PYCHOTHERAPY AND RESEARCH
Psychotherapy is a scientific profession. Research in the field of psychotherapy can be considered as a continuous, structured, methodological process of reflection on clinical practice, related to knowledge based on research into the functioning of human beings.
Scientific grounding means that the theory has a scientific basis, that there are case descriptions, qualitative research, empirical processes and research results, and a combination of qualitative and empirical research.
The concept of evidence-based medicine (EbM), which was primarily developed for the purpose of pharmacy testing, describes and originally contains all these types of research. If a concept contains all categories of research design, it is a useful concept. Unfortunately, some research experts from certain countries tend to view only randomized controlled trials (RCTs) as the “gold standard” in evidence-based medicine. This is a very controversial topic in the scientific community. Some researchers consider this to be an abuse of the concept of evidence-based medicine [1] and absolutely inappropriate for psychotherapeutic research.
A wide range of research conducted in the last few decades has yielded evidence to support the effectiveness of psychotherapy as such. [2] However, there are many unanswered questions, such as “How does psychotherapy work?”, “What are the mechanisms of change?”, “What are the basic and specific competencies of therapists that result in successful therapies?”, Which obliges all psychotherapeutic modalities to continue research.
Such questions can only be answered if both qualitative and quantitative methods are used in research design and if the dynamics and process of the relationship between therapist and client are properly observed. This cannot be achieved by simple randomized controlled trials.
It is important for Public Health to have research with a high level of external validity, which means results obtained as part of everyday practice (this is called naturalistic design) and not in laboratories with well-distributed groups of patients.
European laws on psychotherapy should insist on accepting a wide range of research designs for scientific evaluation, which are appropriate for the specific process of psychotherapy, ie the interaction between therapist and client as a co-creation of the healing process.
[1] Kriz, J. (2014.) Koliko je očigledno zasnivati znanost na dokazima? O dobrom konceptu – i njegovoj zloupotrebi. (Wie evident ist Evidenzbasierung? Über ein gutes Konzept – und seine missbräuchliche Verwendung.) u: S. Sulz (izd.), Psihoterapija je više od znanosti. Je li izvanredna stručnost ugrožena reformom? (Psychotherapie ist mehr als eine Wissenschaft. Ist hervorragendes Expertentum durch die Reform gefährdet?) (str. 154–185). München: CIP
[2] Wampold B, Imel. Z.E. (2015): Velika psihoterapijska debata, 2. izdanje. (The Great Psychotherapy Debate. 2nd edition.) London, Routledge
RESEARCH – One of the Ethical Principles
The decision to conduct research is based on a thoughtful assessment by individual psychotherapists / supervisors (researcher) of how they can best contribute to science and human well-being. The research is conducted with respect and concern for the dignity and well-being of the people involved and knowing the rules and professional standards that apply when conducting research with people as participants.
When planning research, the researcher is responsible for conducting a careful assessment of its ethical acceptability. If the consideration of scientific and human values indicates a violation of any principle, the researcher must, in this regard, distance himself. The primary ethical concern of the researcher is to consider whether, in relation to accepted standards, the participant in the planned research will be a “risk subject” or a “minimal risk subject”.
The researcher respects the individual freedom of the person to refuse to participate in the research or to withdraw from it at any time.
The researcher protects the participant from physical and mental discomfort, harm and danger that could arise from the research process. If there is a risk of such consequences, the researcher informs the participant. Research procedures that may cause permanent or serious harm to participants are not used. The participant must be informed of the procedures for contacting the researcher within a reasonable period of time after the research in the event of stress, potential harm, or related issues or concerns.
After collecting the data, the researcher informs the participants about the nature of the research and tries to eliminate any misconceptions that may have arisen. The information obtained during the research about individual participants is confidential, unless otherwise agreed in advance.
The psychotherapist will work with children and minors with respect for the child’s personality in accordance with the United Nations Convention on the Rights of the Child (New York 1989) and with the written consent of the parent or guardian.