Evidence‐based practice in family therapy and systemic consultation

Carr, Alan

doi:10.1111/1467-6427.00137

Cited by 127 publications

(88 citation statements)

References 139 publications

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“…Recent reviews have alluded to increasing evidence for the effectiveness of family-based therapy for adolescent AN (e.g., Carr, 2000;Wilson & Fairburn, 1998). Based on current evidence, albeit limited, family-based therapy appears to be the treatment of choice for adolescent AN.…”

Section: Discussionmentioning

confidence: 99%

The dearth of psychological treatment studies for anorexia nervosa

Grange

Lock

2005

Int. J. Eat. Disord.

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Section: Discussionmentioning

confidence: 99%

The dearth of psychological treatment studies for anorexia nervosa

Grange

Lock

2005

Int. J. Eat. Disord.

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“…There are many forms of FT, 792 most of which are informed primarily by structural family systems theory 793 and drawing on a wide range of techniques from other interventions, such as CBT. This can make assessing its effectiveness quite challenging, as some forms of therapy are essentially systems-focused cognitive-behavioural interventions.…”

Section: Systemic Family Therapymentioning

confidence: 99%

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

Macdonald

Livingstone

Hanratty

et al. 2016

Health Technol Assess

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BackgroundChild maltreatment is a substantial social problem that affects large numbers of children and young people in the UK, resulting in a range of significant short- and long-term psychosocial problems.ObjectivesTo synthesise evidence of the effectiveness, cost-effectiveness and acceptability of interventions addressing the adverse consequences of child maltreatment.Study designFor effectiveness, we included any controlled study. Other study designs were considered for economic decision modelling. For acceptability, we included any study that asked participants for their views.ParticipantsChildren and young people up to 24 years 11 months, who had experienced maltreatment before the age of 17 years 11 months.InterventionsAny psychosocial intervention provided in any setting aiming to address the consequences of maltreatment.Main outcome measuresPsychological distress [particularly post-traumatic stress disorder (PTSD), depression and anxiety, and self-harm], behaviour, social functioning, quality of life and acceptability.MethodsYoung Persons and Professional Advisory Groups guided the project, which was conducted in accordance with Cochrane Collaboration and NHS Centre for Reviews and Dissemination guidance. Departures from the published protocol were recorded and explained. Meta-analyses and cost-effectiveness analyses of available data were undertaken where possible.ResultsWe identified 198 effectiveness studies (including 62 randomised trials); six economic evaluations (five using trial data and one decision-analytic model); and 73 studies investigating treatment acceptability. Pooled data on cognitive–behavioural therapy (CBT) for sexual abuse suggested post-treatment reductions in PTSD [standardised mean difference (SMD) –0.44 (95% CI –4.43 to –1.53)], depression [mean difference –2.83 (95% CI –4.53 to –1.13)] and anxiety [SMD –0.23 (95% CI –0.03 to –0.42)]. No differences were observed for post-treatment sexualised behaviour, externalising behaviour, behaviour management skills of parents, or parental support to the child. Findings from attachment-focused interventions suggested improvements in secure attachment [odds ratio 0.14 (95% CI 0.03 to 0.70)] and reductions in disorganised behaviour [SMD 0.23 (95% CI 0.13 to 0.42)], but no differences in avoidant attachment or externalising behaviour. Few studies addressed the role of caregivers, or the impact of the therapist–child relationship. Economic evaluations suffered methodological limitations and provided conflicting results. As a result, decision-analytic modelling was not possible, but cost-effectiveness analysis using effectiveness data from meta-analyses was undertaken for the most promising intervention: CBT for sexual abuse. Analyses of the cost-effectiveness of CBT were limited by the lack of cost data beyond the cost of CBT itself.ConclusionsIt is not possible to draw firm conclusions about which interventions are effective for children with different maltreatment profiles, which are of no benefit or are harmful, and which factors encourage people to seek therapy, accept the offer of therapy and actively engage with therapy. Little is known about the cost-effectiveness of alternative interventions.LimitationsStudies were largely conducted outside the UK. The heterogeneity of outcomes and measures seriously impacted on the ability to conduct meta-analyses.Future workStudies are needed that assess the effectiveness of interventions within a UK context, which address the wider effects of maltreatment, as well as specific clinical outcomes.Study registrationThis study is registered as PROSPERO CRD42013003889.FundingThe National Institute for Health Research Health Technology Assessment programme.

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“…Es válido recordar y diferenciar aquellas terapias que no tienen suficiente soporte empírico y que de algún modo están intentando perfeccionar sus intervenciones (véanse por ejemplo los aportes de Fonagy et al (2005) en terapia psicodinámica y de Carr (2000) en terapia sistémica) de aquellas terapias que simplemente no disponen de ningún estudio empírico o no se interesan en demostrar su efectividad. Sólo haría falta observar cómo ciertas terapias que son promovidas, por ejemplo en el contexto peruano, no aparecen en ningún reporte científico o guía de tratamientos, que han sido citados anteriormente.…”

Section: Limitaciones Y Direcciones Futurasunclassified

La urgencia de la evidencia en psicoterapia

Paredes-Rivera

2016

Interacciones

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RESUMENActualmente, y tras una larga historia de desarrollo y evolución, la psicoterapia es un campo en el que se presentan diferentes modelos de intervención, donde cada uno busca obtener un reconocimiento propio y su respectiva promoción. Ante esto, se plantea inicialmente la cuestión acerca de la utilidad de los modelos y que estos ofrezcan realmente resultados, haciéndose urgente contar con indicadores de eficacia respecto a los tratamientos empleados. En ese sentido, un paso importante ha sido la consolidación de los Tratamientos Psicológicos Eficaces (Chambless & Hollon, 1998), y más importante aún la meta de instaurar una Psicología Clínica Basada en la Evidencia (Spring, 2007). El presente artículo hace un análisis y revisión de esta propuesta, destacando la necesidad de adoptarla a favor de la coherencia con la idea de la psicología como ciencia; por otro lado también se describen las críticas o limitaciones planteadas, así como respuestas documentadas ante las mismas, considerando los retos futuros a los que conllevan para el avance de la psicología clínica y de la psicoterapia.Palabras claves: Psicología clínica, psicoterapia, tratamientos psicológicos eficaces, psicología basada en la evidencia. ABSTRACTCurrently, and after a long history of development and evolution, psychotherapy is a field where different models of intervention meet together, and everyone wants to obtain its own recognition and promotion. Considering this, it is contemplated the problem with the usefulness of the models and if them really present results, making the urgency of have an efficacy indicator of the treatments in use. In that sense, an important advance was the consolidation of the Efficacy of Psychological Treatments (Chambless & Hollon, 1998), and even more important the target of establish an Evidence-based Clinical Psychology (Spring, 2007). In this paper, it is made an analysis and review of this proposal, emphasizing the need of adopt it supporting the coherence with the idea of psychology as a science. What is more, it is described the criticism or the limitations of this point of view and some informed responses to them, considering the future challenges in the advance of clinical psychology and psychotherapy.

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Evidence‐based practice in family therapy and systemic consultation

Cited by 127 publications

References 139 publications

The dearth of psychological treatment studies for anorexia nervosa

The dearth of psychological treatment studies for anorexia nervosa

The effectiveness, acceptability and cost-effectiveness of psychosocial interventions for maltreated children and adolescents: an evidence synthesis

La urgencia de la evidencia en psicoterapia

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