Psychotherapy is a medical process that involves therapeutic interaction between and a trained professional. The main conditions addressed by this process are usually psychological in nature. The psychological problems addressed through psychotherapy vary widely and thus require an experienced professional to effectively handle each case.
Psychotherapy has the goal of increasing a person’s sense of well-being. In achieving this aspect, a psychotherapist uses treatment strategies based on communication, dialogue, experiential relationship building and behavior change. These strategies aim at improving a patient’s mental health.
In this paper, the author explores the importance of psychotherapy research to the practitioners as well as the general public. The paper further explores the ethical concerns raised by patients seeking the services of psychotherapists. These concerns range from lack of reliable and consistent information, research inclusion and exclusion to language barrier and the concurrent psychotropic medication. Psychotherapists are tasked with the role of applying their professional skills and knowledge to enhance patient treatment. It is also important that the same clinicians adopt a well planned system of tracking their patients’ progress. This helps in follow up cases, record keeping and enhancement of service delivery to the patients.
Relevance and role of psychotherapy in the practice of psychotherapy
Research in psychotherapy helps in the acquisition and dissemination of relevant information in the field. The practice of psychotherapy and research are distinct but also interdependent. According to Hunsley and Lee (2006), there is a difference between the two terms. The central focus however, is anchored on how they are put into practice and research. These terms have become influential in determining the form of psychotherapy that clinicians use. Barker et al (2008) illustrates that clinical research and practice has raised a lot of concerns. These include; professional negligence, discrimination and lack of proper facilities. In the same line, Aron (1992) illustrates the major issues raised by clinicians regarding generalization of the evidence based treatment findings. This has been the same case with researchers. Most researchers disagree as to whether it is really necessary to focus on the context and the special features of an individual when implementing a treatment plan. However, Hunsley and Lee (2006) argue that clinicians should look at the possible factors that contribute to the treatment, without dwelling much on either the research or the practice. For instance, Newnham and Page (2010) suggest that taking a treatment in Europe or America is very different from taking the same treatment in other a different continent. This scenario indicates the importance of understanding the research findings because they determine the decision to implementing a given treatment plan for a patient.
Newnham and Page (2010) indicate that psychotherapy uses the experience of clinicians present in the field. Clinicians in the field have vast skills and experience,which is important because it helps build a bridge between the psychotherapy and practice as well as improving treatment for the patients. On the other hand, the bonding goals between clinical research and practice can be used by the clinicians to help people understand, and most importantly, improve treatment plans for patients. Thus, research on psychotherapy and the practice of psychotherapy complement one another. On its part,research provides a foundation for knowledge while the clinical practice uses the knowledge provided to customize the treatment (Ablon and Jones, 1999).
Ablon and Jones (1999) contend that the main reason causing conflict between clinical research and practice is interpreting research in tandem with clinical application as well as lack of knowledge on how the moderator work. Hunsley and Lee (2006) point out that if research can do more to moderate the treatment, and clinical practice do better in decision making then, the patients would enjoy quality treatment because there will be harmony in these two fields. On the other hand, Ablon and Jones (1999)point out that the process of bridging research and practice encompasses theories, methods, hypothesis testing and assessment; thus, causing variation in data evaluation among the different disciplines that exist in psychotherapy (Fitzpatrick, 1999).
Hunsley and Lee (2006) show the combination of psychotherapy research and the practice of psychotherapy can improve services rendered to the patients. They further explain that this becomes possible when the data collected from clinical practice can contribute to the research being carried out, and also assist in treating the patient (2006). Clarkin et al also supports this claim, suggesting that the data collected ensures the research is aligned with the clinical practices ( 2007). According to Fitzpatrick (1999) data kept by clinicians can be used in collaboration with researchers to offer a wide range of knowledge for predicting similar occurrences. Fitzpatrick (1999) also emphasizes that it is pointless for clinicians to assume the role of researchers. This is because they are researchers in the sense that they can accept a particular combination of treatment which they view is fit for the patient. They can also come up with strategies which are beneficial for the treatment of the patient (Fitzpatrick, 1999). Therefore, research and practice bridge the gap in psychotherapy and the practice of psychotherapy.
Limitation of the psychotherapy research for the practice of psychotherapy
According to Clarkin et al (2007) various concerns have revolved around the psychotherapy research and the practice of psychotherapy. These concerns have elicited major incompatibility of psychotherapy research and the practice of psychotherapy. Though these fields are closely related, the concerns are traced from their division. One major challenge that psychotherapist face is lack of reliable and consistent information. Mullen and Streiner (2004. p. 113) point out that this concern makes it difficult for clinicians to come up with accurate decisions on the appropriateness of the treatment strategy to use on their patients.
On their part, Mullen and Streiner (2004. p. 114) claim the presence of clinical representatives in the treatment study contribute to the ineffectiveness of psychotherapy research. They contend that during research selection, researchers may use inclusion or exclusion criteria based on the results they anticipate to achieve on the participants. In situations where the inclusion method is used, Mullen and Streiner (2004. p. 116) suggest that there is a likelihood of a chosen participant to have a condition needed for the designed study. On the other hand, in the exclusion method, some potential participants may be eliminated from the study (Clarkin et al., 2007). This might omit some facts from the study. As the study proceeds in both inclusion and exclusion methods, other challenges such as; lack of language skills, symptoms of other disease and concurrent psychotropic medications become eminent.
Kazdin (2002) points out the psychotherapy research provides insufficient information on evidence based treatment in clinical practice. This is because the scope of research is often narrow.This aspect is attributed to the little extraction of information on a range of conditions and treatment that patients may have (Kazdin, 2002). However, Clarkin et al (2007) notes that a lot of effort is being conducted to bridge this gap and address specific problem experienced in clinical practice at various levels of treatment.
Moreover, Hunsley (2007) demonstrates that the restriction of psychotherapy research lies in its applicability in the real world. On this aspect, he notes that for several years, researchers have been keen on distinguishing between treatment efficacy and treatment effectiveness (Barker et al., 2009).They have established the previous research on the topic has not been applied in the clinical practice (Barker et al., 2009). Mostly, the efficacy has been delivered in a research clinic and not in a service clinic, whose key purpose is to improve the efficiency in health service delivery (Barker et al., 2009).
Finally, the psychotherapy research involves intense and challenging treatment plan. Thus, patients are likely to be excluded from the research process. This occurs when patients are found to have medical conditions that would have a risk in the treatment process (Hunsley, 2007).This claim shows that there are many challenges associated with psychotherapy research in complementing psychotherapy treatment.
In a nutshell, evidence based practice in psychotherapy is not a static process, but rather a dynamic process that requires both continuous education and progressive quality assurance from the practitioners (Newnham and Page, 2010). According to Newnham and Page there is a need for a comprehensive research that is more effective in addressing the issues of clinical conditions that are encountered by clinicians practicing psychotherapist treatment (2010).Similarly, a research that compares the effectiveness of how evidence based research complements the standard clinical practice should be highlighted (Hunsley, 2007).Presently, there is a huge gap existing in literatures on the issues posed by the psychotherapy research.This shows a need for a continuous research in the area (Ablon and Jones, 2002).
Recommendation for improving psychotherapy research to make it valuable to the practitioner
In this paper, the author has shown that evidence based research to routine clinical application is a challenging task for clinicians. Besides, many clinicians do not see the necessity in putting empirical findings into practice by involving their patients. This is because they lack confidence in their findings (Ablon and Jones, 2002). Similarly, even when a patient shows a progressive change, clinicians are often biased in accepting the results.
There are some strategies which clinicians should adopt in improving psychotherapy research to ensure accuracy of the findings, and their practicability in real life situations. One of the recommendations clinicians should embrace is appreciating professionalism when dealing with the patient (Ablon and Jones, 1999). This will ensure the patient feel safe and assured in regard to the treatment being given.
Secondly, it is important for clinicians to develop a system that monitors the patient’s progress during and after the treatment.This will enable them to track the progress of their patients as well as respond with speed on patient’s concerns (Waller 2009).
Patient focused research should be embraced by clinicians as an important part of their practice.The research provides the possibility of eliminating scientific- practitioner schism through a number of ways. These include; facilitating evaluation of the effectiveness of the treatment, assessing the progress of the patient, and grouping patients according to their progress and outcomes (Newnham and Page, 2010).By embracing focused research, clinicians will know the various strategies to apply during treatment.
It is important for psychotherapy researchers and practitioners to establish a consensus and a strong medical care database.This would eliminate obstacles they face in their field. Also, harmonizing different fields will ensure various concerns are addressed and resolved. Similarly, this approach will ensure the research findings provide varying interpretation; hence improving decision making.
Clinicians need to appreciate the written materials they use for their research. These materials can act as references for future research. The sources can also be used as a foundation attaining more knowledge. this will help the clinicians to have more concrete knowledge of the diverse patient situations they may come across in practice.
Though more much knowledge may be provided by the evidence based research, clinicians sometimes ignore, or are reluctant to use the information provided. It is important for them to understand that the findings posted by researchers are suitable for use and if implemented properly, they can guarantee good results.
In the recent past, psychotherapy practitioners have relied on efficacy study to defend given treatment strategies.They would benefit by adopting interventions that improve health care and guarantees satisfaction both to them and the patient. It is important for clinicians to understand that their judgment has an impact on a patient.They should keep a positive mind to help patients not to fall back to their critical conditions.It is also important to have systems that assess the patient’s progress throughout the treatment period and allow responses from clinicians.
Ablon, J. S.,& Jones, E. E. (2002). Validity of controlled clinical trials of psychotherapy: Findings from the NIMH Treatment of Depression Collaborative Research Program. The American Journal of Psychiatry, 30(159), 775-783.
Ablon, J. S., & Jones, E. E. (1999). Psychotherapy process in the National Institute of Mental Health Treatment of Depression Collaborative Research Program. Journal of Consulting and Clinical Psychology, 67, 64-75.
Aron, L. (1992). Interpretation as an expression of the analyst’s subjectivity. Psychoanalytic Dialogues, 50 (2), 475-507.
Barker, T.B., McFall, R.M., and Shoham, V. (2008). Current Status and Future Prospects of Clinical Psychology. A Journal of the Association for Psychological Science, 9 (2), 67-103
Clarkin, J. F., Levy, K. N., Lenzenweger, M. F., & Kernberg, O. F. (2007). Evaluating three treatments for borderline personality disorder: A multiwave study. The American Journal of Psychiatry, 164 (6), 922-928.
Fitzpatrick, K. (1999). Terms of endearment in clinical analysis. Psychoanalytic Quarterly, 34(68), 119-125.
Hunsley, J. (2007). Addressing Key Challenges in Evidence-Based Practice in Psychology. Professional Psychology: Research and Practice, 38 (2), 113- 121
Hunsley, J., & Lee, C. M. (2006). Introduction to clinical psychology: An evidence- based approach. Toronto: Wiley.
Kazdin, A. E. (2000). Evidence-Based Treament and Practice: New Opportunities to Bridge Clinical Research and Practice, Enhance the Knowledge Base, and Improve Patient Care, American Psychologist, 63 (8) 146-159
Newnham, E. A, and Page, C.A. (2010). Bridging the Gap between best evidence and the best practice practice in mental health. Clinical Psychology Review, 56 (30), 127-142