The implications of psychotherapy research for clinical practice and service development: Lessons and limitations

Abstract

Evidence-based practice is increasingly discussed and practised within the NHS. Psychotherapy research clearly has a part to play in informing such practice, but the differing agendas of researchers, clinicians and purchasers need to be recognised if research is to make a constructive contribution. A good starting point is to acknowledge that research and clinical practice are not isomorphous, because the methodologies underpinning research inevitably distort outcomes. This makes it risky to generalise uncritically from research to practice, although it is equally true that good practice should take note of accumulating evidence about evidence of efficacy. Drawing on recent academic and NHS policy reviews, this article notes that overall there is good evidence for the efficacy of the psychological therapies, although evidence for the efficacy of specific therapies in relation to specific conditions is not strong, and some therapies are better researched than others. There is also evidence that it may be unhelpful to privilege 'brand names' over pantheoretical factors, such as the therapeutic alliance or therapist skilfulness, both of which appear important to outcomes. The article discusses the policy implications of research, and suggests some future research directions.