ABSTRACT

In light of two recent meta-analyses of the efficacy of group psychotherapy in treating posttraumatic stress disorder (PTSD), this article critically reviews the randomized control trial (RCT) generated findings as well as two of its outgrowths—the production of a variety of clinical practice guidelines for treating PTSD and the dissemination efforts to transfer laboratory findings to clinical practice. All three of these activities have received considerable pushback from experienced clinicians and Boulder-identified scientist practitioners, creating an ongoing and entrenched gap or split between researcher and clinician. The article also reviews the various suggestions that have been offered to heal this gap and ending the hegemony of RCT outcome research as the only game in town for declaring what constitutes evidence. Specifically, the literature suggests two primary strategies for helping to realize the scientist-practitioner model and thus advancing the cause of psychotherapy, in general, and group psychotherapy, in particular: (a) leveling the playing field so that both researcher and practitioner have real authority and voices for shaping the field; and (b) shifting the research priority away from a purely outcome focus, asking only does it work, and moving to a more sophisticated, theoretically guided empirical study of process-outcome, examining the how, why, when, and for whom it works.

摘要

根据最近关于团体心理治疗在治疗创伤后应激障碍 (PTSD) 中的功效的两项荟萃分析，本文批判性地回顾了随机对照试验 (RCT) 的发现及其两个结果——产生了多种治疗 PTSD 的临床实践指南以及将实验室发现转移到临床实践的传播工作。所有这三项活动都受到了经验丰富的临床医生和博尔德鉴定的科学家从业者的强烈反对，在研究人员和临床医生之间造成了持续和根深蒂固的差距或分裂。这篇文章还回顾了为弥合这一差距和结束 RCT 结果研究的霸权而提供的各种建议，因为它是镇上唯一宣布什么构成证据的游戏。具体来说，文献提出了两种主要策略来帮助实现科学家-从业者模型，从而推动心理治疗的事业，尤其是团体心理治疗：(a) 公平竞争，使研究人员和从业者都拥有真正的权威和塑造该领域的声音；(b) 将研究重点从纯粹的结果焦点转移，只询问它是否有效，转向更复杂的、理论指导的过程结果实证研究，检查它如何、为什么、何时以及为谁起作用. (a) 营造公平的竞争环境，使研究人员和从业人员都拥有塑造该领域的真正权威和发言权；(b) 将研究重点从纯粹的结果焦点转移，只询问它是否有效，转向更复杂的、理论指导的过程结果实证研究，检查它如何、为什么、何时以及为谁起作用. (a) 营造公平的竞争环境，使研究人员和从业人员都拥有塑造该领域的真正权威和发言权；(b) 将研究重点从纯粹的结果焦点转移，只询问它是否有效，转向更复杂的、理论指导的过程结果实证研究，检查它如何、为什么、何时以及为谁起作用.