UKCP Report on Humanistic and Integrative Psychotherapies Preliminary Statement:
1. Critique of criteria for the selection of evidence of the Skills for
Health project
2. Case for widening of humanistic category and inclusion of
integrative position
3. Indication of work required to be undertaken
April 2008: Issue 2 (Final)
Research Centre for Therapeutic Education
Roehampton University
Rhiannon Thomas, Sue Stephenson, Del Loewenthal – UKCP Research Unit, Roehampton University
UKCP Report on Humanistic and Integrative Psychotherapies – Preliminary Statement
April 2008
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Humanistic and Integrative Psychotherapies - Preliminary Statement
Introduction
The UKCP Research Unit has been asked to provide three main items of information in this preliminary statement. Firstly,
documented in Section A of this report, a critique of the criteria for selection of evidence used in the Skills for Health
project currently being undertaken by Tony Roth and Steve Pilling; secondly, documented in Section B, the presentation
of the preliminary case for a widening of the humanistic category and inclusion of the integrative position; and thirdly,
documented in Section C, to indicate the work to be undertaken subsequent to this preliminary phase.
Section A
Introduction: Critique of the criteria for selection of evidence used in the Skills for Health project
The critique requested has been structured in the following way. Firstly, a general critique of randomised control trials
(RCTs) in terms of the extent to which they are able accurately to represent research into actual psychotherapy practice,
rather than research into psychotherapy in an experimental, research setting. The argument is put forward that whilst
significant evidence is gained from RCT-structured research methodologies, other research methods provide informatively
different positions in terms of the relation between clinical research and clinical practice and thus must also be considered
as valid forms of evidence. Questions as to the nature of what is considered ‘evidence’ is relevant here and as such,
arguments that have been put forward for practice-based evidence as opposed to RCTs are considered.
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Secondly, a methodological critique of RCTs is put forward. This is not to argue against the value of such research but to
indicate that whilst methodological flaws in terms of validity and reliability are cited with regard to non-RCT based
research, ‘Randomised Control Trials’ per se should not be cited as more or less valid than other forms of research. This
is due to, for example, the variations inherent within the method, with specific reference to research on the use of
placebos (Klein 1997), and also on the impact on outcome measures of, for example, ‘wait list control groups’ (Basham
1986).
Thirdly, the case has been advanced regarding the problems inherent in utilising RCTs for conducting research into nonbehavioural, including humanistic and integrative, psychotherapies.
1.
Randomised Control Trials: Critiques of Research-Practice links
The argument for the widening of the research base is put forward persuasively by Seligman (1995):
‘Because treatment in efficacy studies is delivered under tightly controlled conditions to carefully screened patients,
sensitivity is maximised and efficacy studies are very useful for deciding whether one treatment is better than another
treatment for a given disorder. But my belief has changed about what counts as a “gold standard”…I came to see that
deciding whether one treatment, under highly controlled conditions works better than another treatment or a control group
is a different question from deciding what works in the field’ (Seligman 1995:966).
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According to Margison et al (2000), of importance to clinicians is ‘the poor success of RCTs in predicting outcome at the
level of the individual case from data summarised at the level of group means’ in comparison to ‘the best predictor of
outcome(which) is initial therapeutic alliance’(Margison et al 2000:124). John McLeod argues that ‘despite the general
acknowledgement that it is important for counselling and psychotherapy practice to be informed by research, it is clear
that in recent years a widening gap has emerged between research and practice’ (McLeod 2001a:3).
Chiesa and Fonagy (1999) draw distinctions between condition-specific efficacy research and research which investigates
the effectiveness of treatment as it evolves in routine clinical practice. ‘In “Efficacy Research” the RCT is the gold
standard’ (Mottram 2000:1), however whilst in drug trials, the RCT experimental conditions closely approximate clinical
reality, it is argued that in ‘psychotherapy RCTs the conditions created represent a substantial deviation from usual
psychotherapy clinical practice conditions’ (Mottram 2000:1). Seligman (1995) states that ‘Efficacy study is the wrong
method for empirically validating psychotherapy as it is actually done because it limits too many crucial elements of what
is done in the field’ (Seligman 1995: 966). The issue of how RCT clinical research links to - and potentially informs clinical practice is a significant one, a question that is perhaps not as pertinent in relation to naturalistic research
methodologies where an experimental situation is, in effect, avoided in favour of one which more closely reflects actual
practice. Specifically, Seligman highlights factors such as the question of research-directed fixed duration therapy; the
issue that patients are usually active in selecting a modality and a therapist (especially in private health care); and the fact
that most therapy ‘in the field’ aims at addressing parallel and interacting difficulties with a concern for improvement in
general functioning and quality of life issues, rather than a single focus on symptom reduction of a disorder (Seligman
1995). Mottram states that ‘psychotherapy in practice is a treatment of variable duration, with improvised and self-
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correcting features that aims to improve quality of life as well as symptom relief in patients who are not randomly allocated
and who have multiple problems’ (Mottram 2000:2).
Quantitative research that seeks to make comparisons between groups of treated clients also runs into problems
(Jacobson et al 1999) in terms of the fact that such comparisons provide ‘little or no information regarding the variability in
treatment response from person to person.... Group means, for example, do not in and of themselves indicate the
proportion of participants who have improved or recovered as a result’ (Jacobson et al 1999). Secondly, ‘standard
statistical comparisons between groups seldom determine the practical importance of the treatment effects…(and)
although large effects are likely to be clinically more significant than small ones, even large effects can be clinically
insignificant’ (Jacobson et al 1999). Such debates surrounding the mathematical criteria most appropriate for data
analysis indicate that evidence from RCT research is not without ambiguity. In addition to this are the difficulties inherent
in cross comparison between RCTs where different statistical analyses have been used. This type of comparison is
essentially meaningless and thereby limits the usefulness of RCT evidence in building a picture of the relative efficacy of
various therapeutic modalities.
Kaplan (1998: 95) states that ‘Qualitative is exploratory and theory building. Quantitative tests hypothesis in order to refine
and validate theory’. Carr (1994) identifies that ‘neither approach is superior to the other; qualitative research appears
invaluable for the exploration of subjective experiences … and quantitative methods facilitate the discovery of quantifiable
information’ (Carr 1994:716). Elliott (1999) argues for the usefulness of qualitative research into both new phenomena and
areas that have received ‘substantial quantitative research’ (Elliott 1999:253). More fully critical of the insistence on the
‘evidence based’ ethos, Feltham asserts that this approach is ‘seriously flawed and that psychotherapy is essentially a
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faith-based craft, not a thoroughly researchable scientific enterprise’ (Feltham 2005:131). From these perspectives, it
appears that there is a case for the relevance and importance of research representing both quantitative and qualitative
methodological positions in an inclusive paradigm (Marshall & Rossman 2006; McLeod 2000; McLeod 2001a Sells et al.
1995).
For example, the usefulness of the case study for establishing the validity of, for example, psychoanalytic ideas has
recently been strongly challenged with critics arguing that clinical evidence derived from the consulting room is too
vulnerable to epistemic contamination via suggestion, compliance, circular reasoning, and theoretical predilection (Jones
and Windholz, 1990). However, Edelson (1986; 1988) has argued for the validity of the case study method as a scientific
activity, stating that it can, under certain circumstances, provide evidence of causal explanation and hence serve as a
proving ground for hypotheses. Gedo asserts that ‘Sui generis, statistical methods do not capture rare or unique events.
Yet, as clinicians, we know that such occurrences can be crucial’ (Gedo 1999: 274). He insists that ‘we need to be aware
that an event that is statistically common may have had an uncommon meaning for the patient’ (Gedo 1999: 274)
asserting that ‘those of us doing empirical studies must struggle with the dilemma that not all statistically identical events
are equivalent qualitatively’ (Gedo 1999:276).
Questions as to the gap between psychotherapy research and psychotherapy practice have been considered by
proponents of practice-based evidence. There are a number of papers which have focused on the need for practice
based evidence or arguing in favour of consideration of the service user’s perspective regarding therapy they have
received, including Barkham et al (2001), Foskett (2001) Macran et al (1999) and Mellor-Clark & Barkham (2003) rather
than the tendency to focus on exclusively ‘evidence-based’ research. This is perhaps not least because of the ‘significant
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differences’ (Shepherd et al 1994:6) in perspectives which can exist between, for example, service users, family carers
and professionals (Shepherd et al 1994). ‘The concept of practice based evidence is that it gives a voice to practitioners
and service users, recognising that they have first hand knowledge and experience of what works and alternatively both
what needs to change, and how it may change’ (Ryan & Morgan, 2004).
Some such researchers suggest that qualitative methods are often the most appropriate, for example, Margison et al
(2000) who observe that practice based evidence is particularly well-suited to questions about the quality of interventions,
including the extent to which they are comprehensive, relevant, acceptable, and accessible. Through naturalistic inquiry,
practice-based research has also been used to examine unexpected results, such as early improvement related to hope,
therapeutic engagement, or other common factors across interventions (Stiles et al 2003). These are issues which are
more difficult to address through RCT research.
2.
Methodological problematics of RCTs
There is significant amount of research that highlights methodological problematics of Randomised Control Trials,
including some of the difficulties inherent in many RCTs related to the impact of patients’ knowledge, expectations and
intentions in relation to being placed in an experimental situation. In relation to waiting-list control trials, Basham (1986)
highlights findings that in being informed they are participating in an experiment, ‘subjects are likely to develop conditionspecific expectancies about whether or not they will improve. Most likely, the subjects in the immediate treatment
condition develop an increased expectancy of improving whereas subject in the waiting-list condition develop a reduced
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expectancy of improving and may be further demoralised by having received the less preferred condition’ (Basham
1986:89).
Similarly, debate about placebos in psychotherapy research (Klein 1997:5) indicates that many RCTs utilise different
conceptualisations of placebos ‘as a result of theoretical and terminological ambiguity’ (Klein 1997:5). Therefore, it is
important to highlight that within such research there can exist significant variation as to the credibility of the placebo
treatment.
RCT design is often seen to suffer ‘from a host of scientific difficulties…including poor statistical power, randomization
failure, differential attrition, failure to measure important aspects of clients’ functioning, lack of clarity about actual nature
of therapies offered and restricted samples leading to poor generalizability’ (Elliott 2001: 315-316). The point here is not
to call into question the potential insights available through RCT based research, but to highlight that such research is not
without ambiguity, debate and limitations - often the argument levelled at non-RCT based research.
3.
Suitability of RCTs for non-Behavioural, including Humanistic and Integrative, Psychotherapy Research
One such limitation is the arguable unsuitability of RCT based research to humanistic and integrative psychotherapies.
Difficulties can be seen to arise here in that ‘the RCT is not a theory-neutral evaluative method but rather a research
method shaped by assumptions that originate in behaviourist theories of therapy’ (Schmitt Freire 2006: 323). Connected
to this is the argument that ‘there is no neutral language or basic vocabulary shared by the competing (behaviourist and
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non-behaviourist) therapies theories that would enable the comparison of their observation reports’ by use of an RCT
(Schmitt Freire 2006: 323).
It has been argued that for humanistic psychologists, of particular relevance is that ‘RCTs typically cast clients as passive
recipients of standardized treatments rather than active collaborators and self-healers’ (Elliott 2001: 316), something
which can put this type of research design at odds with a humanistic approach to psychotherapy. Secondly, that
Randomised Control Trials ‘do not warrant causal inferences about single cases… because they rely on an operational
definition of causal influence rather than seeking a substantive understanding of how change actually takes place. In other
words they are “causally empty…’ (Elliott 2001: 316). These factors mean that relying solely on RCTs in relation to the
evidence base for humanistic, and many integrative, psychotherapies limits the range of available evidence and does not
enable the construction of an appropriately broad picture of existing research.
As highlighted earlier, it has also been argued that RCTs are ineffectual at highlighting issues such as therapeutic
alliance, a factor which has – in other forms of research – been consistently identified as a key factor in successful
therapeutic outcomes (Bryan et al 2004; Bowman & Find 2000; Everall & Paulson 2002; Gershefski et al 1996; Thomson
& Hill 1993). Questions of therapeutic alliance are of significant importance to humanistic and integrative practitioners for
whom the therapeutic process is often driven not by ‘technique’ but by the relationship between therapist and client. If it is
to be taken that RCTs may, as has been argued, be inefficient in researching factors such as this, the case must be
advanced for research into humanistic and integrative psychotherapies in particular that includes non-RCT, relational,
methodologies which are better equipped to so investigate (McLeod 2001b, 2002).
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Whilst there are arguments that the essential principles of humanistic, and many integrative psychotherapies, do not lend
themselves to measurement, if this route is to be pursued, alongside practice-based evidence research other alternatives
research designs such as the Hermeneutic Single Case Efficacy Design (HSCED) (Elliott, 2001, 2002) have shown the
potential for a wealth of relevant and credible evidence to be obtained through non RCT- based research and have further
challenged the need to rely exclusively on evidence obtained from Randomised Control Trials.
References
Barkham, M., Margison, F., Leach, C., Lucock, M.P., Mellor-Clark, J., Evans, C., Benson, L., Connell, J., Mellor-Clark, J.,
Audin, J., & McGrath, G. (2001) ‘Service profiling and outcomes benchmarking using the CORE-OM: Toward practicebased evidence in the psychological therapies’ Journal of Consulting and Clinical Psychology Vol. 69 pp.184-196
Basham, R. B. (1986). Scientific and practical advantages of comparative design in psychotherapy outcome research.
Journal of Consulting & Clinical Psychology, 54, 8–94.
Bowman, L & Fine, M. (2000) ‘Client Perspectives of Couples Therapy: Helpful and Unhelpful Aspects’ American Journal
of Family Therapy Vol. 28.4 pp. 295-310
Bryan, L., Dersch, C., Shumway, S. & Arredondo, R. (2004) ‘Therapy outcomes: Client perception and similarity with
therapist view’ American Journal of Family Therapy Vol. 32.1 pp. 11-26
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Carr, Linda T. (1994) The strengths and weaknesses of quantitative and qualitative research: what method for nursing?
Journal of Advanced Nursing, 20 (4), 716–721
Chiesa, M and Fonagy, P (1999) - ‘From the efficacy to the effectiveness model in Psychotherapy research: the APP
multi-centre project’ Psychoanalytic Psychotherapy vol13 no3 pp259-272
Edelson, M. (1986) Causal explanation in science and psychoanalysis Psychoanalytic. Study of Childhood, 41: 89-127
Edelson, M. (1988) Psychoanalysis: A Theory in Crisis Chicago: Univ. Chicago Press.
Elliott, R. (1999) ‘Editor’s Introduction to Special Issue on Qualitative Psychotherapy Research: Definitions, Themes and
Discoveries’, Psychotherapy Research, 9 (3) 251-257
Elliott, R. (2001) ‘Hermeneutic Single Case Efficacy Design’ in K.J.Schneider, J.F.T. Bugental & J.F. Pierson (eds) ‘The
Handbook of Humanistic Psychology: Leading Edges in Theory, Research and Practice’ London: Sage pp. 315-324
Elliott, R., (2002) ‘Hermeneutic Single Case Efficacy Design’ Psychotherapy Research Vol. 12, No. 1 pp. 1-21
Everall, R.D & Paulson, B.L. (2002) ‘The therapeutic alliance: Adolescent perspectives’ Counselling Psychotherapy
Research Vol. 2 No. 2 pp. 78-87
Feltham, C. (2005) ‘Evidence-Based Psychotherapy and Counselling in the UK: Critique and Alternatives’ Journal of
Contemporary Psychotherapy Vol. 35, No. 1 pp.131-143
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Foskett, J. (2001) ‘What of the client’s-eye view? A response to the millennium review’ British Journal of Guidance and
Counselling Vol. 29 No. 3 pp. 345-350
Gedo, Paul M. (1999) Single case studies in psychotherapy research, Psychoanalytic Psychology, 16(2), pp. 274-280
Gershefski, J.J., Arnkoff, D.B., Glass, C.R., Elkin, I. (1996) ‘Clients’ perspectives of treatment for depression I: Helpful
aspects’ Psychotherapy Research Vol. 6, No. 4 pp. 233-248
Jacobson, N & Christensen, A. (1996) ’Studying the Effectiveness of Psychotherapy: How Well Can Clinical Trials Do the
Job?' American Psychologist Vol. 51
Jacobson, N., Roberts, L., Berns, S., & McGlinchey, J. (1999) ‘Methods for Defining and Determining the Clinical
Significance of treatment Effects: Description, Application and Alternatives’ Journal of Consulting and Clinical Psychology
Vol. 67, No. 3 pp. 300-307
Jones, E. E. & Windholz, Michael (1990). The Psychoanalytic Case Study: Toward a Method for Systematic Inquiry,
Journal of the American Psychoanalytic Association, 38, pp.985-1015. http://www.pepweb.org/document.php?id=apa.038.0985a viewed 18/03/08
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Kaplan, F (1998) - “Scientific Art Therapy: An integrative and Research-based approach.” Art Therapy AATA 15(2) 93-98,
1988.
Klein, D.F. (1997) ‘Control Groups in Pharmacotherapy and Psychotherapy Evaluations’ Treatment Vol. 1, Article 1
http://journals.apa.org/treatment/vol1 viewed 13/03/08
Macran, S., Ross, H. Hardy, G.E., Shapiro, D. (1999) ‘The importance of considering clients’ perspectives in
psychotherapy research’ Journal of Mental Health Vol. 8, No 4 pp. 325-337
Margison, F., Barkham, M., Evans, C., McGrath, G., Mellor-Clark, J., Audin, K. & Connell, J. (2000) ‘Measurement and
psychotherapy: evidence based practice and practice based evidence’ British Journal of Psychiatry Vol. 177 pp. 123-130
Marshall, Catherine & Rossman, Gretchen B. (2006) Designing Qualitative Research, London: SAGE (particularly
chapters: ‘Justifying Qualitative Research’ pp.52-53 & ‘The Value of the Qualitative Approach’ pp. 208-213)
McLeod, John (2000) ‘The Contribution of Qualitative Research to evidence-based counselling and psychotherapy’ in
Evidence-Based Counselling and Psychological Therapies: Research and Applications by Nancy Rowland, Stephen
Goss, London: Routledge, pp.111-126
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McLeod, J. (2001a) ‘Developing a research tradition consistent with the practices and values of counselling and
psychotherapy: Why Counselling and Psychotherapy Research is necessary’ Counselling and Psychotherapy Research
Vol. 1, No. 1 pp. 3-11
McLeod, John (2001b) Qualitative Research in Counselling and Psychotherapy. London: SAGE
McLeod, John (2002) Research in person-centred, experiential and humanistic counselling and psychotherapy: meeting
new challenges, Counselling and Psychotherapy Research, 2 (4), pp. 259-262
Mellor-Clark, J. & Barkham, M. (2003) ‘Bridging evidence-based practice and practice-based evidence: Developing a
rigorous and relevant knowledge for the psychological therapies’ Clinical Psychology and Psychotherapy Vol 10.6 pp.319327
Mottram, P. (2000) ‘Towards developing a methodology to evaluate the effectiveness of art therapy in adult mental illness’
http://www.baat.org/taoat/mottram2html viewed 13/03/08
Parry, G (2000) ‘Evidence based Psychotherapy: special case or special pleading?’ Evidence Based Mental Health Vol. 3
May 2000 pp. 35-36
Schmitt Freire, E. (2006) ‘Randomised Controlled Clinical Trials in Psychotherapy Research: An Epistemological
Controversy’ Journal of Humanistic Psychology Vol. 46, No. 3, pp. 323-335
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Seligman, M. (1995) ‘The Effectiveness of Psychotherapy: The Consumer Reports Study’ American Psychologist Dec
1995 Vol. 50 No.12 pp.965-974
Sells, S. P., Smith, T. E., Sprenkle, D. H. (1995) ‘Integrating Qualitative and Quantitative Research Methods: A Research
Model’, Family Process, 34 (2), pp. 199–218
Shepherd, G., Murray, A., Muijen, M. (1994) ‘Relative Values: The differing views of users, family carers and professional
on services for people with schizophrenia in the community’ London: The Sainsbury Centre for Mental Health.
Thomson, B.J. & Hill, C.E. (1993) ‘Client perceptions of therapist competence’ Psychotherapy Research Vol. 3, No.2 pp.
124-130
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Section B
1.
Presentation of the preliminary case for a widening of the humanistic category and inclusion of the
integrative position
The main difficulty that has arisen in relation to this objective is a lack of access to the specific case that has been made
by Roth and Pilling for the humanistic category to have been defined on a fairly narrow basis and the integrative position
to have been excluded, other than this is apparently related to the available evidence base, for example provided by
Greenberg et al (1994). It is understood that the humanistic category has been defined as person-centred (Rogerian) and
experiential therapies and that integrative psychotherapies will be represented under the three currently proposed
categorisations.
In relation to the argument for a widening of the humanistic category, the whole person, multi-dimensional perspective of
humanistic psychology has generated a broad spectrum of approaches that enormously expand the range of options for
dealing with psychological, psychosomatic, psychosocial and psycho-spiritual conditions. There is empirical research (see
below) representing many of the therapies on this spectrum which fall under the umbrella of ‘humanistic’ and which
indicates, in many cases, the successful outcomes of such therapies. As such, there appears to be no real justification for
a definition which includes only client-centred (Rogerian) therapy and excludes others.
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Arguments in favour of the inclusion of the integrative position include the differentiation between ‘integration’ and
‘eclecticism’ where integration is ‘depicted as a comprehensive and internally coherent process, whereas eclecticism
generally refers to a more random process of choosing “what works”’ (Evans & Gilbert 2005: viii). Integration involves a
process whereby "two or more therapies are integrated in the hope that the result will be better than the constituent
therapies alone" (Norcross & Goldfried, 2005: 8). Essentially the argument put forward is that integrative psychotherapy is
more than simply a sum of its parts and whilst individual elements of the approach may be represented in the currently
proposed categorisations, it is in the combination of these specific approaches that the process of integrative
psychotherapy takes place. What integrative psychotherapies share therefore is this conceptual commonality above and
beyond their similarity with other modalities. At the same time, research on the individual components of an integrative
approach does not necessarily give an accurate indication of the effect of that approach when combined with another. In
terms of, for example, Cognitive Analytic Therapy, the argument is that such an approach would not be adequately
represented by either an analytic or behavioural section in that it is the process of integration which primarily defines this
model of therapy.
Specifically, integrative psychotherapies cannot therefore be adequately represented by the individual modalities of an
integrative approach being represented elsewhere. This is primarily because integration is, by definition, an orientation
that ‘exemplifies, or is developing towards, a conceptually coherent, principled theoretical combination of two or more
specific approaches, or represents a new meta-theoretical model of integration in its own right’ (Evans & Gilbert 2005:
viii). As with non-Rogerian humanistic therapies, there is available research on these approaches (see results of literature
search below) and from this perspective therefore there is no apparent justification to exclude these therapies on the lack
of an evidence base.
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References
Evans, K. & Gilbert, M. (2005) ‘An Introduction to Integrative Psychotherapy’ Basingstoke: Palgrave Macmillan
Greenberg, L.S., Elliott, R.K. & Lietaer, G. (1994) ‘Research on Experiential Psychotherapies’ in A.E. Bergin & S.L.
Garfield (eds) Handbook of Psychotherapy and Behaviour Change NY: Wiley
Norcross, J. C. & Goldfried, M. R. (Eds.). (2005). Handbook of psychotherapy integration (2nd ed.). New York: Oxford.
2.
Results of literature search for research in Integrative and Humanistic Psychotherapies
The results of this preliminary literature search have been categorised into the following headings:
1) Randomised Control Trials
2) Other Quantitative Research (non-randomised)
3) Meta-analyses
4) Qualitative Research (excluding case studies)
5) Case Studies
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The intention is to show that there is an available combination of both RCT-based and other forms of research
methodologies that have been used to investigate outcome in relation to a range of humanistic and integrative
psychotherapies. The list of Integrative and Humanistic Psychotherapies that have been used for this search is as follows
(this list was first used by the Research Unit for the recent ‘What Else Works for Whom’ project undertaken for David
Winter, through the UKCP Research Committee):
Humanistic
Adlerian
Body-Centred
Client-Centred
Contextual
Encouragement
Existential
Existential-Humanistic
Feminist
Focusing
Gestalt
Logotherapy
Mainstreaming
Primal Therapy
Process-Experiential
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Psycho-drama
Psychosynthesis
Redecision
Spiritually Sensitive
Transactional Analysis
Transpersonal
Integrative
Active-Self Model
Cognitive Analytic Therapy
Cyclical Psychodynamics
Encounter Groups
Holistic Education
Metaphor Therapy
Prescriptive Therapy
Responsive Therapy
Stress Management
T-Groups
Unified Psychotherapy
Transtheoretical Therapy
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Emotion-Focused Therapy
Cognitive-Interpersonal Therapy
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1. Randomised Control Trials
Adesso, V.J., Euse, F.J., Hanso, R.W., Hendry, D. & Choca, P. (1974) ‘Effects of a personal growth group
on positive and negative self-references’ Psychotherapy: Theory Research and Practice, 11 (4), 354-355
Agras, W.S., Telch, C.G., Arnow, B., Eldredge, K., Detzer, M.J., Henderson, J. & Marnell, M. (1995) ‘Does
interpersonal therapy help patients with binge eating disorder who fail to respond to cognitive-behavioral
therapy?’ Journal of Consulting and Clinical Psychology, 63(3), 356-60.
Boholst, F.A. (2003) 'Effects of Group Therapy on Ego States and Ego State perception' Transactional
Analysis Journal 33(3), 254-261
Carbonell, D.M., Parteleno-Barehmi, C. (1999) 'Psychodrama groups for girls coping with trauma',
International Journal of Group Psychotherapy, 49(3), 285-306
Cederborg, A.C. (2000) 'The hidden meanings of metaphors in family therapy' Scandinavian Journal of
Psychology, 41(3), 217-24
Clance, P.R., Thompson, M.B., Simerly, D.E. & Weiss, A. (1994) ‘The effects of the Gestalt approach on
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Section C
Work to be undertaken following the production of the Preliminary Statement
Following the production of this preliminary statement work as defined in the ‘Brief for the UKCP Research Unit at
Roehampton’, dated 12th March 2008 will be continued. However it may be that this preliminary statement raises some
questions and issues about how and what requires researching and so changes to the original specification may be
appropriate. Presently the further work to be carried out is as follows with a proposed delivery date of 9th June 2008 for
the final report.

It is anticipated that further relevant research including meta-analyses, RCTs and good qualitative research as
defined by the Research Unit using its own or an accepted definition may be discovered through the forthcoming
literature reviews. This will be incorporated in the final report, encompassing the research papers listed above.

Searching relevant books and other literature for evidence

Collecting the additional literature and reviewing it critically

Searching the Cochrane and other ‘evidence-based’ databases for relevant research and criteria of assessment of
research

Presenting relevant criteria for assessment of qualitative studies and critiquing studies on these criteria

Receiving, collating and critiquing studies that are sent from members of HIPS and other researchers. Timescales
for receipt and inclusion will need to be specified by the Research Unit

Preparation of the final report.
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