Zusammenfassung
Die Arbeit stellt, ausgehend von der wachsenden Notwendigkeit von Wirkungsnachweisen auch für das Feld der Psychotherapie, den internationalen Diskussionsstand zur Evidence-Based Medicine (EBM) dar und kontrastiert diesen mit einigen zentralen Aspekten gegenwärtiger Psychotherapieforschung. Im ersten Teil werden zunächst drei Bedeutungen von EBM unterschieden: EBM im weiteren Sinn als regulative Idee, EBM im engeren Sinn als kodifizierte Methode und EBM im Kontext als sozialpolitische Bewegung; anschließend werden Vor- und Nachteile randomisiert kontrollierter Studien (RCT) diskutiert. Im zweiten Teil wird zwischen der Binnen- und der Außenperspektive hinsichtlich EBM in der psychotherapeutischen Medizin differenziert; danach wird kurz auf die Auseinandersetzung um Grawes Metaanalyse und die sogenannte „Consumer Reports”-Studie sowie ausführlicher auf die Diskussion um „Empirically Supported Treatments” eingegangen. Die Probleme der Anwendung von RCT in der Psychotherapieforschung werden dabei ebenso dargelegt wie die derzeitigen Vorschläge für Alternativen, die der Erforschung real praktizierter Psychotherapien dienen.
This review article gives an overview of the state of the art of evidence-based medicine (EBM) which is contrasted with some central aspects of current psychotherapy research. In the first part, three meanings of EBM are discussed: EBM as a regulative idea, EBM as a codified method and EBM as a sociopolitical movement; it follows an evaluation of the advantages and disadvantages of randomized controlled trials (RCT). In the second part, the discussions surrounding the metaanalysis of Grawe, the „Consumer Reports” study and the so-called „Empirically Supported Treatments” are touched upon briefly; it follows a discussion of the specific problems of using RCTs in psychotherapy research and of the suggestions for more naturalistic studies in this field.
Key words
Evidence-based medicine - Psychotherapy research - Randomized controlled trial - Naturalistic designs
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Dr. med. HenningsenPeter
Psychosomatische Universitätsklinik
Thibautstr. 2
69115 Heidelberg
Email: peter_henningsen@med.uni-heidelberg.de
