Reply to "Salvaging Psychotherapy Research: A Manifesto" by James C. Coyne and Robin N. Kok

By Gambrill, Eileen | Journal of Evidence-Based Psychotherapies, September 2014 | Go to article overview

Reply to "Salvaging Psychotherapy Research: A Manifesto" by James C. Coyne and Robin N. Kok


Gambrill, Eileen, Journal of Evidence-Based Psychotherapies


Invited Comment on "Salvaging psychotherapy research: A manifesto"

Coyne and Kok describe many of the shortcomings of research design and reporting. Many have been described for decades yet continue, revealing the degree of avoidable ignorance in this area encouraged by pursuit of status and money and related cognitive biases. Such shortcomings are vital to highlight (and avoid if possible) given the hoped-for guidance of practice and policy decisions by empirical research: if the research is flawed, drawing on this may do more harm than good; policy makers, clinicians and clients all may be misled. As the authors note, many publications are characterized by inflated claims of effectiveness and hiding of harms. These are classic propaganda/marketing strategies (Gambrill, 2012). Reforms such as trial registration that arose because of dubious practices in research concerning pharmaceuticals (e.g., hiding negative results), are, as the authors note, important for all research.

Ioannidis (2005) has led a growing critique of research in the bio-medical area which has encouraged a critique in areas such as psychology including efforts to replicate prior research, often with disappointing results. This thrust has been encouraged by the rigorous guidelines for conduct of systematic reviews described by the Cochrane and Campbell Collaborations, the former initiated in 1992. Conducting research that cannot answer questions posed is a waste of money which hopefully will be discouraged by enterprises such as the Meta- Research Innovation Center (METRICS) recently established at Stanford to strengthen the quality of scientific evidence and combat research waste. Original publications describing the philosophy and process of evidence-informed practice call for the integration of data from well-designed research concerning clinical questions and client circumstances and characteristics, including their preferences and values, drawing on clinical expertise (Straus, Richardson, Glasziou, & Haynes, 2010). This process is a way to handle the inevitable uncertainty in making decisions in an informed, ethical manner. Bogus claims based on flawed research impede such efforts.

Improving the quality of research concerning psychotherapy will require attention to professional education venues awarding degrees as well as continuing education programs (e. g., Baker, McFall, & Shoham, 2008; McFall, 1991). It will require attention to how problems are framed as well as to methodological quality (Gambrill, 2014). Problem framing receives no attention in quality filters such as CONSORT. A psychiatric framing of life's travails dominates psychology, psychiatry, and social work (e. g., Kirk, Gomory, & Cohen, 2013). Alternative well-argued views (e. g., social learning theory) are often ignored in descriptions of randomized controlled trials (e. g., Gambrill & Reiman, 2012). Fortunately, many sources are now available for critically appraising and/or designing research including user-friendly websites such as Testing Treatments, Interactive (TTi) and books such as How to read a paper (Greenhalgh, 2010) and Randomized controlled trials (Jadad & Enkin, 2007). …

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