心理治疗循证实践中“证据”的四个基本问题

循证实践正在成为西方心理治疗发展的主流方向。但如何理解循证实践的"证据"仍是见仁见智。部分社会大众甚至心理学专家仅将"循证"当作一种"修辞"或"时尚",顾名思义地界定"证据",或按主观信仰随意地选择与应用"证据"。文章以"证据"为研究焦点,试图建构系统理解"证据"的全面图景,探讨了心理治疗循证实践中关于"证据"的4个基本问题:(1)从历史考察与理论分析的视角出发,探讨了"心理治疗为什么需要证据";(2)从证据的类型范围、生产者及存在形式三个视角,描述了"心理治疗存在哪些证据";(3)从证据的科学程度、研究设计的严谨程度及解决实践问题的契合程度出发,阐述了"哪些证据才是好的证据";(4)从6个步骤推广证据及创新研究设计两个方面展开,分析了"在现实世界中如何推广与应用证据"。     

Researching psychotherapy integration: A heuristic approach

Moustakas argues that questions and methodology in heuristic research flow out of inner awareness, meaning and inspiration. The approach might arguably embrace a combination of qualitative research methods, and constitute a kind of bricolage. This paper describes a heuristic enquiry into psychotherapy integration that used such a combination of methods – an interpretative phenomenological approach, case studies, reflexive action, and writing. It demonstrates how each of these methods contributed to the six phases of heuristic enquiry, from the initial engagement with psychotherapy as a trainee to the creative synthesis of published works and a PhD thesis, together with some reflection on the enquiry's limitations and rigour. Published texts, training, clinical practice and reflexivity constituted the material from which a new organizing framework for understanding psychotherapy integration was formulated. The author reflects on how the research design allowed deep engagement with this material, and changed his perspective of psychotherapy integration. In conclusion, this paper suggests that both psychotherapy integration and heuristic enquiry can only be conducted on an individual and personal basis, and that it is the quality of the relationship, with the client, or the research material, that produces results.     

Die DPG-Praxis-Studie

All psychotherapeutic methods must be scientifically evaluated. Empirical evaluation of evidence is a prerequisite for acceptance as scientific psychotherapy as well as for payment by health insurance. Currently the psychotherapy methods accepted within the German health system (behavioural therapy, psychodynamic psychotherapy, and analytic psychotherapy) are reviewed by a governmental evaluation committee concerning evidence, necessity and cost-effectiveness. The DPG practice study has basically two aims: 1) to conduct a large naturalistic study to investigate effectiveness, sustainability and economic aspects of psychodynamic and analytic psychotherapy and 2) to offer a framework for psychoanalytic institutes, members, candidates or groups to realize own research ideas by collecting additional data within the study. The present article describes the background, main research questions, structure and design of the DPG practice study with regard to the evaluation questions.     

Conventions and Their Role in Language

Two of the most fundamental questions about language are these: what are languages?; and, what is it to know a given language? Many philosophers who have reflected on these questions have presented answers that attribute a central role to conventions. In one of its boldest forms such a view runs as follows. Languages are either social entities constituted by networks of social conventions or abstract objects where when a particular community speaks a given language they do so in virtue of the conventions operative within that community. Consequently, for an individual to know a given language is for them to be party to the relevant conventions. Call this view conventionalism. In this article my aim is to evaluate conventionalism. I will argue that although there are linguistic conventions and that they do play an important role in language development and communication conventionalism should be rejected in favour of a more psychologistically orientated position.     

网络成瘾症治疗方法研究进展

利用文献分析方法分析和总结了目前国内关于网络成瘾治疗方法的研究进展。简要回顾了网络成瘾症的概念、症状、诊断标准、分类和病因研究现状;介绍和分析了现有文献已报道的心理治疗、药物治疗、整合治疗单元、家庭治疗、社会支持治疗等方法;对网络成瘾治疗方法研究现状进行了讨论并提出了几点研究建议。     

Comparing qualitative research methodologies for systemic research: the use of grounded theory, discourse analysis and narrative analysis

Many of the qualitative research methods developed in the social sciences are well suited to explore research questions pertinent for the systemic field, and make a good fit with systemic thinking. In this paper I briefly outline the value of qualitative research for systemic psychotherapies. I explore some parallel developments in the field of qualitative research and systemic therapy which can inform each other. Three qualitative methodologies, a grounded theory approach, discourse analysis and narrative analysis, particularly useful for the research of subjective experience and meaning, are briefly outlined. To compare and contrast these methodologies, I discuss their application to a pilot study concerning the experiences of living life in more than one language. I demonstrate how each research methodology can highlight different aspects of qualitative research material and address different research questions. The challenge of how these methodologies may be further developed for systemic research is posed.     

The Chestnut Lodge Kiosk: Observations on a Psychiatric Hospital's Work Project Part Two

This article reviews some of the health care issues raised by K. Roy MacKenzie. The author identifies additional contributors to spiralling costs and offers a slightly different perspective on the issue of the efficacy of short-term time-limited psychotherapy. In particular, the author raises questions regarding the cost-driven aspect of today's health care delivery system versus quality of care. He also challenges some of the research findings used in support of MacKenzie's argument that short-term time-limited group therapy is as cost-effective as long-term individual psychotherapy. More specifically, he considers how resistance and the sense of hopefulness might influence the favorable outcomes of the studies cited in MacKenzie's article. In addition, the relationship between short-term psychotherapy and managed care abuse is addressed and a partial solution to preventing such abuse by legislating public accountability is offered.     

Translational research: how social psychology can improve psychotherapy

In an effort to generate innovative treatments, the National Institute of Mental Health has made translational research for alleviating mental illness a major funding priority. Although translational research is a powerful approach for moving basic science findings into novel treatments, it remains ambiguous and rarely implemented in psychology. The current article describes conceptual and methodological issues involved with translational research, including considerations about time frame, scope of hypothesis tested, dose of treatment, contraindication, and sampling. Translational concepts and methods are illustrated with areas of social psychology that are promising for translation into solutions for pressing questions in psychotherapy research.     

VALIDITY OF THE PEARSON‐JOHNSON TAXONOMY OF COMPREHENSION QUESTIONS

Questions constitute an important component of reading instruction and several studies suggest that the Pearson‐Johnson taxonomy of comprehension questions can be applied in classroom situations. However, the validity of the taxonomy has not been directly investigated. The present study was conducted for this purpose and involved 82 fourth‐ and fifth‐grade students. Three research questions were investigated: (1) do mean scores for the taxonomy categories correspond to theoretical expectations regarding difficulty?; (2) do response patterns to questions correspond to taxonomy categories?; and (3) are the relationships among scores on the types of questions logical and to be expected? The results of the study generally conformed to theoretically derived expectations.     

A Social Constructionist Model of Therapeutic Factors

Evidentiary support for the efficacy of therapeutic models has been a contentious issue since the professionalization of psychology. Despite advances in evidence-based practices in psychology and common factors research, discontent still exists among postmodern psychotherapists in that evidence is mainly defined in modernist/positivistic terms, thereby excluding therapeutic models based on alternative nonpositivistic epistemologies. I proposes a model, which is based on social constructionist theories, for investigating the therapeutic efficacy of various approaches. This article evaluates and differentiates between two models for viewing the efficacy of psychotherapy, namely outcome versus process efficacy. A social constructionist model of therapeutic factors is proposed as a means to incorporate therapeutic factors into psychotherapy processes that are consistent with a social constructionist theory of change. Three main therapeutic elements, which are identified as central to an effective psychotherapy process, are outlined in the model. The proposed model may be useful as a guide to efficacious psychotherapy and as a means for investigating the efficacy of social constructionist therapies.     

Social cognition in the first year

Although the study of infancy has answered many important questions about the human capacity for social cognition, the relatively young field of developmental social cognition is far from reaching its adulthood. With the merging of developmental, behavioral and neurocognitive sciences, some growing pains are in store. New work demonstrates that research into early social cognitive development must integrate various research fields and methods in order to achieve a more robust understanding of the nature and parameters of human social cognition.     

Mentalisierungsbasierte Psychotherapie bei schizophrenen Psychosen

Recently, there has been growing interest in new methods of psychotherapeutic interventions for schizophrenic patients. Social cognition, social functioning and quality of life are central objectives. Mentalization-based therapy (MBT) is a specific psychodynamic method developed from the fundament of attachment theory and empirical psychotherapy research for the treatment of borderline personality disorder, particularly focusing on attachment relationships, mentalizing capacity and affect regulation. Studies have shown that MBT is able to ameliorate interpersonal experience and social life. The latest neuroscientific findings support this view and encourage the application of a modified form of MBT in the treatment of schizophrenic patients. The authors present a concept for disorder-specific interventions in schizophrenia, including psychoeducational aspects and mentalizing exercises which step-by-step lead to a more reflective work in mentalization-based group psychotherapy.     

Grounded Theory methods in child psychotherapy research

This article considers the place of qualitative research in psychoanalysis and child psychotherapy. It discusses why research methodology for many years occupied so small a place in these fields, and examines the cultural and social developments since the 1960s which have changed this situation, giving formal but also qualitative methods of research much greater significance. It reflects on the different pressures to develop explicit research methods which arise both from outside the psychoanalytic field, as a condition of its continued professional survival, and from within it, where its main aim is the development of fundamental psychoanalytic knowledge. It suggests that the conduct of mainly quantitative research into treatment outcomes is largely a response to these external pressures, whilst the main benefits to be gained from the development of qualitative research methods, such as Grounded Theory, are in facilitating the knowledge-generating capacities and achievements of child psychotherapists themselves. The paper describes Grounded Theory methods, and explains how they can be valuable in the recognition of hitherto unrecognised meanings and patterns as these are made visible in clinical practice. Finally, it briefly describes three examples of completed doctoral studies, all of which have added significantly to the knowledge-base of child psychotherapy, and which demonstrate how much can be accomplished using this method of research.     

Couple Therapy Research and the Practice of Couple Therapy: Can We Talk?

As has been true in every other realm of psychotherapy, couple therapy research generally has had very little impact on the day-to-day practice of couple therapists. To a significant degree, this unfortunate disconnection may be attributable to an overemphasis by researchers in the field on treatment packages and therapeutic methods/techniques. Insufficient attention has been paid to other important sources of influence on treatment outcomes, especially the couple therapist herself/himself. It is argued that effective couple therapy requires a good "fit" between the person of the therapist and her primary theoretical orientation, and that couple therapists may be more influenced by research that addresses process aspects of the therapeutic approaches to which they have their primary theoretical allegiances.     

On the mechanisms and effects of feedback in group psychotherapy

Group psychotherapists commonly see feedback as one of the primary mechanism that furthers the goals of the group. This paper will summarize the research that has been done on the mechanisms leading members to produce feedback, the factors that induce members to accept feedback (for example, feedback valence and timing), and the effects of feedback on outcome and aspects of group process such as group cohesion. The article will address the practical implications of these findings for the interventions of the group psychotherapist. As will be discussed, the emphasis on the importance of feedback in the interpersonal group psychotherapy literature exceeds the programmatic research that has been done on basic questions. This paper will identify major lines of future investigation that could yield findings critical to the delivery of effective group psychotherapy such as the information processing sequences that underlie feedback delivery and reception.     

Clinical evaluations for transfer of juveniles to criminal court: current practices and future research

Completing clinical evaluations of juveniles considered for transfer to criminal court requires specialized expertise. However, there is little empirical foundation upon which they can be based. Within each of the three major evaluation domains (amenability to treatment, risk for future violence, and sophistication/maturity), we ask the following questions: a) Can forensic examiners properly assess this area, and if so using what tools?; b) How can social science research clarify the transfer evaluation, particularly as it is impacted by systems issues?; and c) How should the evaluation be structured? In doing so, we review clinical suggestions for completing these evaluations and identify pertinent research directions. A number of general issues specific to these evaluations are also discussed. © 1997 John Wiley & Sons, Ltd.     

Confirmatory Factor Analysis of the Structure of Adult ADHD Symptoms

Previous research has examined the factor structure of ADHD symptoms in adults using confirmatory factor analysis and there is mixed support for two-factor, three-factor, or more complex bifactor models. The current study re-examines these factor structures on the basis of not only overall model fit, but also criteria such as chi-square difference tests, invariance, reliability, and validity. Three datasets were pooled to form a total sample of 430 adults (50% female). Participants completed questionnaires assessing their ADHD symptoms, education, psychopathology, and parenting (the latter as validity variables). Although the bifactor models demonstrated the best fit, the reliability and construct replicability of specific factors in these models was poor. The three-factor model had good fit and demonstrated good reliability, validity, construct replicability, and some invariance across gender and dataset. Our results replicate previous studies that find superior fit for bifactor models. However, the superior statistical fit may reflect only the increased complexity of these models. The more parsimonious three-factor model may demonstrate stronger validity and clinical utility.     

Social R & D as a relational contract: Strategies for governing knowledge transactions

With intermittent federal support for social research and development (SR&R), potential users among state and local policymakers face a difficult dilemma over the future availability of useful research products. Two questions are central: 1) can inexpensive sources of SR&D be developed to replace federal ones and, more importantly, 2) will the states be able to influence the direction and content of this research so that it contains some measure of relevant and timely policy knowledge? This article translates these questions into the problem of developing an individualized strategy for governing publicly-funded SR&D. Two alternative approaches to understanding social R&D questions are considered, one centering on the research provider, and the other on governing the relationship between the sponsors and the providers of research. The intent of the analysis is to focus attention on the design of alternative arrangements for SR&D compatible with the needs and resources of the small-scale, public investor.