Beutler L E
Department of Education, University of California, Santa Barbara 93106, USA.
Am Psychol. 2000 Sep;55(9):997-1007.
Traditional clinical methods of assessing the effectiveness of psychological treatments have come under attack. Experience and strong belief frequently lead to false confidence in treatments and sometimes result in damage to patients. Advocates have called for a scientific standard to replace the extant standards based on expert opinion and cost. Yet there are costs to the use of both the old standards and scientific standards based on manualized treatments and associated research. This article proposes a set of criteria for determining whether a treatment is scientifically credible based on empirically informed principles rather than on techniques or single-theory formulations. This proposal offers a way to overcome the problems of rigid manuals as well as those associated with forcing clinicians to adhere to theories and practices that are outside of their interest, experience, and expertise. Instead, scientifically sound, cross-cutting principles of treatment selection are proposed by which a treatment could be evaluated for scientific credibility and applied from a number of theoretical frameworks.
传统的评估心理治疗效果的临床方法受到了抨击。经验和坚定的信念常常导致对治疗的错误信心,有时还会对患者造成损害。倡导者呼吁采用科学标准来取代基于专家意见和成本的现有标准。然而,使用旧标准以及基于标准化治疗和相关研究的科学标准都存在成本。本文提出了一套标准,用于根据经验性原则而非技术或单一理论公式来确定一种治疗是否具有科学可信度。这一提议提供了一种方法,以克服僵化手册带来的问题以及那些迫使临床医生坚持与其兴趣、经验和专业知识无关的理论和实践所带来的问题。相反,本文提出了科学合理、贯穿各领域的治疗选择原则,据此可以评估一种治疗的科学可信度,并从多个理论框架进行应用。