Asking the right questions

Missing the forest for the trees | photo credit: IslesPunkFan | of: Marcel Odenbach

Addiction Today recently posted a summary of a 3 year old paper about problems with the focus of existing research on addiction treatment and proposals for new approaches.

It makes some very important points.

This article lists eight main faults:

  1. EXISTING RESEARCH IGNORES ‘outcome equivalence paradox’
  2. EXISTING RESEARCH SACRIFICES RELATIONSHIP TO TECHNIQUE
  3. EXISTING RESEARCH IGNORES research on unaided change
  4. IT IMPOSES AN INAPPROPRIATE TIMESCALE ON CHANGE
  5. IT FAILS TO TAKE A SYSTEMS OR SOCIAL NETWORK VIEW
  6. IT IGNORES THERAPISTS’ TACIT THEORIES
  7. IT EXCLUDES THE PATIENT’S VIEW
  8. IT IGNORES DEVELOPMENTS IN SCIENCE PHILOSOPHY

and three key ways to address these faults:

  1. FOCUS ON STUDYING THE CHANGE PROCESS
  2. STUDY THE CHANGE PROCESS WITHIN BROADER, LONGER-ACTING SYSTEMS
  3. ACKNOWLEDGE THE VARIETY OF SOURCES OF USEFUL KNOWLEDGE

These faults and ways to address the faults echo arguments made by  Bill White (That research comparing MET vs. CBT vs. REBT vs. TSF is working withing the acute care paradigm and misses the boat.) and Scott Miller (That research comparing MET vs. CBT vs. REBT vs. TSF ignores the most powerful predictor of outcomes—the therapeutic relationship—and misses the boat.).

These recommendations make a great deal of sense to me and I hope to see more researchers take note.