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混合还是不混合?一种元方法,用于重新思考评估实践,以提高心理治疗的有效性和效率,并以感知控制理论的应用为例进行说明。

To Mix or Not To Mix? A Meta-Method Approach to Rethinking Evaluation Practices for Improved Effectiveness and Efficiency of Psychological Therapies Illustrated With the Application of Perceptual Control Theory.

作者信息

Carey Timothy A, Huddy Vyv, Griffiths Robert

机构信息

Centre for Remote Health, Flinders University, Alice Springs, NT, Australia.

Clinical Psychology Unit, University of Sheffield, Sheffield, United Kingdom.

出版信息

Front Psychol. 2019 Jun 26;10:1445. doi: 10.3389/fpsyg.2019.01445. eCollection 2019.

Abstract

Progress in the development of more effective and efficient psychological therapies could be accelerated with innovative and nuanced approaches to research methodology. Therapy development has been dominated by a mono-methodology attitude with randomized controlled trials (RCTs) regarded as a "gold standard" despite the concept of a single methodology being ascribed gold standard status having been called into question. Rather than one particular methodology being considered superior to all others, the gold standard approach should be matching appropriate methodologies to important research questions. The way in which that matching should occur, however, is far from clear. Moving from a mono-methodological approach to mixed-method designs has not been straightforward. The ways in which methods should be mixed, to arrive at robust and persuasive answers to genuine research questions, is not entirely clear. In this paper, we argue that attention to the meta-methods underpinning all research designs will improve research precision and provide greater clarity about the contribution of any particular program of research to scientific progress in that field. From a meta-method perspective, the matter of changed can be delineated from or these changes occurred. Different methods and different types of mixing can be justified for each meta question. A meta-method approach should make explicit the assumptions that guide the development of research designs and also promote the articulation of putative mechanisms that might be relevant. By paying greater attention to assumptions such as how causality occurs, and important mechanisms of change, the mixing of methodologies that are still not mainstream in this area such as routine outcome monitoring and evaluation and functional model building, can occur. By adopting methodologies that focus on learning about a program's strengths and weaknesses rather than presiding over judgments of whether or not the program is deemed to be effective, we will move much closer to a position of being able to understand what programs under which conditions people find most helpful for their purposes.

摘要

采用创新且细致入微的研究方法,可加速更有效、更高效心理治疗方法的开发进程。治疗方法的开发一直受单一方法学态度主导,随机对照试验(RCTs)被视为“金标准”,尽管单一方法学被赋予金标准地位这一概念已受到质疑。金标准方法不应是认为某一种特定方法学优于所有其他方法学,而应是将合适的方法学与重要的研究问题相匹配。然而,这种匹配应如何实现,却远非清晰明了。从单一方法学方法转向混合方法设计并非一帆风顺。方法应如何混合,以得出针对真正研究问题的有力且有说服力的答案,这并不完全清楚。在本文中,我们认为关注支撑所有研究设计的元方法,将提高研究精度,并更清晰地阐明任何特定研究项目对该领域科学进展的贡献。从元方法的角度来看,变化的问题可以与变化发生的方式或这些变化发生的原因区分开来。对于每个元问题,可以为不同的方法和不同类型的混合提供合理依据。元方法途径应明确指导研究设计开发的假设,并促进对可能相关的假定机制的阐述。通过更加关注诸如因果关系如何发生以及重要的变化机制等假设,就可以实现该领域仍非主流的方法学的混合,如常规结果监测与评估以及功能模型构建。通过采用专注于了解一个项目的优势和劣势而非主导对该项目是否被视为有效的判断的方法学,我们将更接近于能够理解在何种条件下人们会发现哪些项目对他们最有帮助的境地。

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