Nock Matthew K
Department of Psychology, Harvard University, 33 Kirkland Street, Cambridge, MA 02138, USA.
Alcohol Clin Exp Res. 2007 Oct;31(10 Suppl):4s-12s. doi: 10.1111/j.1530-0277.2007.00488.x.
Considerable progress has been made toward the development of evidence-based treatments for a wide range of psychological disorders; however, little is known about the mechanisms through which these treatments actually lead to clinical change. Although the use of traditional randomized controlled treatment designs and tests of statistical mediation have significantly advanced understanding of psychological treatments, they are insufficient to test mechanisms of change.
This article outlines the conceptual and methodological requirements for evaluating mechanisms of change, highlights the importance of such a focus, and offers specific recommendations for research aimed at elucidating change mechanisms.
Conceptualizing and conducting studies that test mechanisms of change requires substantial modifications to traditional research designs, but doing so will significantly enhance scientific understanding as well as the efficiency and effectiveness of clinical interventions.
在为多种心理障碍开发循证治疗方法方面已经取得了相当大的进展；然而，对于这些治疗方法实际导致临床改变的机制却知之甚少。尽管传统的随机对照治疗设计和统计中介检验的使用显著推进了对心理治疗的理解，但它们不足以检验改变机制。
本文概述了评估改变机制的概念和方法要求，强调了这种关注的重要性，并为旨在阐明改变机制的研究提供了具体建议。
概念化并开展检验改变机制的研究需要对传统研究设计进行重大修改，但这样做将显著增强科学理解以及临床干预的效率和效果。
