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Gepubliceerd in: GZ - Psychologie 4/2011

01-06-2011 | Wetenschap

Uitkomstonderzoek en mechanismen van verandering: twee handen op één buik?

Auteur: Prof. dr. E.H.W. Koster

Gepubliceerd in: GZ - Psychologie | Uitgave 4/2011

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Samenvatting

Binnen het klinisch handelen wordt er in toenemende mate verwacht dat psychologen zich baseren op de bevindingen uit uitkomstonderzoek. Binnen dit onderzoek wordt er met name veel gewicht toegekend aan de resultaten van randomized controlled trials. Hoewel deze tendens een belangrijke stap voorwaarts betekent, zijn er enkele belangrijke kanttekeningen te plaatsen bij deze ontwikkelingen. In dit artikel wordt beargumenteerd dat we binnen de klinische psychologie waakzaam moeten zijn ten opzichte van een hegemonie van uitkomstonderzoek. Er wordt gesteld dat het noodzakelijk is dat er naast informatie uit behandeluitkomstonderzoek meer gewicht zou moeten worden toegekend aan (1) onderzoek naar verandermechanismen, (2) onderzoek naar succesvolle cliënten en (3) onderzoek naar succesvolle therapeuten.
Literatuur
go back to reference Blatt, S.J., Sanislow, C.A., Zuroff, D.C., e.a. (1996). Characteristics of effective therapists: further analyses of data from the National Institute of Mental Health treatment of depression collaborative research program. Journal of Consulting and Clinical Psychology, 64, 1276–84.CrossRefPubMed Blatt, S.J., Sanislow, C.A., Zuroff, D.C., e.a. (1996). Characteristics of effective therapists: further analyses of data from the National Institute of Mental Health treatment of depression collaborative research program. Journal of Consulting and Clinical Psychology, 64, 1276–84.CrossRefPubMed
go back to reference Bohart, A.C., & Tallman, K. (2010). Clients: the neglected common factor in psychotherapy. In: Duncan, B.L., Miller, S.D., Wampold, B.E., & Hubble, M.A. (red.). The heart and soul of change: delivering what works in therapy (2e ed.). American Psychological Association: Waskington. Bohart, A.C., & Tallman, K. (2010). Clients: the neglected common factor in psychotherapy. In: Duncan, B.L., Miller, S.D., Wampold, B.E., & Hubble, M.A. (red.). The heart and soul of change: delivering what works in therapy (2e ed.). American Psychological Association: Waskington.
go back to reference Cuijpers, P., Straten, A. van, Andersson, G., e.a. (2008). Psychotherapy for depression in adults: a meta-analysis of comparative outcome studies. Journal of Consulting and Clinical Psychology, 76, 909–22.CrossRefPubMed Cuijpers, P., Straten, A. van, Andersson, G., e.a. (2008). Psychotherapy for depression in adults: a meta-analysis of comparative outcome studies. Journal of Consulting and Clinical Psychology, 76, 909–22.CrossRefPubMed
go back to reference Cuijpers, P., Straten, A. van, Oppen, P.C. van, e.a. (2010). Welke psychologische behandeling, uitgevoerd door wie, is het meest effectief bij depressie? Gedragstherapie, 43, 79–113. Cuijpers, P., Straten, A. van, Oppen, P.C. van, e.a. (2010). Welke psychologische behandeling, uitgevoerd door wie, is het meest effectief bij depressie? Gedragstherapie, 43, 79–113.
go back to reference Dimidjian, S., Hollon, S.D., Dobson, K.S., e.a. (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 74, 658–70.CrossRefPubMed Dimidjian, S., Hollon, S.D., Dobson, K.S., e.a. (2006). Randomized trial of behavioral activation, cognitive therapy, and antidepressant medication in the acute treatment of adults with major depression. Journal of Consulting and Clinical Psychology, 74, 658–70.CrossRefPubMed
go back to reference Hayes, A.M., Laurenceau, J-P., Feldman, G.C., e.a. (2007). Change is not always linear: the study of nonlinear and discontinuous patterns of change in psychotherapy. Clinical Psychology Review, 27, 715–24.CrossRefPubMedPubMedCentral Hayes, A.M., Laurenceau, J-P., Feldman, G.C., e.a. (2007). Change is not always linear: the study of nonlinear and discontinuous patterns of change in psychotherapy. Clinical Psychology Review, 27, 715–24.CrossRefPubMedPubMedCentral
go back to reference Kazdin, A.E. (2007). Mediators and mechanisms of change in psychotherapy research. Annual Review of Clinical Psychology, 3, 1–27.CrossRefPubMed Kazdin, A.E. (2007). Mediators and mechanisms of change in psychotherapy research. Annual Review of Clinical Psychology, 3, 1–27.CrossRefPubMed
go back to reference Kendall, P.C., Holmbeck, G., & Verduin, T. (2004). Methodology, design, and evaluation in psychotherapy research. In: Lambert M. (ed.). Bergin and Garfield’s Handbook of psychotherapy and behavior change (5th ed). New York: Wiley. Kendall, P.C., Holmbeck, G., & Verduin, T. (2004). Methodology, design, and evaluation in psychotherapy research. In: Lambert M. (ed.). Bergin and Garfield’s Handbook of psychotherapy and behavior change (5th ed). New York: Wiley.
go back to reference Koster, E.H.W., Stein, E.J., & Soetens, B. (2009). Evidence-based werken binnen de klinische psychologie: op zoek naar wetenschappelijke informatie. Gedragstherapie, 42, 149–67. Koster, E.H.W., Stein, E.J., & Soetens, B. (2009). Evidence-based werken binnen de klinische psychologie: op zoek naar wetenschappelijke informatie. Gedragstherapie, 42, 149–67.
go back to reference Luborsky, L., McLellan, A., Diguer, L., e.a. (1997). The psychotherapist matters: comparison of outcomes across twenty-two therapists and seven patient samples. Clinical Psychology: Science and Practice, 4, 53–65. Luborsky, L., McLellan, A., Diguer, L., e.a. (1997). The psychotherapist matters: comparison of outcomes across twenty-two therapists and seven patient samples. Clinical Psychology: Science and Practice, 4, 53–65.
go back to reference McNally, R.J. (2007). Mechanisms of exposure therapy: how neuroscience can help improve psychological treatment for anxiety disorders. Clinical Psychology Review, 27, 750–9.CrossRefPubMed McNally, R.J. (2007). Mechanisms of exposure therapy: how neuroscience can help improve psychological treatment for anxiety disorders. Clinical Psychology Review, 27, 750–9.CrossRefPubMed
go back to reference Rosenzweig, S. (1936). Some implicit common factors in diverse methods of psychotherapy. American Journal of Orthopsychiatry, 6, 412–5.CrossRef Rosenzweig, S. (1936). Some implicit common factors in diverse methods of psychotherapy. American Journal of Orthopsychiatry, 6, 412–5.CrossRef
go back to reference Slade, K., Lambert, M.J., Harmon, S.C., e.a. (2008). Improving psychotherapy outcome: the use of immediate electronic feedback and revised clinical support tools. Clinical Psychology & Psychotherapy. Slade, K., Lambert, M.J., Harmon, S.C., e.a. (2008). Improving psychotherapy outcome: the use of immediate electronic feedback and revised clinical support tools. Clinical Psychology & Psychotherapy.
go back to reference Tang, T.Z., & DeRubeis, R.J. (1999). Sudden gains and critical sessions in cognitive behavioral therapy for depression. Journal of Consulting and Clinical Psychology, 67, 894–904.CrossRefPubMed Tang, T.Z., & DeRubeis, R.J. (1999). Sudden gains and critical sessions in cognitive behavioral therapy for depression. Journal of Consulting and Clinical Psychology, 67, 894–904.CrossRefPubMed
go back to reference Tang, T.Z., DeRubeis, R.J., Hollon, S.D., e.a. (2007). Sudden gains in cognitive therapy of depression and depression relapse/recurrence. Journal of Consulting and Clinical Psychology, 75, 404–8.CrossRefPubMed Tang, T.Z., DeRubeis, R.J., Hollon, S.D., e.a. (2007). Sudden gains in cognitive therapy of depression and depression relapse/recurrence. Journal of Consulting and Clinical Psychology, 75, 404–8.CrossRefPubMed
go back to reference Titov, N., Andrews, G., Davies, M., e.a. (2010). Internet treatment for depression: a randomized controlled trail comparing clinician versus technician assistance. PLoS One, 5, e10939.CrossRefPubMedPubMedCentral Titov, N., Andrews, G., Davies, M., e.a. (2010). Internet treatment for depression: a randomized controlled trail comparing clinician versus technician assistance. PLoS One, 5, e10939.CrossRefPubMedPubMedCentral
go back to reference Wampold, B.E. (2001). The great psychotherapy debate: models, methods, and findings. Mahwah, NJ: Lawrence Erlbaum Associates. Wampold, B.E. (2001). The great psychotherapy debate: models, methods, and findings. Mahwah, NJ: Lawrence Erlbaum Associates.
go back to reference Wampold, B.E. (2007). Psychotherapy: the humanistic (and effective) treatment. American Psychologist, 62, 857–73.CrossRef Wampold, B.E. (2007). Psychotherapy: the humanistic (and effective) treatment. American Psychologist, 62, 857–73.CrossRef
go back to reference Westen, D., Novotny, C.M., & Thompson-Brenner, H. (2004). The empirical status of empirically supported psychotherapies: assumptions, findings, and reporting in controlled clinical trials. Psychological Bulletin, 130, 631–63.CrossRefPubMed Westen, D., Novotny, C.M., & Thompson-Brenner, H. (2004). The empirical status of empirically supported psychotherapies: assumptions, findings, and reporting in controlled clinical trials. Psychological Bulletin, 130, 631–63.CrossRefPubMed
Metagegevens
Titel
Uitkomstonderzoek en mechanismen van verandering: twee handen op één buik?
Auteur
Prof. dr. E.H.W. Koster
Publicatiedatum
01-06-2011
Uitgeverij
Bohn Stafleu van Loghum
Gepubliceerd in
GZ - Psychologie / Uitgave 4/2011
Print ISSN: 1879-5080
Elektronisch ISSN: 1879-5099
DOI
https://doi.org/10.1007/s41480-011-0038-z

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