Naturalistic studies

Although some naturalistic studies of psychotherapy have been used to claim that psychotherapy is effective, (7> more often naturalistic designs are used to examine issues such as the dose-response relationship in psychotherapy, or predictors of therapeutic change. For example, Kopta et a/.(23) examined the patterns of symptomatic recovery for 854 patients in psychotherapy. The authors report that for chronic distress symptoms, it took until 52 sessions until 60 to 86 per cent (depending upon the specific symptom) of patients had clinically significant change. For selected acute distress and chronic distress symptoms, it was estimated that it takes 58 sessions until 75 per cent of patients achieve a clinically significant change. While this form of naturalistic study has several advantages, including the fact that the data are drawn from actual clinical services in the real world, such data do not add to an understanding of which forms of psychotherapy work and which do not, and they do not provide strong causal statements. Hypotheses generated from naturalistic studies can inform the planning of experiments that can make stronger statements about causality. In addition, naturalistic studies provide useful descriptive information about the service delivery system.

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