Évaluation, psychothérapies et psychanalyse : réflexions et perspectives éthiques, épistémologiques et scientifiques

Abstract

The field of psychotherapies’ evaluation has become a sector of research in France following the thunderclap represented by the report of Inserm (2004) proposing an inventory of the international scientific literature on the subject. Although criticized in many ways, this report had the merit of bringing practitioners and researchers, whether psychoanalysts or not, to position themselves and discuss this scientific and political question. Often criticized, the approach of the medical model applied to psychotherapies has rarely been from an epistemological and scientific point of view. Namely, does it bring increase knowledge? Starting from an epistemological consideration on the scientific criteria used to produce this report, we will propose a critical reflection on the pharmaceutical and statistical medical model in human sciences. We will argue at the end of the article some perspectives and considerations in order to think differently about clinical evaluation, by moving the question of refutability, reproducibility or internal and external validities to a field clinic including subjectivity, therapeutic relation, transference dynamics and the adequacy between the objectives of the therapeutic devices evaluated and the evaluative methodology, by putting the patient himself at the center of the evaluation as a reference frame-witness of evaluative process itself with some examples.