Psychotherapy is a scientific profession. Research in the field of psychotherapy can be considered a continuous, structured, methodological process of reflection on clinical practice, linked to knowledge based on research into the functioning of human beings.
Scientific grounding means that the theory has a scientific basis, that there are case descriptions, qualitative research, empirical processes, and outcome research, as well as combinations of qualitative and empirical research.
Koncept medicine zasnovane na dokazima (EbM) koja je prije svega razvijena u svrhu testiranja ljekarni, opisuje i originalno sadrži sve ove vrste istraživanja. Ako koncept sadrži sve kategorije dizajna istraživanja, to je koristan koncept. Nažalost, neki stručnjaci u području istraživanja iz određenih zemalja imaju tendenciju sagledavati samo randomizirane kontrolirane pokuse (RCT) kao „zlatni standard“ u sklopu medicine zasnovane na dokazima. Ovo je vrlo kontroverzna tema u znanstvenoj zajednici. Neki istraživači smatraju to zlouporabom koncepta medicine zasnovane na dokazima1 te apsolutno neprikladnim za psihoterapijsko istraživanje.
Široki spektar istraživanja provedenih u posljednjih nekoliko dekada iznjedrio je dokaze koji podržavaju efikasnost psihoterapije kao takve.2 Doduše, postoje mnoga neodgovorena pitanja, poput „Kako psihoterapija funkcioniše?“, „Koji su to mehanizmi promjene?“, „Koje su to temeljne i specifične kompetencije terapeuta koje rezultiraju uspješnim terapijama?“, što obvezuje sve psihoterapijske modalitete da nastave s istraživanjem.
Such questions can only be answered if both qualitative and quantitative methods are used within the research design, and if the dynamics and process of the relationship between the therapist and the client are properly observed. This cannot be achieved through simple randomized controlled trials.
For Public Health, it is important to have research with a high level of external validity, which implies results obtained within the framework of everyday practice (this is called naturalistic design), rather than in laboratories with well-distributed patient groups.
European laws on psychotherapy should insist on the acceptance of a wide range of research designs for scientific evaluation, which are suitable for the specific process of psychotherapy, i.e., the interactions between the therapist and the client as a co-creation of the healing process.
Research – jedno od etičkih načela
The decision to conduct research is based on a thoughtful assessment by individual psychotherapists/supervisors (researcher) regarding how they can best contribute to science and the well-being of people. The research is conducted with respect and care for the dignity and welfare of the participants, while adhering to the rules and professional standards that apply when conducting research with humans as participants.
When planning research, the researcher is responsible for conducting a careful assessment of its ethical acceptability. If the consideration of scientific and human values suggests a violation of any principle, the researcher must distance themselves accordingly. The primary ethical concern of the researcher is to reflect on whether, in relation to accepted standards, the participant in the planned research will be a “risky subject” or a “minimal risk subject.”
Except when the research involves minimal risk, the researcher must establish a clear and fair agreement with the participants before their involvement, which explains the obligations and responsibilities of each party. The researcher must honor all promises and commitments made in this agreement. The researcher informs the participants about all aspects of the research that may potentially influence their willingness to participate and, in accordance with their questions, clarifies any other aspects of the research.
The researcher respects the individual’s freedom to refuse to participate in the research or to withdraw from it at any time.
The researcher protects the participant from physical and mental discomfort, harm, and any dangers that may arise from the research process. If there is a risk of such consequences, the researcher informs the participant. Research procedures that could cause lasting or serious harm to participants are not used. The participant must be informed about the procedures for contacting the researcher within a reasonable time after the research, in case stress, potential harm, or any questions or concerns arise related to it.
After collecting the data, the researcher informs the participants about the nature of the research and strives to clarify any misconceptions that may have arisen. Information obtained during the research about individual participants is confidential, unless otherwise agreed in advance.
The psychotherapist will perform their work with children and adolescents while respecting the child’s personality in accordance with the Convention on the Rights of the Child of the United Nations (New York, 1989) and with the written consent of the parents or guardians.
- Kriz, J. (2014.) Koliko je očigledno zasnivati znanost na dokazima? O dobrom konceptu – i njegovoj zloupotrebi. (Wie evident ist Evidenzbasierung? Über ein gutes Konzept – und seine missbräuchliche Verwendung.) u: S. Sulz (izd.), Psihoterapija je više od znanosti. Je li izvanredna stručnost ugrožena reformom? (Psychotherapie ist mehr als eine Wissenschaft. Ist hervorragendes Expertentum durch die Reform gefährdet?) (str. 154–185). München: CIP ↩︎
- Wampold B, Imel. Z.E. (2015): Velika psihoterapijska debata, 2. izdanje. (The Great Psychotherapy Debate. 2nd edition.) London, Routledge ↩︎