Have RCTs passed their time? A structured discussion on the value of RCTs in psychotherapy research today

Rost, F. (2019). Have RCTs passed their time? A structured discussion on the value of RCTs in psychotherapy research today. In: 50th SPR International Annual Meeting, 4-6 Jul 2019, Buenos Aires, Argentina.

Abstract

The gold standard of outcome research, the randomized controlled trial, has been increasingly criticized on its value for psychotherapy this past decade. For instance, its ecological validity is strongly doubted and given the abundance of evidence of the efficacy of various treatments, its dominance over other research formats (e. g. , process research) is criticized. Nonetheless, the RCT remains its gold standard for its rigorous and controlled design and important role in informing policy decisions. The question however emerges: have we reached saturation in RCT generated evidence or should more RCTs be conducted to safeguard the future of our field, and in the latter case: how should future RCTs look like? Clearly, the past decades, RCTs have divided the field of psychotherapy research into advocates and opponents. This structured discussion aims at a lively discussion on the value of RCTs for the field of psychotherapy today, explicitly aiming to give voice to both pros and cons to result in a nuanced and balanced debate. Several issues will be addressed, for instance:
1) What is the current status of RCTs in the field of psychotherapy?
a. Why do we need RCTs: evidence on efficacy of treatments and/ or a means to convince policy?
b. Mixed methods randomized controlled trials: the future?
i. The role of qualitative research in RCTs
ii. The value of case studies in RCTs
c. Does "the RCT" exist or do different designs carry different advantages and drawbacks?
d. Alternatives: different needs require differ research questions and different research methods?

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