Psychotherapy research: basic or applied?

Borkovec and Miranda (1996) have argued that the "greatest progress in the development of increasingly useful interventions" (p. 14) will come from redefining comparative trials research on psychotherapy outcome as basic research. They foresee that such a reconceptualization will lead to the increased use of dismantling, parametric, and additive research strategies and that it will result in increasing collaboration with other basic researchers. The assumption that a redefinition will stimulate increased collaboration and specificity of causal mechanisms is questioned as are the assumptions that randomization, group comparison designs, and within therapist designs will lead inherently to more valid assessments of cause-effect relationships. Analyses of a randomized clinical trials study is used to illustrate how clinical research can be guided by theory to tease out causal relationships, within therapy, and within patient factors. Ultimately, a combination of research paradigms, including N = 1, clinical utility, and controlled research, will best provide answers to important questions of change mechanisms and treatment effectiveness. A simple reconceptualization, however, is not necessary to make this happen and belies the complexity and overlap of the problems to be addressed.