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Experimental versus naturalistic psychotherapy research: consequences for researchers, clinicians, policy makers, and patients

Mattias Desmet (UGent)
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Abstract
During the first half of the twentieth century, psychotherapy research was synonymous to single case research. Research and practice were highly integrated in this era, but to be considered full-fledged scientific research, the case descriptions lacked methodological rigor. From 1970 onwards, the experimental Randomized Controlled Trial (RCT) design gained momentum in the field of psychotherapy research and the single case paradigm was marginalized. In this article, it is argued that the classical RCT design is ethically troublesome, created a dramatic gap between research and practice, fails to yield the promised ‘objective’ evaluation of the efficacy of psychotherapy, and systematically disadvantages the types of therapy that prove to be most effective in everyday clinical practice. For several reasons, returning to the classical single case paradigm, however, is not an option. As an alternative, a research program based on naturalistic effectiveness studies and empirical single case studies is put forward. It is argued that, compared to RCT research, this type of research (1) is methodologically superior, (2) is more informative towards clinicians, (3) is a more reliable basis for anticipating cost-effectiveness of psychotherapy.
Keywords
Naturalistic Psychotherapy Research, RCT design, Experimental Psychotherapy Research

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MLA
Desmet, Mattias. “Experimental versus Naturalistic Psychotherapy Research: Consequences for Researchers, Clinicians, Policy Makers, and Patients.” PSYCHOANALYTISCHE PERSPECTIEVEN, edited by Filip Geerardyn, vol. 31, no. 1, 2013, pp. 59–78.
APA
Desmet, M. (2013). Experimental versus naturalistic psychotherapy research: consequences for researchers, clinicians, policy makers, and patients. PSYCHOANALYTISCHE PERSPECTIEVEN, 31(1), 59–78.
Chicago author-date
Desmet, Mattias. 2013. “Experimental versus Naturalistic Psychotherapy Research: Consequences for Researchers, Clinicians, Policy Makers, and Patients.” Edited by Filip Geerardyn. PSYCHOANALYTISCHE PERSPECTIEVEN 31 (1): 59–78.
Chicago author-date (all authors)
Desmet, Mattias. 2013. “Experimental versus Naturalistic Psychotherapy Research: Consequences for Researchers, Clinicians, Policy Makers, and Patients.” Ed by. Filip Geerardyn. PSYCHOANALYTISCHE PERSPECTIEVEN 31 (1): 59–78.
Vancouver
1.
Desmet M. Experimental versus naturalistic psychotherapy research: consequences for researchers, clinicians, policy makers, and patients. Geerardyn F, editor. PSYCHOANALYTISCHE PERSPECTIEVEN. 2013;31(1):59–78.
IEEE
[1]
M. Desmet, “Experimental versus naturalistic psychotherapy research: consequences for researchers, clinicians, policy makers, and patients,” PSYCHOANALYTISCHE PERSPECTIEVEN, vol. 31, no. 1, pp. 59–78, 2013.
@article{5645063,
  abstract     = {{During the first half of the twentieth century, psychotherapy research was synonymous to single case research. Research and practice were highly integrated in this era, but to be considered full-fledged scientific research, the case descriptions lacked methodological rigor. From 1970 onwards, the experimental Randomized Controlled Trial (RCT) design gained momentum in the field of psychotherapy research and the single case paradigm was marginalized. In this article, it is argued that the classical RCT design is ethically troublesome, created a dramatic gap between research and practice, fails to yield the promised ‘objective’ evaluation of the efficacy of psychotherapy, and systematically disadvantages the types of therapy that prove to be most effective in everyday clinical practice. For several reasons, returning to the classical single case paradigm, however, is not an option. As an alternative, a research program based on naturalistic effectiveness studies and empirical single case studies is put forward. It is argued that, compared to RCT research, this type of research (1) is methodologically superior, (2) is more informative towards clinicians, (3) is a more reliable basis for anticipating cost-effectiveness of psychotherapy.}},
  author       = {{Desmet, Mattias}},
  editor       = {{Geerardyn, Filip}},
  issn         = {{0771-5862}},
  journal      = {{PSYCHOANALYTISCHE PERSPECTIEVEN}},
  keywords     = {{Naturalistic Psychotherapy Research,RCT design,Experimental Psychotherapy Research}},
  language     = {{eng}},
  number       = {{1}},
  pages        = {{59--78}},
  title        = {{Experimental versus naturalistic psychotherapy research: consequences for researchers, clinicians, policy makers, and patients}},
  volume       = {{31}},
  year         = {{2013}},
}