[Psychotherapy research and therapeutic management]

The history of psychotherapy research has been closely allied with the development of clinical practice, as this review demonstrates. Empirical psychotherapy research aims at the scientific evaluation of existing practice and at the discovery of new fields of application. The early phases of psychotherapy research were concerned with scientific justification and societal legitimation. These questions changed with the extension of possible indications, the growing differentiation of treatment procedures and the progressive implementation of psychotherapy within the health-care system. The early issue "does psychotherapy work at all?" has been replaced by the questions "to whom is psychotherapy helpful?" and "how does psychotherapy work?". As an established part of the health-care system, psychotherapy is now faced with the same urgent problems as other medical specialties: therapeutic goals and economic conditions have to be brought in balance. Thus the perspectives of psychotherapy research have to encompass the individual patient as well as the system of care. These demands create new questions which enlarge the approaches of traditional psychotherapy research; new structural and logistic methodologies are asked for. We conclude by referring to a multicenter study on the psychodynamic treatment of eating disorders that has been initiated by the Center for Psychotherapy Research in Stuttgart as a prototype form of the new look in psychotherapy research.