Limitations of Randomized Control Designs in Psychotherapy Research
Open accessAbstract
Despite the growing influence of lists of empirically supported therapies (ESTs) there are concerns about the design and conduct of this body of research. These concerns include limitations inherent in the requirements of randomized control trials (RCTs) that favor those psychotherapies that define problems and outcome in terms of uncomplicated symptoms. Additional concerns have to do with criteria for patient selection, lack of integration with research on psychotherapy process and effectiveness studies, limited outcome criteria, and lack of controls for experimenter bias. RCT designs have an important place in outcome research; however it is important to recognize that these designs also place restrictions on what and how psychotherapy can be studied. There is a need for large scale psychotherapy outcome research based on designs that allow for inclusion of process variables and the study of the effects of those idiographic approaches to therapy that do not lend themselves to RCT designs. Interpretative phenomenological analysis may provide a useful method for the evaluation of the effectiveness of idiographic approaches to psychotherapy where outcome is not understood solely in terms of symptom reduction.
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The absence of strict exclusion criteria and the location of clinics in large cities across the Netherlands enhance the external validity of the results.
“No strict exclusion criteria are used and clinics are in large cities across the Netherlands, which enhances the external validity of our results [119, 120].”
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- Authors
- Shean, G.
- Affiliations
- William & Mary (US)
- Corresponding author
- Shean, Glenn
- ORCID
- Shean, Glenn
- Venue
- Advances in Psychiatry
- Publisher
- Hindawi Limited
- Published
- 2014-11-06
- Volume
- 2014
- Pages
- 1-5
- ISSN
- 2314-7768 (ISSN-L)
- 2356-685X
- OpenAlex
- W1967728573
- Cited by
- 72
- References
- 27
- Citations by year
- 2026: 3 · 2025: 10 · 2024: 4 · 2023: 5 · 2022: 3 · 2021: 18 · 2020: 9 · 2019: 9 · 2018: 6 · 2017: 3 · 2016: 1
- FWCI
- 1.57
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Advances in Psychiatry (publishedVersion, cc-by)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Keywords
- randomized controlled trials, psychotherapy outcome research, empirically supported treatments, patient selection criteria, researcher bias, interpretative phenomenological analysis, symptom relief
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