Hershenberg Rachel, Goldfried Marvin R
Mental Illness Research, Education and Clinical Center at Philadelphia VA Medical Center, and University of Pennsylvania.
Stony Brook University.
Behav Ther. 2015 Mar;46(2):156-65. doi: 10.1016/j.beth.2014.09.014. Epub 2014 Oct 13.
The field of psychotherapy is at an important juncture. Recent changes in the field include (a) the skeptical reception of the fifth edition of the Diagnostic and Statistical Manual and (b) NIMH's prioritization of an alternative classification system to guide translational and intervention research. Moreover, (c) the field continues to be held accountable to governmental agencies and third-party payers to demonstrate its empirical basis. Thus, psychological research as it relates to the practice of psychotherapy is at a crossroads. In this article, we provide a brief overview of several generations of psychotherapy outcome research, including the consequences that followed in the 1980s as psychotherapy research moved toward randomized controlled trials for clinical disorders. We delineate the inherent strengths and limitations of this movement and address how the NIMH has recently responded with the Research Domain Criteria (RDoC). We then address philosophical and practical implications of the emphasis on a neuroscientific conceptualization of psychological problems. Finally, we discuss opportunities for a next generation of convergent science that incorporates, rather than replaces, psychosocial variables across stages of translational research and treatment development.
心理治疗领域正处于一个重要的转折点。该领域最近的变化包括：（a）对《诊断与统计手册》第五版持怀疑态度；（b）美国国立精神卫生研究所（NIMH）将一种替代分类系统作为指导转化研究和干预研究的优先事项。此外，（c）该领域继续要向政府机构和第三方支付方负责，以证明其实证基础。因此，与心理治疗实践相关的心理学研究正处于十字路口。在本文中，我们简要概述了几代心理治疗结果研究，包括20世纪80年代随着心理治疗研究转向针对临床疾病的随机对照试验所产生的后果。我们阐述了这一转变的内在优势和局限性，并探讨了NIMH最近如何以研究领域标准（RDoC）做出回应。然后，我们讨论了强调对心理问题进行神经科学概念化的哲学和实际意义。最后，我们探讨了下一代融合科学的机会，这种科学在转化研究和治疗开发的各个阶段纳入而不是取代社会心理变量。
