the Department of Health in support of the submission to the Comprehensive Spending Review

 

 

'...This paper provides a brief overview of evidence based psychological treatments for anxiety disorders. It addresses the following questions:

How common are anxiety disorders?

What psychological treatments have empirical support?

What recovery rates can be achieved with these treatments?

How enduring are their effects?

Is there value in combining psychological treatments with medication?

Psychological treatments can be delivered in a variety of formats. This paper restricts itself to the traditional, and most extensively researched, format of face-to-face contact with a fully qualified therapist...'
open

Department of Health:

 

Improving access to psychological therapies (IAPT) programme

Computerised cognitive behavioural therapy (cCBT)

implementation guidance March 2007

Detailed implementation guidelines

open

Duncan, Barry

Evidence Based Practice (EBP): Talking Points

 

'...The intent here is not to demonize EBP-any approach can be just the ticket for a particular client-but rather expose its limitations because it is often wielded as a mandate for competent and ethical practice. Such edicts are gross misrepresentations of the data and blatant misuses of the evidence...' open

Durham, Rob

 

Long-term outcome of cognitive behaviour therapy (CBT) clinical trials in central Scotland

 

'...For the anxiety disorders treatment with CBT was associated with a better long-term outcome than non-CBT in terms of overall symptom severity but not in regard to diagnostic status. The positive effects of CBT found in the original trials were eroded over longer time periods and there is no evidence of intensity of therapy being related to long-term outcome. Long-term outcome was found to be related to the complexity and severity of presenting problems at the time of referral, to completion of treatment irrespective of modality and to the amount of interim treatment during the follow-up period...'
open

Fonagy, Peter

 

Evidence-Based Psychodynamic Psychotherapies

 

 

 

'...The key questions that should be asked of this literature given the current state of research in this area (also see Westen, Morrison, & Thompson-Brenner, 2004) are: (1) are there any disorders for which short-term psychodynamic psychotherapy (STPP) can be considered evidence-based; (2) are there any disorders for which STPP is uniquely effective as either the only evidence based treatment or as a treatment that is more effective than alternatives, (3) is there any evidence base for long-term psychodynamic psychotherapy (LTPP) either in terms of achieving effects not normally associated with short-term treatment, or addressing problems which have not been addressed by STPP?...'
open

Ford, Dominic

2005

 

Measuring quality in mental health services in the United States

'...The Institute of Medicine defined quality as "the degree to which health services for individuals and populations increase the likelihood of desired health outcomes and are consistent with current professional knowledge." This classical definition of quality is problematic for mental health, where housing, employment, psychosocial rehabilitation and peer support, for example, are an essential part of the spectrum of care...'
open

Fournier, Jay C.

 

Cognitive Therapy vs. Antidepressant Medications in the Treatment of Depressed

Patients with and without Personality Disorder 9

 

'...Conflicting evidence exists regarding the effect of comorbid personality pathology in the treatment of depression. Objective: To analyze attrition, response to treatment, and relapse in patients with and without personality disorder in data from a randomized controlled trial of cognitivetherapy versus antidepressant medication...'
open

Furukawa, Toshi A et al

Psychotherapy plus anti-depressant for panic disorder with or without agoraphobia: a systematic review

'...Objectives: To review evidence concerning short- and long-term merits and demerits of combined psychotherapy plus antidepressant treatment for panic disorder with or without agoraphobia in comparison with either therapy alone...'
open

Goodman, Robert

 

The Youthinmind algorithm for calculating added value: a novel approach to assessing CAMHS effectiveness

 

'...the youthinmind algorithm for calculating added value was developed to use information from national rather than local epidemiological surveys.  Several British surveys have shown what happens when children with mental health problems do not receive any help over the course of the next few months or years: typically they improve to some extent, with the magnitude of this 'spontaneous' improvement depending mainly on the initial level and type of the mental health problems, but perhaps also influenced by 'complexity factors' such as family type and physical health...'
open

Herzig, Abby et al

Overview of Empirical Support for the DSM Symptom-Based Approach to Diagnostic Classification

 

 

'...The current diagnostic system has great limitations, however, particularly with respect to its ability to translate from research to clinical practice and to help clinicians in their work. Over the past 30 years, the mainstream psychiatric approach to diagnosis of mental health disorders has focused on surface symptom patterns in the hopes of achieving enhanced reliability and validity for diagnostic categories. Nonetheless, many argue that in the effort to devise a more objective, reliable, and operationalizable system, the validity of the diagnostic criteria has been questionable..'.
open

HILSENROTH, MARK J.

2007

A programmatic study of short-term psychodynamic psychotherapy:

Assessment, process, outcome, and training

 

'...A hybrid model of psychotherapy research is outlined that integrates efficacy and effectiveness methodology to examine interrelated issues

regarding (a) psychological assessment, (b) psychotherapy process, (c) treatment outcome, and (d) training of graduate

clinicians. The integration of applied clinical research initiatives into a doctoral training program, clinical implications, and directions for future research are also presented...'
open

Holmes, Jeremy

All you need is cognitive behaviour therapy?

'...Psychological therapies increasingly form an integral part of government planning for mental health care, and cognitive behaviour therapy tends to be seen as the first line treatment for many psychiatric disorders
The superior showing of cognitive behaviour therapy in trials may be more apparent than real
sychotherapy is concerned with people in a developmental context and cannot be reduced to the technical elimination of "disorders"
Psychotherapy research and practice must move beyond "brand names" of different therapies to an emphasis on common factors, active ingredients, specific skills, and psychotherapy integration...'
open

House, Richard

BOOK REVIEW Science and Pseudoscience in Clinical Psychology

'...the cognitive-behavioural bias in much of the book confirms that it is broadly informed by a modernist ideology which, far from being an 'objective' and validly scientific approach to emotional and mental distress, is located within an historically specific, materialistic paradigm which has come under severe epistemological challenge on a whole range of fronts (e.g. Woolfolk and Richardson, 1984; Polkinghorne, 1990), with its assumption that only the immediately observable and measurable are deemed to count as valid scientific knowledge...'
open

In-Albon, Tina et al

 

Psychotherapy of Childhood Anxiety Disorders: A Meta-Analysis

 

'...The present study compared the efficacy of psychotherapy for childhood anxiety disorders (excluding trials solely treating post-traumatic stress disorder or obsessive-compulsive disorder)...'
open

Jenicek, Milos

 2006

Evidence-based medicine: Fifteen years later. Golem the good, the bad, and the ugly in need of a review?

 

'...Despite its well-deserved strengths, Evidence-Based Medicine (EBM)'s shell still remains half-full. Its strong points are clouded in persisting philosophical gaps and mostly ideological advancements of its concepts and rules. Further clarification of its logic and critical use of evidence is required...'
open

Kennedy, Eilis
2004

NHS

Child and Adolescent Psychotherapy: A Systematic Review of Psychoanalytic Approaches

'... Given the increasing emphasis on evidence based commissioning of services, it is important that all the evidence for the effectiveness of psychoanalytic child psychotherapy, according to accepted criteria, is being made available for scrutiny...'
open

King, Michael 

Randomised controlled trial of non-directive counselling, cognitive-behaviour therapy, and usual general practitioner care for patients with depression. I: Clinical effectiveness

'...Objective: To compare the clinical effectiveness of general practitioner care and two general practice based psychological therapies for depressed patients.
Design: Prospective, controlled trial with randomised and patient preference allocation arms.
Setting: General practices in London and greater Manchester...'
open

Knekt, Paul

 

Randomized trial on the effectiveness of long and short-term psychodynamic psychotherapy and solution-focused therapy on psychiatric symptoms during a 3-year follow-up

'... Insufficient evidence exists for a viable choice between long and short-term psychotherapies in the treatment of psychiatric disorders. Objective: To compare the effectiveness of long and short-term psychodynamic psychotherapy and solution-focused therapy in the treatment of mood and anxiety disorders...'

open

Knijnik, Daniela, Z. et al

 

A Pilot Study of Clonazepam versus Psychodynamic Group Treatment plusClonazepam in the Treatment of Generalized Social Anxiety Disorder

 

'...Psychodynamic Group Therapy (PGT) and clonazepam have proven efficacious in reducing symptoms of generalized social anxiety disorder (GSAD).Despite their efficacy, many individuals remain symptomatic after treatment with PGT or clonazepam as monotherapy. The goal of this study was to compare the efficacy of PGT plus clonazepam administered concurrently versus clonazepam alone for the treatment of GSAD...'
open

Kraft, Susanne

undated

Treatment Intensity and Regularity in Early Outpatient

Psychotherapy and Its Relation to Outcome

 

'...The distribution of treatment sessions (number of interruptions, weeks without psychotherapy, and session number) during the first three months of psychodynamic psychotherapy (PD), cognitive behavioral therapy (CBT), and psychoanalytic psychotherapy (PA) was analyzed prospectively during two-years in a sample of 256 outpatients...'

open

Luborsky, Lester 1998

The Researcher's Own Therapy Allegiances: A "Wild Card" in Comparisons of Treatment Efficacy

 

'...This report examines a possible distortion in the results of comparative treatment studies due to the association of the researcher's treatment allegiances with outcomes of those treatments. In eight past reviews a trend appeared for significant associations between the researcher's allegiance and outcomes of treatments compared. In a new review of 29 studies of treatment comparisons, a similar trend appeared. Allegiance ratings were based not only on the usual reprint method, but also on two new methods: ratings by colleagues who knew the researcher well, and self-ratings by the researchers themselves...'
open

Maina, Giuseppe et al

 

Combined Brief Dynamic Therapy and

Pharmacotherapy in the Treatment of

Major Depressive Disorder: A Pilot Study

 

'...The relative efficacy of supplemental psychotherapy in the treatment of depression is still a matter of debate. Moreover, the superiority of brief dynamic therapy (BDT) over supportive psychotherapies is not well established.

The aim of this study is to compare the efficacy of BDT added to medication with that of brief supportive psychotherapy (BSP) added to medication in the treatment of major depressive disorder...'
open

March, John S.

The Treatment for Adolescents with Depression Study (TADS):

Short-Term Effectiveness and Safety Outcomes

 

'... The empirical literature concerning the initial treatment of Major Depressive Disorder (MDD) in adolescents supports the efficacy of cognitive-behavior therapy and the selective serotonin reuptake inhibitor, fluoxetine. However, little is known about their relative or combined effectiveness. [...] In this study of outpatient adolescents with Major Depressive Disorder, the combination of fluoxetine and cognitive-behavior therapy offered the most favorable tradeoff between benefit and risk...'
open

Milrod, Barbara

Do Comorbid Personality Disorders Moderate Panic-Focused Psychotherapy?  An Exploratory Examination of the APA Practice Guideline

 

'...The APA practice guideline for Panic Disorder (PD) recommends psychodynamic psychotherapy for PD patients with comorbid personality disorders. No data underlie this recommendation. This exploratory study assessed the moderating effect of personality disorder on psychodynamic and non-psychodynamic psychotherapy outcome...'
open

Milrod, Barbara, M.D. et al

 

A Randomized Controlled Clinical Trial of Psychoanalytic Psychotherapy for Panic Disorder

'...The purpose of this study was to determine the efficacy of panic-focused psychodynamic psychotherapy relative to applied relaxation training, a credible psychotherapy comparison condition...'

open

Multiple authors ????????

Disruptive behavior disorders were defined as oppositional defiant disorder, disruptive behavior disorder, and conduct disorder as per the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria.

'...A series of studies mainly concerned with treatment of ADHD  'oppositional defiant disorder' and 'conduct disorders. The last of which concludes that: '...The evidence suggests that family and parenting interventions for juvenile delinquents and their families have beneficial effects on reducing time spent in institutions and their criminal activity. In addition to the obvious benefit to the participant and their family, this may result in a cost saving for society...'
open

Newnes, Craig

The implausibility of researching and regulating psychotherapy

 

'...This paper discusses two current themes in psychotherapy practice - research and registration - in relation to the proposals contained in the UK Government's Depression Report. Psychotherapy is highlighted as an essentially human endeavour than can be neither researched nor internally regulated outside the bounds of self interest. Nor can it conceivably produce the results that the Depression Report promises...'
open

Novotny, Catherine, M.

The Empirical Status of Empirically Supported Psychotherapies:

Assumptions, Findings, and Reporting in Controlled Clinical Trials

 

'...This article provides a critical review of the assumptions and findings of studies used to establish psychotherapies as empirically supported.  The attempt to identify empirically supported therapies (ESTs) imposes particular assumptions on the use of randomized controlled trial (RCT) methodology that appear to be valid for some disorders and treatments (notably exposure-based treatments of specific anxiety symptoms) but substantially violated for others.  Meta-analytic studies support a more nuanced view of treatment efficacy than implied by a dichotomous judgment of supported versus unsupported...'
open

Parker, Ian

Material Interests: the Manufacture of Distress

 

'...Some psychologists believe that the consciousness we have of our actions is no more than sea-froth, that this little bit extra that makes us feel human is a mere 'epiphenomenon' of the real stuff which is behaviour that can be measured and reinforced. This view of ourselves fits quite neatly with alienated life under capitalism, where we may feel our bodies to be lifeless machines in which we think but over which we have little control...'
open

Piper, William E.

2007

Group Composition and Group Therapy for Complicated Grief

 

'...This prospective study investigated the impact of group composition on the outcome of 2 forms of time-limited, short-term group therapy (interpretive, supportive) with 110 outpatients from 18 therapy groups, who presented with complicated grief. The composition variable was based on the patient's level of quality of object relations. The higher the percentage of patients in a therapy group who had a history of relatively mature relationships, the better the outcome for all patients in the group, regardless of the form of therapy or the individual patient's quality of object relations score...'
open

Pope, Catherine

2003

Resisting evidence: the study of evidence-based medicine as a contemporary social movement

Evidence-based medicine (EBM) emerged relatively recently to describe the explicit process of applying research evidence to medical practice. [...] This article shows how a social movement perspective can be used to analyse the emergence of EBM and shed light on power struggles between segments of the medical profession.
open

Raine, Rosalind, et al

2004
www.thelancet.com Vol 364 July 31, 2004

 

An experimental study of determinants of group judgments in clinical guideline development

'...Clinical guidelines for improving the quality of care are a familiar part of clinical practice. Formal consensus methods such as the nominal group technique are often used as part of guideline development, but little is known about factors that affect the statements produced by nominal groups, and on their consistency with the research evidence...'
open

Rothwell, Peter M.

Treating Individuals 1

External validity of randomised controlled trials: "To whom do the results of this trial apply?"

 

'...In making treatment decisions, doctors and patients must take into account relevant randomised controlled trials (RCTs) and systematic reviews. Relevance depends on external validity (or generalisability)- ie, whether the results can be reasonably applied to a definable group of patients in a particular clinical setting in routine practice. There is concern among clinicians that external validity is often poor, particularly for some pharmaceutical industry trials, a perception that has led to underuse of treatments that are effective...'
open

Shevrin, Howard

The Contribution of Cognitive Behavioral and Neurophysiological Frames of Reference to a Psychodynamic Nosology of Mental Illness

 

'...Shevrin, an empirical psychoanalytic researcher, draws upon the range of studies in cognitive psychology and in neurophysiology, his own and that of others, to show how they complexly interdigitate with (correlate with) psychoanalytic conceptualizations to build a multisided explanatory framework of the phenomena of mental and emotional illness, in his words, to explain comprehensively their 'irrational,' 'peremptory,' and 'unbidden' aspects...'

open

Smith, Jonathan

2007

From base evidence through to evidence base: a onsideration of the NICE guidelines

'...The author begins by noting the almost complete absence of any recommendation for Psychodynamic Psychotherapy

whether Brief or Long-term in any of the Mental Health

Guidelines published by the National Institute of Clinical

Excellence [NICE]. He questions the scientific validity of this position...'

open

Snell, Robert

Jacques-Alain Miller (ed), L'Anti-Livre noir de la psychanalyse.

'...France is facing an Anglo-Saxon invasion - by 'les TCC', les therapies cognitivo-comportementales, better known on these shores as Cognitive Behavioural Therapy. [...], CBT/TCC has in fact been part of the therapeutic landscape in France for several decades [...]What has been taking place over the last few years is, as Jacques-Alain Miller writes, a new marketing onslaught: TCC re-launched and presented to health administrators and insurance companies as "a fully developed product, meeting European and international standards, and offering rapid and low-cost solutions to the majority of psychological problems"...'
open

Stiles, William B.

Effectiveness of Cognitive-Behavioural, Person-Centred, and Psychodynamic Therapies as Practiced in National Health Service Settings

 

'...Psychotherapy's equivalence paradox is that treatments have equivalently positive outcomes despite non-equivalent theories and techniques. We compared the effectiveness of contrasting approaches practiced in routine care.

Method. Patients (n = 1,309) who received cognitive-behavioural therapy (CBT), person-centred therapy (PCT) and psychodynamic therapy (PDT) at one of 58 NHS primary and secondary care sites during a three-year period completed the Clinical Outcomes in Routine Evaluation-Outcome Measure (CORE-OM) at the beginning and end of their treatment,..'
open

Traynor, Michael 2000

 

Purity, conversion and the

evidence based movements

 

 

'...This article explores parallels between some aspects of the history of Judaeo Christianity and recent writing promoting evidence based medicine (EBM). Taking as a starting point Kristeva's and Douglas' investigations of Old Testament dietary regulation, it proposes that rigorous attention to research intake fulfils a similar symbolic function within these EBM texts as the strict dietary laws of Leviticus. It is noted that EBM texts also feature accounts of personal conversion central to evangelical religious discourse...'
open

Trowel, J

Childhood depression: a place for psychotherapy An outcome study comparing individual psychodynamic psychotherapy and family therapy.

'... the use of Individual Psychodynamic Psychotherapy or Family Therapy as treatments for depression in children and young adolescents.[...] A clinical trial assessed the effectiveness of these two forms of psychotherapy in treating moderate and severe depression in this age group. Individual Therapy and Family Therapy. A total of 74.3% of cases were no longer clinically depressed following Individual Therapy and 75.7% of cases were no longer clinically depressed following Family Therapy...'
open 

Vinnars, Bo M.A. et al

Manualized Supportive-Expressive Psychotherapy Versus Nonmanualized Community-Delivered Psychodynamic Therapy for Patients With Personality Disorders:

Bridging Efficacy and Effectiveness

'...Time-limited manualized dynamic psychotherapy was compared with community-delivered psychodynamic therapy for outpatients with personality disorders...'
open

Walach,  Harald et al

The therapeutic effect of clinical trials: understanding placebo response rates in clinical trials - A secondary analysis

'...Placebo response rates in clinical trials vary considerably and are observed frequently. For new drugs it can be difficult to prove effectiveness superior to placebo. It is unclear what contributes to improvement in the placebo groups. We wanted to clarify, what elements of clinical trials determine placebo variability.

Methods: We analysed a representative sample of 141 published long-term trials (randomized, double-blind, placebo-controlled; duration > 12 weeks) to find out what study characteristics predict placebo response rates in various diseases. Correlational and regression analyses with study characteristics and placebo response rates were carried out...'
open

Wallerstein, Robert S

Psychoanalytic Therapy Research: Its History, Its Present Status and Its Projected Future

 

'...This essay  is a historical survey of psychoanalytic therapy research, back to its beginnings with a first contribution in Boston close to a century ago, in 1917, through a slow and quite simplistic early unfolding over its first half-century, and into a recently burgeoning and increasingly sophisticated methodological and substantive development, into two differentiated, outcome and process, streams, related, but also distinctive, that characterizes its present status...'
open

Westen, Drew et al

Personality Diagnosis with the Shedler-Westen Assessment Procedure (SWAP):

Bridging the Gulf Between Science and Practice

 

'...In recent decades, the mental health professions have also emphasized data from the research laboratory over data from the clinical consulting room. Personality diagnosis once depended on expert clinical judgment and inference about subtle, textured, and nuanced personality processes. Clinicians considered a range of data, relying not just on what patients said, but also on how they said it, drawing complexly determined inferences from patients' accounts of their lives and important relationships, from their manner of interacting with the clinician, and from their own emotional reactions to the patient...'
open

Williams, D.D.R. et all

The Evidence against 'the evidence': a different perspective on evidence-based medicine

'...An evidence-based approach to psychiatry is playing and increasingly prominent role in treatment decision-making for individual patients and for populations. Many doctors are now critical of the emphsis being placed on 'the evidence' and concerned that clinical practice will become more constrained...'
open

Wise, Edward, A.
2004

Methods for Analyzing Psychotherapy Outcomes:

A Review of Clinical Significance, Reliable Change, and Recommendations for Future Directions

'...The purpose of this article is to provide a brief review of the history, development, and current status of the concepts of clinical significance (CS) and the reliable change index (RCI). I address issues regarding the development, criticisms, and applications of CS and RCI. I review the use of normative data, cutoff points, formula adjustments, and the comparative validity of various RCI methods. An examination of the convergence of multiple domains and multiple measures demonstrates ways to further develop the concepts of reliable change and CS...'
open