Response to ‘the Future of the Transference-Based Therapies’

Lesley Murdin's paper starts from the presumption that clinicians, and researchers too, are concerned with fostering the development of good psychotherapy practice, and the delivery of better treatments to patients, and indeed the ethical imperative to do so. The paper sets out to address ‘the meaning of the requirement for an evidence base that emanates from the NHS and the universities’. In this response, I propose to examine some questions which arise from the issues raised in the paper. What is ‘evidence’ and how does it relate to the term ‘evidence base?’ What is ‘required’? What does ‘research’ do, and does it have anything to offer the clinician? I will then apply the ‘findings’ of my enquiry to the research cited in Murdin's paper, which is reported in the article ‘Comprehensive process analysis of insight events in cognitive-behavioural and psychodynamic-interpersonal psychotherapy’ by Elliott et al. (1994).

Evidence is a multifaceted term which may be used in philosophical, judicial or scientific contexts. What it shares in all these contexts is the notion that it relates what is observed or discovered to the understanding of what is observed. Evidence is the foundation stone of systematic enquiry, whether philosophical, judicial or scientific: what do our observations/discoveries tell us about the nature of the experienced world, the object of enquiry? Questions then arise: what counts as evidence? How can it be verified, or falsified, as supporting a theory? What part does ‘interpretation’ play in the evaluation of evidence? These are on-going questions for scientific method and are articulated in a variety of forms, as new methods evolve and enquiry deepens. The discussion of the ‘Comprehensive Process Analysis’ method below shows how one method evolved to address some of these questions.

What, then, is an ‘evidence base’? Used popularly, as it is in this paper, it refers to the very recent pheno