Assessing Evidence-Based Psychotherapy

Northwestern University, Evanston IL

Investigators

Abstract

General Audience Summary This postdoctoral fellowship will support a two-year study that investigates the rise of evidence-based, talk-therapeutic interventions. The study will include institutional and historical analyses of documents from training organizations, accreditation requirements, insurance reimbursement guidelines, and journal publications. These data will complement the author's extensive ethnographic observations and interviews with clinicians to facilitate the publication of articles and a monograph. The author will engage in a concerted effort to disseminate the study's findings to practitioners. Moreover, this project will include opportunities for training undergraduate students in research practices and developing their interests in science and technology studies and the sociology of medicine. Lastly, this study will result in a teaching module focused on contestations around "evidence" in the psychological sciences. The module will incorporate both analytical perspectives and primary materials, and will be freely available on the web. Technical Summary The study will make four contributions to existing scholarship. First, it will illuminate the processes by which novel conceptual tools and practices travel between domains of knowledge; specifically, it will provide an account of how notions of "efficacy" and "evidence" originally associated with pharmaceutical drug testing came to be the standards in talk therapeutic research. Second, this study will shed light on contestations within the human sciences by demonstrating that the construction of credible knowledge that can travel between the research trial and the clinic depends on the mediation of insurance companies. Third, it will contribute to current debates about the status of the medical profession by suggesting that standards can solidify rather than undermine experts' jurisdictional and authority claims. Fourth, it will fill an empirical gap in existing literature by tracing the development and rise to dominance of a set of approaches that has been largely overlooked, namely cognitive behavioral therapies. The overarching goal is to show how the science of talk challenges the standard interpretation of the ascendancy of cognitive behavior therapies. Another explanatory mechanism advanced in this study is economic viability; it is used to focus attention on the co-constitution of particular notions of "good science" and an economic regime that favors standardizable conceptions of mental illness. These results will be relevant to policy-makers, clinicians, and patients. They will also contribute to ongoing debates in the psychotherapy field regarding the empirical validation of psychoanalytic interventions and the continued relevance of such practices in clinical work.