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临床心理学家应如何看待补充与替代医学?实证、认识论及伦理考量。

How should clinical psychologists approach complementary and alternative medicine? Empirical, epistemological, and ethical considerations.

作者信息

Hughes Brian M

机构信息

Department of Psychology, National University of Ireland, Galway, University Road, Galway City, Ireland.

出版信息

Clin Psychol Rev. 2008 Apr;28(4):657-75. doi: 10.1016/j.cpr.2007.09.005. Epub 2007 Oct 2.

Abstract

As complementary and alternative medicine (CAM) practices are often recommended for mental health problems, many clients in clinical psychology will be in receipt of such treatments from other practitioners. Some psychologists have argued that CAM and psychology are natural bedfellows, given their sharing of philosophies (e.g., holism), professional orientations (e.g., person-centeredness), and theoretical positions (e.g., mind-body connectionism). It has specifically been argued that the practices of CAM could productively be appropriated, or at least promoted, by clinical psychologists. However, other commentators have criticized CAM for comprising therapies that, by definition, are both intrinsically unscientific and lacking in empirical evidence. This article examines the current standing of CAM from empirical, epistemological, and ethical perspectives. CAM treatments are found to be based on heterogeneous epistemologies and to suffer from poor records in empirical efficacy research. Attention is given to possible psychological explanations for CAM's popularity in the face of poor evidence for efficacy. It is argued that, given the likely incompatibility of CAM with clinical psychology's positivist scientific ethos, CAM practices should not be integrated into clinical psychology at this time.

摘要

由于补充和替代医学(CAM)疗法常被推荐用于解决心理健康问题,许多临床心理学的客户会从其他从业者那里接受此类治疗。一些心理学家认为,鉴于补充和替代医学与心理学在哲学理念(如整体论)、专业取向(如以患者为中心)和理论立场(如身心连接主义)上的共通之处,二者是天生的盟友。具体而言,有人认为临床心理学家可以有效地采用,或者至少推广补充和替代医学的疗法。然而,其他评论家批评补充和替代医学,称其疗法从定义上讲本质上既不科学,又缺乏实证依据。本文从实证、认识论和伦理的角度审视了补充和替代医学的现状。研究发现,补充和替代医学疗法基于多种不同的认识论,且在实证疗效研究方面记录不佳。文章还关注了在疗效证据不足的情况下,补充和替代医学仍广受欢迎的可能心理学原因。有人认为,鉴于补充和替代医学可能与临床心理学的实证主义科学精神不相容,目前不应将补充和替代医学疗法纳入临床心理学。

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