Practice-Oriented Research in Psychotherapy. Past, Present, and Future

Abstract

In recent decades, randomized-controlled trials (RCTs) have established a broad evidence base of psychotherapy with moderate-to-large effects for various mental disorders. In addition to determining the efficacy of psychotherapy, studies examining its effectiveness under everyday conditions historically paved the way for developing a practice-oriented research paradigm. This paper argues that, within this paradigm, practice-based studies are a valuable complement to RCTs as they can address existing problems in psychotherapy research. In current practice-oriented research, new approaches from personalized medicine and methods from computational psychiatry provide important clues for optimizing effects in psychotherapy. In the context of personalization, for example, clinical multivariable prediction models are being developed that enable evidence-based outcome monitoring through feedback loops to practitioners in the short term and strengthen the German practice-research network in the long term. In conclusion, the paper derives and discusses future directions for practice-oriented research in terms of the "precision mental health care"paradigm.