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The British Journal of Psychiatry (2000) 177: 123-130
© 2000 The Royal College of Psychiatrists

PSYCHOTHERAPY PAPERS

Measurement and psychotherapy

Evidence-based practice and practice-based evidence{dagger}

FRANK R. MARGISON, FRCPsych and GRAEME McGRATH, FRCPsych

Department of Psychotherapy, Manchester Royal Infirmary

MICHAEL BARKHAM, PhD, JOHN MELLOR CLARK, MA, KERRY AUDIN, BSc and JANICE CONNELL, BSc

Psychological Therapies Research Centre, University of Leeds

CHRIS EVANS, MRCPsych

Rampton Hospital, Nottinghamshire and Tavistock Centre, London

Correspondence: Dr Frank R. Margison, Gaskell Psychotherapy Centre, Manchester Royal Infirmary, Swinton Grove, Manchester M13 0EU, UK. E-mail: frmargison{at}aol.com

Declaration of interest The Mental Health Foundation, the Counselling in Primary Care Trust, and the Society for Psychotherapy Research (UK) (Northern Group) have supported the work of the CORE System Group.

{dagger} See editorial, pp. 93-94, this issue.

Background Measurement is the foundation of evidence-based practice. Advances in measurement procedures should extend to psychotherapy practice.

Aims To review the developments in measurement relevant to psychotherapy.

Method Domains reviewed are: (a) interventions; (b) case formulation; (c) treatment integrity; (d) performance (including adherence, competence and skilfulness); (e) treatment definitions; (f) therapeutic alliance; and (g) routine outcome measurement.

Results Modern methods of measurement can support ‘evidence-based practice’ for psychological treatments. They also support ‘practice-based evidence’, a complementary paradigm to improve clinical effectiveness in routine practice via the infrastructure of Practice Research Networks (PRNs).

Conclusions Advances in measurement derived from psychotherapy research support a model of professional self-management (practice-based evidence) which is widely applicable in psychiatry and medicine.




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