Department of Psychology, Stony Brook University.
J Consult Clin Psychol. 2023 Mar;91(3):119-121. doi: 10.1037/ccp0000798. Epub 2023 Feb 16.
This article discusses the fundamental need for lived experience perspectives in developing and evaluating psychotherapies. The primary professional goal of clinical psychology is to serve individuals and communities living with or at risk of mental illness. To date, the field has fallen persistently short of this goal, despite decades of research on evidence-based treatments and myriad innovations in psychotherapy research. Brief and low-intensity programs, transdiagnostic approaches, and digital mental health tools have all challenged long-held assumptions of what "psychotherapy" can be, pointing toward novel pathways to effective care. And yet, population-level rates of mental illness are high and rising, access to care remains abysmally low, early treatment dropout among people who do access care is common, and science-backed treatments rarely make it into everyday practice. The author argues that the impact of psychotherapy innovations has been constrained by a fundamental flaw in clinical psychology's intervention development and evaluation pipeline. . From the start, intervention science has deprioritized the views and voices of those our treatments aim to support-from here, "experts by experience" (EBEs)-in the design, assessment, and dissemination of novel treatments. EBE-partnered research can strengthen engagement, inform best-practices, and personalize assessments of meaningful clinical change. Further, in fields adjacent to clinical psychology, EBE engagement in research is common. These facts render the virtual absence of EBE partnership from mainstream psychotherapy research especially striking. Without centering EBE views, intervention scientists cannot optimize supports for the diverse communities they aim to serve. Instead, they risk building programs that people with mental health needs may never access, benefit from, or want. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
本文讨论了在开发和评估心理治疗方法时,从实际经验角度出发的基本必要性。临床心理学的主要专业目标是为患有或有患精神疾病风险的个人和社区提供服务。尽管几十年来一直在研究基于证据的治疗方法,并在心理治疗研究方面进行了无数创新,但迄今为止,该领域仍未能实现这一目标。简短且低强度的项目、跨诊断方法和数字心理健康工具都对什么是“心理治疗”提出了挑战,为有效的治疗提供了新的途径。然而,精神疾病的人群发病率仍然很高,而且还在上升,获得治疗的机会仍然极低,那些接受治疗的人在早期治疗中经常退出,而且基于科学的治疗方法很少能应用于日常实践。作者认为,心理治疗创新的影响受到临床心理学干预开发和评估管道中的一个基本缺陷的限制。从一开始,干预科学就优先考虑了那些接受治疗的人的观点和意见,而不是我们的治疗目标所支持的人,从这里开始,“有经验的专家”(EBE)在设计、评估和传播新的治疗方法中处于次要地位。EBE 参与的研究可以加强参与度,为最佳实践提供信息,并对有意义的临床变化进行个性化评估。此外,在临床心理学领域之外,EBE 参与研究是很常见的。这些事实表明,EBE 伙伴关系在主流心理治疗研究中几乎不存在,这尤其引人注目。如果不关注 EBE 的观点,干预科学家就无法为他们所服务的不同社区提供最佳支持。相反,他们有可能构建出那些有心理健康需求的人可能永远无法获得、受益或想要的项目。(PsycInfo 数据库记录(c)2023 APA,保留所有权利)。