Empiricism in Psychotherapy: Behavioural Specification and Measurement

¹ Medical Director at the Santa Ana Psychiatric Center, Santa Ana, California, and Assistant Director of Psychiatry (adjunct) University of California, Irvine, California, U.S.A.
² Director of the Program in Clinical Research, Camarillo-Neuropsychiatric Institute Research Center, Camarillo State Hospital, Camarillo, California; Deputy Program Leader at the Oxnard (California) Community Mental Health Center; and Associate Research Psychiatrist at the University of California at Los Angeles.

The behavioural approach to clinical problems offers specification, measurement, and experimental analysis of treatment effects to the practising psychiatrist. As in the case examples cited above, recording observable and clinically meaningful behaviours provides the psychiatrist with important feedback as to which treatment methods are effective. Techniques per se, whether based upon learning theory or psychoanalysis, should not guide clinical, psychiatric treatment. Rather, psychotherapeutic practitioners from all `schools' should join in evolving a technology that germinates from an adherence to measurement of observable behaviour. Observable behaviour includes verbal behaviour (that is, what a patient says about his experience and distress) and non-verbal, affective behaviour (that is, posture, facial expression and voice loudness). While behaviour therapists are expanding the focus of their interests to more complicated social, physiological, and affective behaviours, psychodynamically-oriented clinicians might consider utilizing empirical methods to evaluate critically their efforts.

The experimental analysis of single cases has provided an important empirical foundation to behaviour technology as it has been applied to problems of children and adults in out-patient, in-patient, school and home environments. Experimental analysis can provide critical evaluation of creative practices in all types of psychiatric treatment as well as a vital check on the abuses and setbacks to psychiatry by therapeutic fads. At the same time, experimental analysis can reveal the useful contributions of psychodynamic psychotherapy, such as the power of the therapeutic relationship.