Clicca qui per scaricare

Condividi
Dove sono le evidenze della terapia "basata sulle evidenze"?
Titolo Rivista: PSICOTERAPIA E SCIENZE UMANE 
Autori/Curatori: Jonathan Shedler 
Anno di pubblicazione:  2018 Fascicolo: 3  Lingua: Italiano 
Numero pagine:  16 P. 383-398 Dimensione file:  204 KB
DOI:  10.3280/PU2018-003003
Il DOI è il codice a barre della proprietà intellettuale: per saperne di più:  clicca qui   qui 


La dicitura "terapia basata sulle evidenze" è diventata di fatto una espressione in codice per alludere a un tipo di terapia cognitivo-comportamentale prescrittiva e quasi sempre breve. Da più parti si proclama che le terapie "basate sulle evidenze" (evidence-based) sono scientificamente validate e superiori a tutte le altre psicoterapie. Però la ricerca empirica dimostra il contrario, e cioè che le terapie "basate sulle evidenze" sono poco efficaci, i loro effetti sono minimi, pochi pazienti migliorano, e durano poco anche i minimi effetti che a volte si ottengono. Spesso le ricerche vengono condotte in modo non rigoroso, così che emerge un quadro fuorviante dei risultati delle terapie "basate sulle evidenze": a volte mancano gruppi di controllo appropriati, i campioni sono costituiti da pazienti selezionati e non adeguatamente randomizzati, e vengono nascosti i risultati negativi.


Keywords: Terapia basata sulle evidenze; Trattamenti supportati empiricamente (EST); Ricerca sul risultato della psicoterapia; Terapia cognitivo-comportamentale (CBT); Terapia psicodinamica

  1. American Psychological Association (Presidential Task Force on Evidence-Based Practice) (2006). Evidence-based practice in psychology. American Psychologist, 61, 4: 271-285.
  2. American Psychological Association (2013). Recognition of psychotherapy effectiveness. Psy-chotherapy, 50, 1: 102-109.
  3. Angell M. (2011). The epidemic of mental illness: Why? The New York Review of Books, 58, 11 (June 23): 20-22; The illusions of psychiatry. The New York Review of Books, 58, 12 (July 14): 20-22 (trad. it.: L’epidemia di malattie mentali e le illusioni della psichiatria. Psicoterapia e Scienze Umane, 2012, XLVI, 2: 263-282., DOI: 10.3280/PU2012-002008)
  4. Baker T.B., McFall R.M. & Shoham V. (2008). Current status and future prospects of clinical psychology: Toward a scientifically principled approach to mental and behavioral health care. Psychological Science in the Public Interest, 9, 2: 67-103.
  5. Baker T., McFall R. & Shoham V. (2009). Is your therapist a little behind the times? Washington Post, November 15, 2009.
  6. Begley S. (2009). Ignoring the evidence. Why do psychologists reject science? Newsweek, 154, 15 (Oct. 12): 30 (www.newsweek.com/why-psychologists-reject-science-begley-81063).
  7. Bendat M. (2014). In name only? Mental health parity or illusory reform. Psychodynamic Psy-chiatry, 42, 3: 353-375.
  8. Cuijpers P., Smit F., Bohlmeijer E., Hollon S.D. & Andersson G. (2010). Efficacy of cognitive-behavioural therapy and other psychological treatments for adult depression: Meta-analytic study of publication bias. British Journal of Psychiatry, 196, 3: 173-178.
  9. Driessen E., Van H.L., Don F.J., Peen J., Kool S., Westra D., Hendriksen M., Schoevers R.A., Cuijpers P., Twisk J.W. & Dekker J.J. (2013). The efficacy of cognitive-behavioral therapy and psychodynamic therapy in the outpatient treatment of major depression: A randomized clinical trial. American Journal of Psychiatry, 170, 9: 1041-1050.
  10. Elkin I. (1994). Treatment of depression collaborative research program: Where we began and where we are. In: Garfield S.L. & Bergin A.E., editors, Handbook of Psychotherapy and Behavior Change, 4th Edition. New York: Wiley, 1994, pp. 114-139.
  11. Elkin I., Shea T., Watkins T., Imber S.D., Sotsky S.M., Collins J.F., Glass D.R., Pilkonis P.A., Leber W.R., Docherty J.P., Feister J., Parloff M.B. (1989). NIMH Treatment of Depression Collaborative Research Program: General effectiveness of treatment. Archives of General Psychiatry, 46, 11: 971-982.
  12. Gilboa-Schechtman E., Foa E., Shafran N., Aderka I-M., Powers M-B., Rachamim L., Rosen-bach L., Yadin E. & Apter A. (2010). Prolonged exposure versus dynamic therapy for ado-lescent PTSD: A pilot randomized controlled trial. Journal of the American Academy of Child and Adolescent Psychiatry, 49, 10: 1034-1042.
  13. Gilboa-Schechtman E., Shafran N., Foa E.B. (2011). Drs. Gilboa-Schechtman et al. reply. Journal of the American Academy of Child and Adolescent Psychiatry, 50, 5: 522-524.
  14. Hollon S.D., Thase M.E. & Markowitz J.C. (2002). Treatment and prevention of depression. Psychological Science in the Public Interest, 3, 2: 39-77., DOI: 10.1111/1529-1006.00008
  15. Kazdin A.E. (2006). Arbitrary metrics: Implications for identifying evidence-based treatments. American Psychologist, 61, 1: 42-49.
  16. Klerman G.L., Weissman M.M., Rounsaville B.J. & Chevron E.S. (1984). Interpersonal Psychotherapy of Depression. New York: Basic Books (trad. it.: Psicoterapia interpersonale della depressione. Torino: Bollati Boringhieri, 1989).
  17. Leichsenring F. & Steinert C. (2017). La terapia cognitivo-comportamentale è veramente la più efficace? Psicoterapia e Scienze Umane, 51, 4: 551-558., DOI: 10.3280/PU2017-004003
  18. Migone P. (2005). Farmaci antidepressivi nella pratica psichiatrica: efficacia reale. Psicoterapia e Scienze Umane, XXXIX, 3: 312-322.
  19. Migone P. (2015). Problemi della ricerca farmacologica: il caso dello “Studio 329”. Psicoterapia e Scienze Umane, 2015, XLIX, 4: 589-594., DOI: 10.3280/PU2015-004003
  20. Mischel W. (2008). Connecting clinical practice to scientific progress. Psychological Science in the Public Interest, 9, 2: i-ii.
  21. Sackett D.L., Rosenberg W.M., Gray J.A., Haynes R.B. & Richardson W.S. (1963). Evidence based medicine: What it is and what it isn’t. British Medical Journal, 312, 7023: 71-72.
  22. Shedler J. (2010). The efficacy of psychodynamic therapy. American Psychologist, 65, 2: 98-109.
  23. Shedler J. (2015). Where is the evidence for “evidence-based” therapy? Journal of Psychological Therapies in Primary Care, 4, 1: 47-59.
  24. Turner E.H., Matthews A.M., Linardatos E., Tell R.A. & Rosenthal R. (2008). Selective Publication of Antidepressant Trials and Its Influence on Apparent Efficacy. New England Journal of Medicine, 358, 3: 252-260.
  25. Wampold B.E., Budge S.L., Laska K.M., Del Re A.C., Baardseth T.P., Fluckiger C., Minami T., Kivlighan D.M. 2nd & Gunn W. (2011). Evidence-based treatments for depression and anxiety versus treatment-as-usual: A meta-analysis of direct comparisons. Clinical Psychology Review, 31, 8: 1304-1312.
  26. Wasserstein R.L. & Lazar N.A. (2016). The ASA’s statement on p-values: Context, process, and purpose. American Statistician, 70, 2: 129-33., DOI: 10.1080/00031305.2016.1154108
  27. Westen D. & Morrison K. (2001). A multidimensional meta-analysis of treatments for depression, panic, and generalized anxiety disorder: An empirical examination of the status of empirically supported therapies. Journal of Consulting and Clinical Psychology, 69, 6: 875-899., DOI: 10.1037/0022-006X.69.6.875
  28. Westen D., Morrison Novotny K. & Thompson-Brenner H. (2004). The empirical status of empirically supported psychotherapies: Assumptions, findings, and reporting in controlled clinical trials. Psychological Bulletin, 130, 4: 631-663.
  29. Wittmann L., Halpern J., Adams C.B., Orner R.J. & Kudler H. (2011). Prolonged exposure and psychodynamic treatment for posttraumatic stress disorder. Journal of the American Academy of Child and Adolescent Psychiatry, 50, 5: 521-522.



  1. Impossibile comunicare con Crossref: The request was aborted: Could not create SSL/TLS secure channel.

Jonathan Shedler, in "PSICOTERAPIA E SCIENZE UMANE" 3/2018, pp. 383-398, DOI:10.3280/PU2018-003003

   

FrancoAngeli è membro della Publishers International Linking Association associazione indipendente e no profit per facilitare l'accesso degli studiosi ai contenuti digitali nelle pubblicazioni professionali e scientifiche