Assessing Evidence-Based Psychotherapy

该博士后奖学金将支持一项为期两年的研究，调查基于证据的谈话治疗干预措施的兴起。这项研究将包括对来自培训机构、认证要求、保险报销指南和期刊出版物的文件进行制度和历史分析。这些数据将补充作者广泛的人种学观察和与临床医生的访谈，以促进文章和专著的出版。作者将共同努力向从业人员传播研究结果。此外，本计划将提供机会，训练本科生进行研究实践，并培养他们对科学技术研究和医学社会学的兴趣。最后，本研究将产生一个教学模块，侧重于围绕心理科学中“证据”的争论。该模块将结合分析观点和主要材料，并将在网上免费提供。本研究将对现有奖学金作出四项贡献。首先，它将阐明新的概念工具和实践在知识领域之间传播的过程；具体来说，它将提供一个关于最初与药物测试相关的“功效”和“证据”概念如何成为谈话治疗研究的标准的说明。其次，本研究将通过证明在研究试验和临床之间传播的可信知识的构建取决于保险公司的调解，从而阐明人文科学内部的争论。第三，它将有助于当前关于医疗行业地位的争论，因为它表明标准可以巩固而不是削弱专家的管辖权和权威主张。第四，它将通过追踪一组在很大程度上被忽视的方法，即认知行为疗法的发展和主导地位，填补现有文献中的经验空白。总体目标是展示谈话科学如何挑战认知行为疗法优势的标准解释。本研究提出的另一个解释机制是经济可行性；它被用来将注意力集中在“良好科学”的特定概念和有利于精神疾病标准化概念的经济制度的共同构成上。这些结果将与决策者、临床医生和患者相关。他们还将有助于心理治疗领域关于精神分析干预的经验验证和临床工作中此类实践的持续相关性的持续辩论。

General Audience SummaryThis 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 SummaryThe 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.