Evidence based practice or Practice based evidence: An Integrative perspective on psychotherapy research

The author of the article critiques the current preoccupations and practices of the evidence based practice movement. He emphasises the importance of work with evidence to back up practice, but at the same time he challenges existing assumptions about what constitutes ‘best’ evidence. He takes issue with the over-emphasis on quantitative evidence where the use of randomised controlled trials (RCTs) is held up as the ‘gold standard’. He also takes issue with the evidence-based practice movement’s focus on comparing the effectiveness and outcomes of various therapy modalities since research suggests differences between them are less relevant than underlying relational processes which they share. Later in the paper the author offers his preferred form of evidence based practice. He makes the case for a special type of evidence: qualitative relational-centred, practice-based evidence. He advocates more research on therapeutic process (rather than on just outcomes) showing how therapy evolves in practice and over time. He believes it is important for the practitioner to feel there are things they can do in their everyday practice which may be regarded as a respectable level of ‘research activity’ towards making a difference to the wider profession and to clients. While the context of the paper is the current ‘political’ situation in the United Kingdom, the content is relevant to all European nations and especially to the USA, which was the first nation to experience ‘managed care’ and its consequences. This address is a slightly amended adaptation of chapter 4 of a forthcoming book Relational Centred Research for Psychotherapists: Exploring Meanings and Experience to be published by Wiley Blackwell in September 2009. Dr. Linda Finlay is the co-authorship of the book.