Board editorial: Psychological therapies and or as transformational research?

Abstract

In research cultures there is, I believe, a pervasive fear of anything lacking intellectual precision. In this context accounts of research into mental health and illness, and health in general for that matter, tend towards a cautious and defensive stance, giving the reader the impression of a practitioner/researcher who is more organised and coherent than is actually the case (Freshwater, 2003). Mental illness is not a neutral, value free, scientifically precise term, which begs the question: How can it be researched as such? Research is often invoked as a method of establishing whether or not it is necessary to provide a service, which service to provide, or how to measure the efficacy of a service. However, the huge amount of research conducted into areas such as psychological therapy over and during the last 40 years has, to a large extent, at least until recently, failed to influence the design of services or treatments. Where research has demonstrated that a particular type of treatment would benefit patients, NHS service providers have not always ensured that the necessary skill base is developed and appropriate funding ring fenced. One such example of this is the strong evidence that the therapeutic relationship is the sine qua non of successful therapy; a relationship that requires time, energy and effort to cultivate. And yet, most often, the focus of psychological therapies research centres around the effectiveness of short-term interventions such as cognitive behavioural and psychosocial skills. Proponents of such therapies now usefully contest the long held belief that short-term psychological therapeutic interventions do no prize or emphasise the importance of the relationship continues to be challenged by such research studies as presented in this focus issue on contemporary psychological therapies research. We are all, by now, familiar with the idiom ‘what counts cannot always be counted’. It is of course rightly argued that evidence for advanced practice must be based on research, and that this research must be scientific, which means that it should be objective, ideally assuming a quantitative approach. Furthermore, anything worthwhile that is subjective is covered by qualitative approaches, which might be included as research evidence – if they can prove they are scientific. The philosopher Kierkegaard (1941) argued that objective thought translates everything into results and helps all mankind to cheat, by copying these off and reciting them by rote. Public consensual knowledge of mental illness is based, by and large,