Mediators and Mechanisms of Change in Psychotherapy Research

Annual Review of Clinical Psychology - Tập 3 Số 1 - Trang 1-27 - 2007
Alan E. Kazdin1
1Department of Psychology, Yale University, New Haven, CT 06520-8205, USA. [email protected]

Tóm tắt

There has been enormous progress in psychotherapy research. This has culminated in recognition of several treatments that have strong evidence in their behalf. Even so, after decades of psychotherapy research, we cannot provide an evidence-based explanation for how or why even our most well studied interventions produce change, that is, the mechanism(s) through which treatments operate. This chapter presents central requirements for demonstrating mediators and mechanisms of change and reviews current data-analytic and designs approaches and why they fall short of meeting these requirements. The role of the therapeutic alliance in psychotherapy and cognitive changes in cognitive therapy for depression are highlighted to illustrate key issues. Promising lines of work to identify mediators and mechanisms, ways of bringing to bear multiple types of evidence, recommendations to make progress in understanding how therapy works, and conceptual and research challenges in evaluating mediators and mechanisms are also presented.

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Tài liệu tham khảo

10.1038/nrn1056

American Psychiatric Association, 2000, Am. J. Psychiatry, 157, 1

10.1037/0022-006X.68.6.1027

10.1037//0022-006X.64.5.927

10.1037//0022-3514.51.6.1173

10.1037/0022-006X.73.3.371

Berg BL, 2001, Qualitative Research Methods for the Social Sciences, 4

10.1023/A:1022678622119

10.1016/S0005-7894(01)80008-3

10.1037/0022-006X.73.4.749

10.1037/1040-3590.11.1.77

10.1126/science.1072290

10.1016/S0031-9384(03)00149-5

10.1016/j.nurx.2005.12.008

10.1111/j.0963-7214.2005.00367.x

10.1126/science.274.5286.430

Denzin NK, 2005, The SAGE Handbook of Qualitative Research, 3

10.1037//0022-006X.58.6.862

10.1007/BF01172968

10.1037/0022-006X.68.5.857

10.1001/archpsyc.61.7.738

Grawe K, 2004, Psychological Therapy

10.1056/NEJM199903253401204

10.1093/clipsy/7.1.3

10.1001/archpsyc.63.3.298

Hollon SD, 2004, Bergin and Garfield's Handbook of Psychotherapy and Behavior Change, 5, 447

10.1093/jpepsy/27.1.87

Horvath AO, 2002, Psychotherapy Relationships That Work: Therapist Contributions and Responsiveness to Patients, 37

10.1037//0022-006X.62.3.429

10.1111/j.1467-9280.2006.01742.x

10.1111/j.1468-2850.1994.tb00016.x

10.1017/S0954579405050042

10.1093/med:psych/9780195126181.001.0001

Kazdin AE, 2003, Research Design in Clinical Psychology, 4

Kazdin AE, 2005, Parent Management Training: Treatment for Oppositional, Aggressive, and Antisocial Behavior in Children and Adolescents

10.1037/11384-005

10.1111/1469-7610.00195

Kazdin AE, 2003, Evidence-Based Psychotherapies for Children and Adolescents

10.1037/0022-006X.74.2.346

Kenny DA, 1998, Handbook of Social Psychology, 1, 4, 233

10.1037//0022-006X.68.4.603

10.1001/archpsyc.1997.01830160065009

10.1176/appi.ajp.158.6.848

10.1001/archpsyc.59.10.877

10.1016/S0005-7916(03)00021-1

Lambert MJ, 2004, Bergin and Garfield's Handbook of Psychotherapy and Behavior Change, 5

Lin K, 1993, Psychopharmacology and Psychobiology of Ethnicity

10.1037/1082-989X.7.1.83

10.1016/S0376-8716(02)00216-8

10.1146/annurev.psych.48.1.1

10.1073/pnas.0511311103

10.1038/nn1494

10.1016/S0896-6273(02)01064-4

10.1093/med:psych/9780195304145.001.0001

Orlinsky DE, 2004, Bergin and Garfield's Handbook of Psychotherapy and Behavior Change, 5, 307

Patterson GR, 1982, Coercive Family Process

Patterson GR, 1992, Antisocial Boys

10.1093/clipsy/bpi045

10.1523/JNEUROSCI.3422-03.2004

10.1037/10468-000

10.1001/archpsyc.61.11.1136

10.1037/1082-989X.7.4.422

10.1037/10468-004

10.1037/0022-006X.67.6.894

10.1037//0022-006X.60.1.64

Twain M, 1874, The Gilded Age: A Tale of Today

10.1111/1469-7610.00002

10.1093/clipsy/6.3.300

Zigler E, 1986, A Developmental Approach to Adult Psychopathology