Science and Research

Psychotherapy is a scientific profession. Research in the domain of psychotherapy can be understood as an ongoing structured, methodological process of reflecting on clinical practice, connected with knowledge from research on the functioning of human beings.

Scientific validation means, that the theory has a scientific base, that there are case descriptions, qualitative research, empiric process and outcome research and combinations of qualitative with empiric deigns.

The concept of Evidence based Medicine (EbM), that first was developed for testing pharmacies, describes and contains originally all these kinds of researches. If the concept contains all categories of research designs, it is a useful concept. But unfortunately some research experts in some countries tend to count only so called randomized controlled trials (RCT) as a the “gold standard” in EbM. This is highly controversial discussed in the scientific communitiy. Some researchers say that this is an abuse of the concept of EbM ⁽¹⁾ and absolutely not suitable for psychotherapy research.

There has been a wide spectrum of research done in the last few decades that has generated evidence supporting the effectiveness of psychotherapy in general.⁽²⁾ However, there are a lot of questions not yet answered, such as “How does psychotherapy work?” “What are the change mechanisms?”, “What are the core and specific competencies of therapists that lead to successful therapies?” which oblige all psychotherapy modalities to engage in further research.

Such questions can only be answered if qualitative methods and quantitative methods are getting mixed in a research design and if the dynamic and process of the relation between therapist and client are properly observed. This cannot be done with simple RCT designs.

For public health it is necessary to have research with a high external validation, which means results that are gained in everyday practice (this is called a naturalistic design) and not in laboratories with well sorted out patient groups.

European laws on psychotherapy should insist in accepting a wide range of research designs for scientific validation, that are appropriate to the specific process of psychotherapy in interaction between therapist and client as a co-creation of a healing process.

Science and Research Committee (SARC)

(1) Kriz, J. (2014). Wie evident ist Evidenzbasierung?
Über ein gutes Konzept – und seine missbräuchliche Verwendung. In S. Sulz (Hrsg.), Psychotherapie ist mehr als eine Wissenschaft. Ist hervorragendes Expertentum durch die Reform gefährdet? (S. 154–185). München: CIP.
(2) Wampold B, Imel. Z.E. (2015): The Great Psychotherapy Debate. 2nd edition. London, Routledge