The fundamental need for lived experience perspectives in developing and evaluating psychotherapies.

Abstract

This article discusses the fundamental need for lived experience perspectives in developing and evaluating psychotherapies. The primary professional goal of clinical psychology is to serve individuals and communities living with or at risk of mental illness. To date, the field has fallen persistently short of this goal, despite decades of research on evidence-based treatments and myriad innovations in psychotherapy research. Brief and low-intensity programs, transdiagnostic approaches, and digital mental health tools have all challenged long-held assumptions of what "psychotherapy" can be, pointing toward novel pathways to effective care. And yet, population-level rates of mental illness are high and rising, access to care remains abysmally low, early treatment dropout among people who do access care is common, and science-backed treatments rarely make it into everyday practice. The author argues that the impact of psychotherapy innovations has been constrained by a fundamental flaw in clinical psychology's intervention development and evaluation pipeline. . From the start, intervention science has deprioritized the views and voices of those our treatments aim to support-from here, "experts by experience" (EBEs)-in the design, assessment, and dissemination of novel treatments. EBE-partnered research can strengthen engagement, inform best-practices, and personalize assessments of meaningful clinical change. Further, in fields adjacent to clinical psychology, EBE engagement in research is common. These facts render the virtual absence of EBE partnership from mainstream psychotherapy research especially striking. Without centering EBE views, intervention scientists cannot optimize supports for the diverse communities they aim to serve. Instead, they risk building programs that people with mental health needs may never access, benefit from, or want. (PsycInfo Database Record (c) 2023 APA, all rights reserved).