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A Qualitative Investigation of Therapists’ Attitudes towards Research: Horses for Courses?

Published online by Cambridge University Press:  16 December 2013

Alex Gyani ,
Roz Shafran ,
Suzanna Rose  and
Michelle J. Lee
Alex Gyani*
Affiliation:
University of Reading, UK
Roz Shafran
Affiliation:
University College London, UK
Suzanna Rose
Affiliation:
Berkshire Healthcare NHS Foundation Trust, Reading, UK
Michelle J. Lee
Affiliation:
University of Reading, UK
*
Reprint requests to Alex Gyani, School of Psychology and Clinical Language Sciences, University of Reading, Berkshire RG6 6AL, UK: E-mail: [email protected]
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Abstract

Background: A large body of research has identified that many therapists do not use research to inform their practice, but few studies investigate the reasons behind this. Aims: The current study seeks to understand what sources therapists use to inform their practice and why they are chosen. Method: Thirty-three interviews with psychological therapists in the UK were undertaken. These were transcribed and analysed using Interpretative Phenomenological Analysis. Results: Two superordinate themes emerged. The former focused on the nature of evidence and the latter described why certain sources were used to make clinical decisions. When discussing evidence, participants felt that research studies, specifically Randomized Controlled Trials (RCTs), used unrepresentative samples. Therapists felt that research other than RCTs, particularly qualitative research, was important. Therapist specific factors were felt to be as, or more, important than the technique used to treat patients. When discussing the sources they used, therapists preferred to use their clinical experience or their patients’ experience to make clinical decisions. Theoretical or practical information was preferred to empirical research. The presentation of information was felt to be important to encourage the implementation of research, and therapists also felt tools such as outcome measures and manuals were too rigid to be useful. Finally, patients’ choice of treatment was felt to be important in treatment decisions. Conclusions: The views of therapists were heterogeneous, but this study highlighted some of the barriers to closing the gap between science and practice. This knowledge can be used to increase the translation of science into practice.

Keywords

EvidenceNICEpractitioner surveyclinical trialpsychotherapy trainingqualitative methodstherapeutic alliancetherapist competenceBABCPresearch
Type
Research Article
Information
Behavioural and Cognitive Psychotherapy , Volume 43 , Issue 4 , July 2015 , pp. 436 - 448
Copyright
Copyright © British Association for Behavioural and Cognitive Psychotherapies 2013 

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References

Addis, M. E. and Krasnow, A. D. (2000). A national survey of practicing psychologists’ attitudes toward psychotherapy treatment manuals. Journal of Consulting and Clinical Psychology, 68, 331–339.CrossRefGoogle ScholarPubMed
Beck, A. T., Rush, A., Shaw, B. and Emery, G. (1979). Cognitive Therapy of Depression. New York: Guilford.Google Scholar
Beutler, L. E., Williams, R. E., Wakefield, P. J. and Entwistle, S. R. (1995). Bridging scientist and practitioner perspectives in clinical psychology. American Psychologist, 50, 984–994.Google Scholar
Crits-Christoph, P., Gibbons, M. B. C., Hamilton, J., Ring-Kurtz, S. and Gallop, R. (2011). The dependability of alliance assessments: the alliance-outcome correlation is larger than you might think. Journal of Consulting and Clinical Psychology, 79, 267–278.CrossRefGoogle ScholarPubMed
Dawes, R. M., Faust, D. and Meehl, P. E. (1989). Clinical versus actuarial judgment. Science, 243, 1668–1674.CrossRefGoogle ScholarPubMed
Dowrick, C., Leydon, G. M., McBride, A., Howe, A., Burgess, H., Clarke, P., et al. (2009). Patients’ and doctors’ views on depression severity questionnaires incentivised in UK quality and outcomes framework: qualitative study. British Medical Journal, 338. doi: 10.1136/bmj.b663Google Scholar
Fairburn, C. G. (2008). Cognitive Behavior Therapy and Eating Disorders: New York: Guilford.Google Scholar
Gyani, A., Shafran, R., Myles, P. and Rose, S. (in press). The gap between science and practice: how therapists make their clinical decisions. Behavior Therapy. http://dx.doi.org/10.1016/j.beth.2013.10.004Google Scholar
Harré, R. and Moghaddam, F. (Eds.) (2012). Psychology for the Third Millennium. London: Sage Publications.Google Scholar
Hogue, A., Henderson, C. E., Dauber, S., Barajas, P. C., Fried, A. and Liddle, H. A. (2008). Treatment adherence, competence, and outcome in individual and family therapy for adolescent behavior problems. Journal of Consulting and Clinical Psychology, 76, 544–555.CrossRefGoogle ScholarPubMed
Horvath, A. O. (2005). The therapeutic relationship: research and theory. Psychotherapy Research, 15, 3–7.CrossRefGoogle Scholar
Jorm, A. F. (2000). Mental health literacy: public knowledge and beliefs about mental disorders. The British Journal of Psychiatry, 177, 396–401.CrossRefGoogle ScholarPubMed
Kendall, P. C., Gosch, E., Furr, J. M. and Sood, E. (2008). Flexibility within fidelity. Journal of the American Academy of Child and Adolescent Psychiatry, 47, 987–993.Google Scholar
Lambert, M. J. and Barley, D. E. (2001). Research summary on the therapeutic relationship and psychotherapy outcome. Psychotherapy: Theory, Research, Practice, Training, 38, 357–361.Google Scholar
Levant, R. F. (2005). Report of the 2005 Presidential Task Force on Evidence-based Practice. Washington, DC: Author.Google Scholar
Lilienfeld, S. O. (2007). Psychological treatments that cause harm. Psychological Science, 2, 53–70.Google ScholarPubMed
Loeb, K. L., Wilson, G. T., Labouvie, E., Pratt, E. M., Hayaki, J., Walsh, B. T., et al. (2005). Therapeutic alliance and treatment adherence in two interventions for bulimia nervosa: a study of process and outcome. Journal of Consulting and Clinical Psychology, 73, 1097–1107.CrossRefGoogle ScholarPubMed
Michie, S. and Lester, K. (2005). Words matter: increasing the implementation of clinical guidelines. Quality and Safety in Health Care, 14, 367–370.CrossRefGoogle ScholarPubMed
Morrow-Bradley, C. and Elliott, R. (1986). Utilization of psychotherapy research by practicing psychotherapists. American Psychologist, 41, 188–197.Google Scholar
Mulrow, C. D., Oxman, A. and Cochrane Collaboration (1996). The Cochrane Collaboration Handbook: version 3.0: San Antonio: Cochrane Center.Google Scholar
Nelson, T., Steele, R. and Mize, J. (2006). Practitioner attitudes toward evidence-based practice: themes and challenges. Administration and Policy in Mental Health and Mental Health Services Research, 33, 398–409.Google Scholar
Norcross, J. C. (1995). Dispelling the Dodo bird verdict and the exclusivity myth in psychotherapy. Psychotherapy: Theory, Research, Practice, Training, 32, 500–504.Google Scholar
Norcross, J. (Ed.) (2010). Evidence-Based Therapy Relationships. Washington, DC: American Psychological Association.Google Scholar
Patel, S. R. and Bakken, S. (2010). Preferences for participation in decision making among ethnically diverse patients with anxiety and depression. Community Mental Health Journal, 46, 466–473.Google Scholar
Perlis, M. L., Jungquist, C., Smith, M. T. and Posner, D. A. (2005). Cognitive Behavioral Treatment of Insomnia: a session-by-session guide: New York: Springer Science and Business Media.Google Scholar
Rogers, E. M. (1995). Diffusion of Innovations: New York: Simon and Schuster.Google Scholar
Rosenzweig, S. (1936). Some implicit common factors in diverse methods of psychotherapy. American Journal of Orthopsychiatry, 3, 412–415.Google Scholar
Sackett, D. L., Rosenberg, W. M. C., Gray, J. A. M., Haynes, R. B. and Richardson, W. S. (1996). Evidence based medicine: what it is and what it isn't. British Medical Journal, 312, 71–72.CrossRefGoogle ScholarPubMed
Schmidt, F. and Taylor, T. K. (2002). Putting empirically supported treatment into practice: lessons learned in a children's mental health center. Professional Psychology: Research and Practice, 33, 483–489.Google Scholar
Schuster, B., Forsterlung, F. and Weiner, B. (1989). Perceiving the causes of success and failure: a cross-cultural examination of attributional concepts. Journal of Cross-Cultural Psychology, 20, 191–213.Google Scholar
Shafran, R., Clark, D. M., Fairburn, C. G., Arntz, A., Barlow, D. H., Ehlers, A., et al. (2009). Mind the gap: improving the dissemination of CBT. Behaviour Research and Therapy, 47, 902–909.Google Scholar
Smith, J. A. and Osborn, M. (2008). Interpretative phenomenological analysis. In Smith, J. A. (Ed.), Qualitative Psychology: a practical guide to research methods (pp. 53–80). London: Sage.Google Scholar
Stewart, R. E. and Chambless, D. L. (2007). Does psychotherapy research inform treatment decisions in private practice? Journal of Clinical Psychology, 63, 267–281.Google Scholar
Stewart, R. E. and Chambless, D. L. (2010). Interesting practitioners in training in empirically supported treatments: research reviews versus case studies. Journal of Clinical Psychology, 66, 73–95.Google Scholar
Stewart, R. E., Stirman, S. W. and Chambless, D. L. (2012). A qualitative investigation of practicing psychologists’ attitudes toward research-informed practice: implications for dissemination strategies. Professional Psychology: Research and Practice, 43, 100–109.CrossRefGoogle ScholarPubMed
Stirman, S. W., DeRubeis, R. J., Crits-Christoph, P. and Rothman, A. (2005). Can the randomized controlled trial literature generalize to nonrandomized patients. Journal of Consulting and Clinical Psychology, 73, 127–135.Google Scholar
Stobie, B., Taylor, T., Quigley, A., Ewing, S. and Salkovskis, P. M. (2007). “Contents may vary”: a pilot study of treatment histories of OCD patients. Behavioural and Cognitive Psychotherapy, 35, 273–282.Google Scholar
Wachtel, P. L. (2009). Beyond “ESTs”: problematic assumptions in the pursuit of evidence-based practice. Psychoanalytic Psychology, 27, 251–272.Google Scholar
Waller, G. (2009). Evidence-based treatment and therapist drift. Behaviour Research and Therapy, 47, 119–127.Google Scholar
Weisz, J. R., Jensen-Doss, A. and Hawley, K. M. (2006). Evidence-based youth psychotherapies versus usual clinical care: a meta-analysis of direct comparisons. American Psychologist, 61, 671–689.Google Scholar
Westen, D. and Weinberger, J. (2005). In praise of clinical judgment: Meehl's forgotten legacy. Journal of Clinical Psychology, 61, 1257–1276.Google Scholar
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