Evidence, Policy and Regulation: Talking Therapies: evidence and evaluation - What Should an Evidence-based Pathway for Improving Work and Wellbeing look like to People who are on it?
For mental health clinicians and experts the demand that practice be evidence-based represents both an opportunity and a challenge. The focus of this project is on evidence for therapies for depression – not just with reducing symptoms of depression but with understanding how recovery happens in vivo: how do people use therapy to build resilient character and improve their capacity for meaningful relationships and their ability to live the lives they choose? These are the kinds of outcomes that service users themselves tell us they value but that to date evidence-based pharmaceutical treatments have neglected and talking therapies are only just now focussing on. What kind of evidence could be collected in order to make these claims – that a therapy can deliver the kind of recovery that is relevant and valued by users – credible? Or show them to have effect? And which therapies are most effective, how and why, and under what circumstances?
Evaluation methodologies over recent decades have privileged randomised controlled trials (RCTs) as the dominant paradigm – the ‘gold standard’ – for establishing whether or not treatments work. Not only has this discriminated against more complex kinds of treatment, such as psychological therapies, which are less straightforward to test using RCTs, it has also had the unfortunate side effect of missing many of the real outcomes that matter to service users, in contrast to more easily targeted symptoms.
This project will hold two intensive workshops with practicing therapists, methodologists and others with interests in these questions from around the UK to investigate, first, how to construct empirical studies to collect evidence from interpersonal processes that lead to change during psychotherapy and, second, how to make valid and reliable inferences about causal mechanisms for use in improved clinical decision making. The aim is to begin to forge some solid research plans for the kind of research described, with the ultimate aim of developing new methodological tools more appropriate than those currently in favour for assessing the effectiveness of talking therapies for the outcomes that matter to service users.
Workshop 1: 27 April 2016, Seminar Room, Institute of Advanced Study What evidence works best for which NICE therapy?
Workshop 2: 03 June 2016, Seminar Room, Institute of Advanced Study What should an evidence-based pathway for improving work and wellbeing look like to the people who are on it?
The project is organised jointly by Professor Nancy Cartwright, an expert on methods for causal inference, and Jeremy Clarke, an adviser to the UK government on psychological therapies and a practicing clinician. Anyone with an interest in these problems is invited to attend.
Those interested in participating should contact the administrator for Durham’s Centre for Humanities Engaging Science & Society (CHESS) at firstname.lastname@example.org.
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