Division 29 (Psychotherapy) did some great work putting together a special issue critiquing the APA guidelines on the treatment of PTSD. If you haven’t already, check it out here. I read through the articles yesterday and had a ton of reactions. There was some really great work in there. I tweeted a bunch of them out (link below) but I have one big takeaway:
If we continue to do research on therapy efficacy, we can’t ignore the largest basis of literature supporting the role of working alliance as a central mechanism of change. RCTs that know of a causal mechanism that do not control for those effects are not performing good science. Working alliance CAN and MUST be measured for us to make any claims about ‘what treatment is best’.
Alex Williams (the author of a fantastic recent article on the state of RCT/evidence-based care) commented that the reason that they haven’t done so was because doing so ‘didn’t answer the question they wanted to ask’, but blindfolds and intentional avoidance don’t make for good science.