Psychotherapy Outcome Research: Implications of a New Clinical Taxonomy

Clin Psychol Psychother. 2021 Jun 27. doi: 10.1002/cpp.2638. Online ahead of print.ABSTRACTSince the publication of DSM-III in 1980 the scientist-practitioner gap in clinical psychology has expanded, as almost all outcome research in clinical psychology has been on diagnosed mental disorders within a medical model using drug trial methodologies, while most practising clinicians undertake functional analyses and case formulations of clinical psychological problems (CPPs), and then apply tailored interventions within an ongoing hypothesis-testing methodology. But comparatively reliable assessment and generalisable conclusions in psychotherapy outcome research require a comprehensive theory-derived conception or operational definition of 'CPPs', standardised functional analyses, and a taxonomy of CPPs comparable to DSM's listings of mental disorders. An alternative conception and taxonomy of CPPs has recently been proposed, offering improvements in the reliability and generalisability of case formulation-based psychotherapy outcome research. It conceives of CPPs as instances of the formation and operation of self-sustaining problem-maintaining circles (PMCs) of psychological-level causal elements - that is, at the level of cognitions, behaviours, emotions, and events or situations (stimuli). The paper describes this new conception of CPPs, a subsequent nascent taxonomy of evidence-based PMCs which standardises the underlying mechanisms that maintain CPPs, and ensuing benefits to...

Source: Clinical Psychology and Psychotherapy - June 28, 2021 Category: Psychiatry Authors: Gary M Bakker Source Type: research