Carey Timothy A, Griffiths Robert, Dixon James E, Hines Sonia
Institute of Global Health Equity Research, University of Global Health Equity, Kigali, Rwanda.
Mental Health Nursing Research Unit, Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom.
Front Psychiatry. 2020 Apr 17;11:291. doi: 10.3389/fpsyt.2020.00291. eCollection 2020.
The identification of fundamental mechanisms is an important scientific pursuit in many fields of enquiry. With regard to the development of psychological treatments, understanding the mechanisms through which change occurs such that psychological distress resolves, can enable us to develop more effective and efficient interventions. In the field of psychotherapy, mechanisms are often identified either statistically or conceptually. The most powerful and useful mechanisms, however, are functional rather than statistical or conceptual. More specifically, with regard to mechanisms relevant to psychotherapy, it is difficult to identify what any of these mechanisms actually in a mechanistic sense. That is, the mechanics of putative mechanisms are generally unspecified. In order to obtain a rigorous and comprehensive account of the current mechanisms in psychotherapy, as well as to evaluate their usefulness, a systematic scoping review was conducted. The systematic scoping review did not yield any mechanisms that were expressed in functional terms. We argue that, in order for psychotherapy to improve its effectiveness and efficiency, the standard for what is accepted as a useful mechanism needs to be substantially raised. Only functional mechanisms that express plausible actions consistent with known biological processes should be used to inform therapeutic interventions.
识别基本机制是许多研究领域的一项重要科学探索。关于心理治疗的发展，了解心理困扰得以解决的改变发生机制，能够使我们开发出更有效且高效的干预措施。在心理治疗领域，机制通常通过统计学或概念性方法来识别。然而，最强大且有用的机制是功能性的，而非统计学或概念性的。更具体地说，就与心理治疗相关的机制而言, 很难从机械论的角度确定这些机制中的任何一个实际是什么。也就是说，假定机制的原理通常未明确说明。为了对心理治疗中的当前机制进行严谨且全面的阐述，并评估其效用，我们进行了一项系统的范围综述。该系统范围综述未得出任何以功能性术语表述的机制。我们认为，为了提高心理治疗的有效性和效率，被视为有用机制的标准需要大幅提高。只有那些表达出与已知生物过程相一致的合理作用的功能性机制，才应用于为治疗干预提供依据。
