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Article

Phyllis Solomon

This entry defines Randomized Control Trials (RCTs) and puts them in an historical context. It provides an understanding of the distinction between efficacy and effectiveness RCTs and explains why effectiveness trials are more relevant to social work interventions. The strengths and limitations of RCTs that use experimental designs are delineated. It discusses the reporting requirements of RCTs by the standards of the CONSORT (Consolidated Standards of Reporting Trials).. It also presents the controversies of social workers in the use of RCTs.. Current health services research emphasizes evidence-based practices, research on comparative effectiveness, and using dissemination and implementation research to understand the gaps between empirically supported interventions and the services that are offered in routine care. RCTs have emerged as a central methodology in all of these efforts. Social workers, therefore, need to be knowledgeable and engage in these efforts.

Article

Scott O. Lilienfeld

Although psychotherapy is on balance effective for a broad array of psychological problems, a relatively small but steadily accumulating body of evidence suggests that at least some psychological interventions are harmful. Until recently, however, relatively little research attention has been paid to the identification of harmful psychological treatments. Although it has long been recognized that a nontrivial minority of people become worse following therapy, this finding does not necessarily mean that they have become worse because of therapy. Nevertheless, recent research has homed in on a small subset of interventions that may produce psychological harm, physical harm, or both. In addition, there is growing interest in pinpointing potential mechanisms of deterioration effects in psychotherapy, as well as in distinguishing harmful therapies from harmful therapists.

Article

Scott O. Lilienfeld and Candice Basterfield

Evidence-based therapies stemmed from the movement toward evidence-based medicine, and later, evidence-based practice (EBP) in psychology and allied fields. EBP reflects a progressive historical shift from naïve empiricism, which is based on raw and untutored observations of patient change, to systematic empiricism, which refines and hones such observations with the aid of systematic research techniques. EBP traces its roots in part to the development of methods of randomization in the early 20th century. In American psychology, EBP has traditionally been conceptualized as a three-legged stool comprising high-quality treatment outcome evidence, clinical expertise, and patient preferences and values. The research leg of the stool is typically operationalized in terms of a hierarchy of evidentiary certainty, with randomized controlled trials and meta-analyses of such trials toward the apex. The most influential operationalization of the EBP research leg is the effort to identify empirically supported treatments, which are psychotherapies that have been demonstrated to work for specific psychological conditions. Still, EBP remains scientifically controversial in many quarters, and some critics have maintained that the research base underpinning it is less compelling than claimed by its proponents.

Article

Wayne A. Beach, Kyle Gutzmer, and Chelsea Chapman

Beginning with phone calls to an emergency psychiatric hospital and suicide prevention center, the roots of Conversation Analysis (CA) are embedded in systematic analyses of routine problems occurring between ordinary persons facing troubling health challenges, care providers, and the institutions they represent. After more than 50 years of research, CA is now a vibrant and robust mode of scientific investigation that includes close examination of a wide array of medical encounters between patients and their providers. Considerable efforts have been made to overview CA and medicine as a rapidly expanding mode of inquiry and field of research. Across a span of 18 years, we sample from 10 of these efforts to synthesize important priorities and findings emanating from CA investigations of diverse interactional practices and health care institutions. Key topics and issues are raised that provide a unique opportunity to identify and track the development and maturity of CA approaches to medical encounters. Attention is also given to promising new modes of research, and to the potential and challenges of improving medical practices by translating basic and rigorous empirical findings into innovative interventions for medical education. A case is made that increasing reliance on CA research can positively impact training and policies shaping the delivery of humane and quality medical care.

Article

Collaborative research has a critical role to play in furthering our understanding of African politics. Many of the most important and interesting questions in the field are difficult, if not impossible, to tackle without some form of collaboration, either between academics within and outside of Africa—often termed North–South research partnerships—or between those researchers and organizations from outside the academic world. In Africa in particular, collaborative research is becoming more frequent and more extensive. This is due not only to the value of the research that it can produce but also to pressures on the funding of African scholars and academics in the Global North, alongside similar pressures on the budgets of non-academic collaborators, including bilateral aid agencies, multilateral organizations, and national and international non-government organizations. Collaborative projects offer many advantages to these actors beyond access to new funding sources, so they constitute more than mere “marriages of convenience.” These benefits typically include access to methodological expertise and valuable new data sources, as well as opportunities to increase both the academic and “real-world” impact of research findings. Yet collaborative research also raises a number of challenges, many of which relate to equity. They center on issues such as who sets the research agenda, whether particular methodological approaches are privileged over others, how responsibility for different research tasks is allocated, how the benefits of that research are distributed, and the importance of treating colleagues with respect despite the narrative of “capacity-building.” Each challenge manifests in slightly different ways, and to varying extents, depending on the type of collaboration at hand: North–South research partnership or collaboration between academics and policymakers or practitioners. This article discusses both types of collaboration together because of their potential to overlap in ways that affect the severity and complexity of those challenges. These challenges are not unique to research in Africa, but they tend to manifest in ways that are distinct or particularly acute on the continent because of the context in which collaboration takes place. In short, the legacy of colonialism matters. That history not only shapes who collaborates with whom but also who does so from a position of power and who does not. Thus, the inequitable nature of some research collaborations is not simply the result of oversights or bad habits; it is the product of entrenched structural factors that produce, and reproduce, imbalances of power. This means that researchers seeking to make collaborative projects in Africa more equitable must engage with these issues early, proactively, and continuously throughout the entire life cycle of those research projects. This is true not just for researchers based in the Global North but for scholars from, or working in, Africa as well.