[Evaluation of psychotherapy in clinical practice]

Empirical research on psychotherapies must be integrated into clinical practice. This is highly beneficial for both this research and the clinical practice itself. When research protocols are focused upon the everyday clinical problems and practice, filling up the corresponding scales or questionnaires does not appear any more as a tedious extra charge. Instruments are available which are based upon clinical usual approaches, and allow for reliable enough assessments of various and meaningful data (concerning symptoms, global health-sickness level, patient/therapist relationships, patients' involvement, etc....). Patients' and therapists' discourses can be analysed from tape recordings or from their responses to open-ended questions. Profiles of changes can be drawn, rather than unidimensional indexes of change. Naturalistic approach does not spoil the spontaneous clinical situation; but experimental settings are possible in some very precise circumstances. When a clinical staff decides to undertake such a research program, many institutional problems arise in an unusual way and thus can often be solved. Collectively filling up the questionnaires is frequently appreciated by the clinical staff. Patients usually appreciate to be questioned about their feelings and opinions concerning themselves and their treatment. However, if auto-evaluation brings highly worthwhile local benefits, the general conclusions of such empirical researches should be very cautiously discussed.