La brecha entre la investigación y la práctica clínica: Hacia la integración de la psicoterapia

• Javier Fernández-Álvarez ^[1] ; Javier Prado-Abril ^[4] ; Sergio Sánchez-Reales ^[5] ; Guadalupe Molinari ^[5] ; Juan Martín Gómez Penedo ^[2] ; Soo Jeong Youn ^[3]
  1. [1] Catholic University of the Sacred Heart

     Catholic University of the Sacred Heart

     Milán, Italia

     
  2. [2] Universidad de Buenos Aires

     Universidad de Buenos Aires

     Argentina

     
  3. [3] Massachusetts General Hospital

     Massachusetts General Hospital

     City of Boston, Estados Unidos

     
  4. [4] Servicio Aragonés de Salud
  5. [5] Servicio Murciano de Salud

  Mostrar afiliaciones +
• Localización: Papeles del psicólogo, ISSN-e 1886-1415, ISSN 0214-7823, Vol. 41, Nº. 2, 2020 (Ejemplar dedicado a: Hacia la integración de la psicoterapia), págs. 81-90
• Idioma: español
• DOI: 10.23923/pap.psicol2020.2932
• Títulos paralelos:
  • The gap between research and practice: Towards the integration of psychotherapy
• Enlaces
  • Texto completo (pdf)
• Dialnet Métricas: 11 Citas
• Resumen
  • español

    La brecha entre investigación y práctica clínica constituye uno de los rasgos distintivos de la psicoterapia. Esta brecha se ha conceptualizado históricamente como un problema de diseminación unidireccional. Sin embargo, existen razones consistentes para considerar que la desarticulación entre ciencia y práctica también responde al modo en que se ha venido produciendo el conocimiento científico en el campo. En el presente artículo se desarrollan algunos de los principales aspectos que, hasta la fecha, han obstaculizado la construcción de una ciencia integrada de la psicoterapia y la implementación de la mejor investigación disponible en los entornos clínicos naturales. En particular, se presenta el paradigma de la Investigación Orientada por la Práctica (IOP) como una aproximación que aporta propuestas específicas para articular la brecha entre investigación y práctica con el doble propósito de mejorar tanto la calidad de los proyectos de investigación que se realizan como la práctica clínica habitual.

  • English

    The gap between research and clinical practice constitutes one of the distinctive features of psychotherapy. This gap has historically been conceptualized as a problem of unidirectional dissemination. However, there are compelling reasons to consider that the disarticulation between science and practice also responds to the way in which scientific knowledge has been produced. This article describes some of the main aspects that, to date, have hindered the development of an integrated science of psychotherapy and its implementation in naturalistic clinical settings. The paradigm of practice-oriented research (POR) is presented as an approach that provides specific proposals to bridge the gap between research and practice with the dual purpose of improving the quality of both research projects that are carried out and routine clinical practice.

• Referencias bibliográficas
  • Andersson, G., Titov, N., Dear, B. F., Rozental, A., y Carlbring, P. (2019). Internet delivered psychological treatments: From innovation...
  • APA Presidential Task Force on Evidence-Based Practice (2006). Evidence-based practice in psychology. The American Psychologist, 61, 271-285....
  • Barkham, M., Delgadillo, J., Firth, N. y Saxon, D. (2018). Practice-based evidence and the law of variability in psychological treatment....
  • Barkham, M., Hardy, G. E. y Mellor-Clark, J. (Eds.) (2010). Developing and delivering practice-based evidence: A guide for the psychological...
  • Bennett-Levy, J. y Finlay-Jones, A. (2018). The role of personal practice in therapist skill development: A model to guide therapists, educators,...
  • Berg, H. y Slaattelid, R. (2017). Facts and values in psychotherapy-A critique of the empirical reduction of psychotherapy within evidence-based...
  • Beutler, L. E., Williams, R., Wakefield, P. y Entwistle, S. (1995). Bridging scientist and practitioner perspectives in Clinical Psychology....
  • Beutler, L. E. y Forrester, B. (2014). What needs to change: Moving from “research informed” practice to “empirically effective” practice....
  • Borkovec, T. D., Echemendia, R. J., Ragusea, S. A. y Ruiz, M. (2001). The Pennsylvania Practice Research Network and future possibilities...
  • Boswell, J. F. (2019). Monitoring processes and outcomes in routine clinical practice: A promising approach to plugging the holes of the practice-based...
  • Callahan, J. L. y Watkins, C. E., Jr. (2018). Evidence-based training: The time has come. Training and Education in Professional Psychology,...
  • Cassin, B. (2000). Sofística. En J. Brunschwig y G. Lloyd (Eds.), Diccionario Akal de El saber griego (pp. 744-776). Madrid: Akal.
  • Castonguay, L. G., Barkham, M., Lutz, W. y McAleavey, A. (2013). Practice oriented research: Approaches and applications. En M. J. Lambert...
  • Castonguay, L. G., Constantino, M. J. y Beutler, L. E. (Eds.). (2019a). Principles of change. How psychotherapists implement research in practice....
  • Castonguay, L. G., Constantino, M. J. y Xiao, H. (2019b). Integrating research and practice. En J. C. Norcross y M. R. Goldfried (Eds.), Handbook...
  • Castonguay, L. G., Eubanks, C. F., Goldfried, M. R., Muran, J. C. y Lutz, W. (2015b). Research on psychotherapy integration: Building on the...
  • Castonguay, L. G. y Muran, J. C. (2015). Fostering collaboration between researchers and clinicians through building practiceoriented research:...
  • Castonguay, L., Nelson, D., Boutselis, M., Chiswick, N., Damer, D., Hemmelstein, N. y Borkovec, T. (2010). Clinicians and/or researchers?...
  • Castonguay, L. G., Youn, S., Xiao, H., Muran, J. C., y Barber, J. P. (2015a). Building clinicians-researchers partnerships: Lessons from diverse...
  • Cautin, R. L. (2011). A century of psychotherapy, 1860- 1960. En J. C. Norcross, G. R. VandenBos y D. K. Freedheim (Eds.), History of psychotherapy:...
  • Chambless, D. L. y Hollon, S. D. (1998). Defining empirically supported therapies. Journal of Consulting and Clinical Psychology, 66, 7-18....
  • Chambless, D. L. y Ollendick, T. H. (2001). Empirically supported psychological interventions: Controversies and evidence. Annual Review of...
  • David, D., Cristea, I. y Hofmann, S. G. (2018). Why Cognitive Behavioral Therapy is the current gold standard of psychotherapy. Frontiers...
  • Dazinger, K. (1979). The posi t ivis t repudiation of Wundt. Journal of the History of the Behavioral Sciences, 15(3), 205-230.
  • Deacon, B. J. (2013). The biomedical model of mental disorder: A critical analysis of its validity, utility, and effects on psychotherapy...
  • de Jong, K. (2016). Deriving implementation strategies for outcome monitoring feedback from theory, research and practice. Administration...
  • Drapeau, M. (2012). The value of progress tacking in psychotherapy. Integrating Science and Practice, 2(2), 5–6.
  • Fairburn, C. G., Cooper D Phil, Dip Psych, Z., Doll D Phil, H. A., O’Connor, M. E., Bohn D Phil, Dip Psych, K., Hawker, D. M., ... y Palmer,...
  • Fernández-Álvarez, H. y Castonguay, L. G. (2018). Investigación orientada por la práctica: Avances en colaboraciones entre clínicos e investigadores....
  • Fernández-Álvarez, H., Gómez, B. y García, F. (2015). Bridging the gap between research and practice in a clinical and training network: Aigle’s...
  • Flückiger, C., Del Re, A. C., Wampold, B. E. y Horvath, A. O. (2018). The alliance in adult psychotherapy: A metaanalyt ic synthesis. Psychotherapy,...
  • Frith, U. (2019). Fast lane to slow science. Trends in Cognitive Sciences. https://doi.org/10.1016/j.tics.2019.10.007
  • Gimeno-Peón, A., Barrio-Nespereira, A., & Prado-Abril, J. (2018). Monitorización sistemática y feedback en psicoterapia. Papeles del Psicólogo,...
  • Goldfried, M. R. (2019). Obtaining consensus in psychotherapy: What holds us back. American Psychologist, 74, 484-496. http://dx.doi.org/10.1037/amp0000365
  • Goldfried, M. R. y Wolfe, B. E. (1996). Psychotherapy practice and research: Repairing a strained relationship. American Psychologist, 51,...
  • Gómez, B., Iwakabe, S. y Vaz, A. (2019). International themes in psychotherapy integration. En J. C. Norcross y M. R. Goldfried (Eds.), Handbook...
  • González-Blanch, C. y Carral-Fernández, L. (2017). ¡Enjaulad a Dodo, por favor! El cuento de que todas las psicoterapias son igual de eficaces....
  • Gyani, A., Shafran, R., Myles, P. y Rose, S. (2014). The gap between science and practice: How therapists make their clinical decisions. Behavior...
  • Harvey, A. G., Watkins, E. R., Mansell, W., y Shafran, R. (2004). Cognitive behavioural processes across psychological disorders: A transdiagnostic...
  • Henrich, J., Heine, S. y Norenzayan, A. (2010). The weirdest people in the world? Behavioral and Brain Sciences, 33, 61-83. https://doi.org/10.1017/S0140525X0999152X
  • Hofmann, S. G. (2019). Imagine there are no therapy brands, it isn’t hard to do. Psychotherapy Research. https://doi.org/10.1080/10503307.2019.1630781
  • Hofmann, S. G. y Barlow, D. H. (2014). Evidence-based psychological interventions and the common factors approach: The beginnings of a rapprochement?...
  • Hofmann, S. G. y Weinberger, J. (Eds.). (2007). The Art of Psychotherapy. New York, NY: Routledge/Taylor & Francis.
  • Hopwood, C. J., Bagby, M., Gralnick, T. M., Ro, E., Ruggero, C., Mul l ins -Sweatt , S., … Zimmermann, J. (2019). Integrating psychotherapy...
  • Hoyer, J., oli , J., Pittig, A., Crawcour, S., Moeser, M., Ginzburg, D., … Stangier, U. (2017). Manualized cognitive therapy versus cognitive-behavioral...
  • Kazdin, A. E. y Blase, S. L. (2011). Rebooting psychotherapy research and practice to reduce the burden of mental illness. Perspectives on...
  • Kind, A. (Ed.). (2019). Philosophy of Mind in the Twentieth and Twenty-Firs t Centuries. London: Rout ledge. https://doi.org/10.4324/9780429508127
  • Lambert, M. J. (2013). The efficacy and effectiveness of psychotherapy. En M. J. Lambert (Ed.), Bergin and Garfield’s handbook of psychotherapy...
  • Laska, K. M., Gurman, A. S. y Wampold, B. E. (2014). Expanding the lens of Evidence-based practice in psychotherapy: A common factors perspective....
  • Lee, C. M., y Hunsley, J. (2015). Evidence-based practice: Separating science from pseudoscience. The Canadian Journal of Psychiatry, 60(12),...
  • Leichsenring, F., Abbass, A., Hilsenroth, M., Leweke, F., Luyten, P., Keefe, J., ... Steinert, C. (2017). Biases in research: Risk factors...
  • Locke, B. D., Bieschke, K. J., Castonguay, L. G. y Hayes, J. A. (2012). The Center for Collegiate Mental Health: Studying college student...
  • Lucock, M., Barkham, M., Donohoe, G., Kellett, S., McMillan, D., Mullaney, S., … y Delgadillo, J. (2017). The role of Practice Research Networks...
  • Mansell, W. (2019). Transdiagnostic psychiatry goes above and beyond classification. World Psychiatry, 18(3), 360.
  • Marques, L., Valentine, S.E., Kaysen, D., Mackintosh, M., Dixon De Silva, L.E., Ahles, E.M., Youn, S., Shtasel, D.L., Simon, N.M., y Wiltsey-Stirman,...
  • McHugh, R. K., y Barlow, D. H. (2010). The dissemination and implementation of evidence-based psychological treatments: a review of current...
  • Meehl, P. E. (1957). When shall we use our heads instead of the formula? Journal of Counseling Psychology, 4, 268- 273. https://doi.org/10.1037/h0047554
  • Norcross, J. C., Karpiak, C. P. y Santoro, S. O. (2005). Clinical psychologists across the years: The division of clinical psychology from...
  • Norcross, J. C., Pfund, R. A. y Prochaska, J. O. (2013). Psychotherapy in 2022: A Delphi poll on its future. Professional Psychology: Research...
  • Norcross, J. C. y Wampold, B. E. (2019). Relationships and responsiveness in the psychological treatment of trauma: The tragedy of the APA...
  • O’Donohue, W. (2013). Clinical Psychology and the Philosophy of Science. New York, NY: Springer Science. http://dx.doi.org/10.1007/978-3-319-00185-2
  • Olfson, M. y Marcus, S. C. (2010). National trends in outpatient psychotherapy. American Journal of Psychiatry, 167, 1456- 1463. https://doi.org/10.1176/appi.ajp.2010.10040570
  • Orlinsky, D. E. y Rønnestad, M. H. (2005). How psychotherapists develop: A study of therapeutic work and professional growth. Washington,...
  • Paris, J. (2013). How the history of psychotherapy interferes with integration. Journal of Psychotherapy Integration, 23, 99-106. http://dx.doi.org/10.1037/a0031419
  • Peón, A. G., Nespereira, A. B., & Abril, J. P. (2018). Monitorización sistemática y feedback en psicoterapia. Papeles del psicólogo, 39(3),...
  • Perepletchikova, F., Treat, T. A. y Kazdin, A. E. (2007). Treatment integrity in psychotherapy research: Analysis of the studies and examination...
  • Prado-Abril, J., Fernández-Álvarez, J., Sánchez-Reales, S., Youn, S. J., Inchausti, F. y Molinari, G. (2019b). La persona del terapeuta: Validación...
  • Prado-Abril, J., Gimeno-Peón, A., Inchausti, F. y Sánchez-Reales, S. (2019a). Pericia, efectos del terapeuta y práctica deliberada: El ciclo...
  • Prado-Abril, J., Sánchez-Reales, S. y Inchausti (2017). En busca de nuestra mejor versión: Pericia y excelencia en Psicología Clínica. Ansiedad...
  • Ramsey, W. (2008). Eliminative materialism. En E. N. Zalta (Ed.), The Stanford encyclopedia of philosophy. Retrieved from http://plato.stanford.edu/archives/fall2008/entries/materialism-eliminative/
  • Rousmaniere, T. G., Goodyear, R. K., Miller, S. D., y Wampold, B. E. (Eds.). (2017). The cycle of excellence: Using deliberate practice to...
  • Sakaluk, J. K., Williams, A. J., Kilshaw, R. E. y Rhyner, K. T. (2019). Evaluating the evidential value of empirically supported psychological...
  • Saxena, S., Kestel, D., Sunkel, C., London, E., Horton, R., Patel, V., y Swaminathan, S. (2019). Countdown global mental health 2030. Lancet,...
  • Shimokawa, K., Lambert, M. J., y Smart, D. W. (2010). Enhancing treatment outcome of patients at risk of treatment failure: Meta-analytic...
  • Tackett, J. L., Brandes, C. M., King, K. M. y Markon, K. E. (2019). Psychology’s replication crisis and Clinical Psychology Science. Annual...
  • Tasca, G. A., Sylvestre, J., Balfour, L., Chyurlia, L., Evans, J., … y Wilson, B. (2015). What clinicians want: Findings from a psychotherapy...
  • Tolin, D. F., McKay, D., Forman, E. M., Klonsky, E. D. y
  • Thombs, B. D. (2015). Empirically supported treatment: Recommendations for a new model. Clinical Psychology: Science and Practice, 22, 317-338....
  • Tortella-Feliu, M., Vázquez, C., Valiente, C., Quero, S., Soler, J., … Baños, R. M. (2016). Retos en el desarrollo de intervenciones psicológicas...
  • Truijens, F., Zühlke-van Hulzen, L. y Vanheule, S. (2019). To manualize, or not to manualize: Is that still the question? A systematic review...
  • van Os, J., Guloksuz, S., Vijn, T. W., Hafkenscheid, A., y Delespaul, P. (2019). The evidence based group level symptom reduction model as...
  • Wampold, B. E. e Imel, Z. E. (2015). The great psychotherapy debate: The research evidence for what works in psychotherapy (2nd Ed.). New...
  • Weisz, J. R., Kuppens, S., Ng, M. Y., Eckshtain, D., Ugueto, A. M., Vaughn-Coaxum, R., Jensen-Doss, A., Hawley, K. M., Krumholz Marchette,...
  • West, J. C., Mo cicki, E. K., Duffy, F. F., Wilk, J. E., Countis, L., Narrow, W. E., y Regier, D. A. (2015). APIRE Practice Research Network:...
  • Youn, S., Sauer-Zavala, S., Patrick, K.A., Ahles, E.M., Aguilar Silvan, A., Greig, A., Marques, L. y Shtasel, D.L. (2019). Barriers and facilitators...
  • Youn, S., Xiao, H., McAleavey, A. A., Scofield, B. E., Pedersen, T. R., Castonguay, L. G., Hayes, J. A., y Locke, B. D. (2019). Assessing...
  • Zimmerman, J., Barnett, J. E., & Campbell, L. (Eds.). (2020). Bringing psychotherapy to the underserved: Challenges and strategies. New...