Table of Contents
Advances in Psychiatry
Volume 2014, Article ID 561452, 5 pages
Review Article

Limitations of Randomized Control Designs in Psychotherapy Research

College of William & Mary, P.O. Box 8795, Williamsburg, VA 23187-8795, USA

Received 18 June 2014; Revised 15 September 2014; Accepted 15 October 2014; Published 6 November 2014

Academic Editor: Christine M. Blasey

Copyright © 2014 Glenn Shean. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Despite the growing influence of lists of empirically supported therapies (ESTs) there are concerns about the design and conduct of this body of research. These concerns include limitations inherent in the requirements of randomized control trials (RCTs) that favor those psychotherapies that define problems and outcome in terms of uncomplicated symptoms. Additional concerns have to do with criteria for patient selection, lack of integration with research on psychotherapy process and effectiveness studies, limited outcome criteria, and lack of controls for experimenter bias. RCT designs have an important place in outcome research; however it is important to recognize that these designs also place restrictions on what and how psychotherapy can be studied. There is a need for large scale psychotherapy outcome research based on designs that allow for inclusion of process variables and the study of the effects of those idiographic approaches to therapy that do not lend themselves to RCT designs. Interpretative phenomenological analysis may provide a useful method for the evaluation of the effectiveness of idiographic approaches to psychotherapy where outcome is not understood solely in terms of symptom reduction.