Psychology 595; Clinical Methods
Dr. David J. McKirnan
The University of Illinois at Chicago
Department of Psychology

General orientation, discussion of MA topics.

Basic issues in theory, explanations and research

Treatment outcome research: Overview & examples.

More on basic design and causality

More basic experimental methods, meta-analysis.

The nature, criteria, and status of empirically supported therapy.

Efficacy v. effectiveness research.

Cultural and social issues in clinical research

No readings this week: come prepared to discuss your general MA approach.
Lecture notes (for this week and next) here.

Readings:
Garfinkel, A.  (1981).   Forms of Explanation: Rethinking the Questions in Social Theory.  Yale University Press, New Haven.  Pp. 1-74. Link.

McGuire WJ. 1983. A contextualist theory of knowledge: its implications for innovation and reform in psychological research. In Advances in Experimental Social Psychology, ed. L Berkowitz, 16:1-47. New York: Academic. Link.

Bonus Readings:
McGuire, W. J. (1973). The yin and yang of progress in social psychology: Seven koan. Journal of Personality and Social Psychology, 26(3), 446-456. Link.
McGuire, W. J. (1997). CREATIVE HYPOTHESIS GENERATING IN PSYCHOLOGY: Some Useful Heuristics
Annual Review of Psychology, 48, 1-30. Link.

More on basic design & causality.

Bonus Readings:
A lot of university-based health research is funded privately.  The most conspicuous of this is drug research.  Pre-clinical and efficacy trials for a new medication can easily cost half a million dollars, so private industry is an important source of funding.  This raises serious reporting and validity issues.  This piece from Atlantic is a nice overview.
Press, E. & Washburn, J. (2000).  The Kept University.  The Atlantic Monthly.  Volume 285, No. 3; page 39-54. (On-line version; www.TheAtlantic.com/ issues/2000/03/press.htm).  Link.

A cute description of non-linear models, in this case of crime: Gladwell, M.  (1996).  The Tipping Point.  New Yorker, June 3, Pp. 32-38. Link.

Readings:
Kazden, A.E. (1999).   Overview of research design issues in clinical research.  In Kendall, P.C. et al. (Eds), Handbook of Research Methods in Clinical Psychology.  New York, Wiley.  (Chapter 1, Pp. 3-30). Link.

Kendall, P.C., Flanner-Schreoder, E.C., Ford, J.D. 1999).  Therapy outcome research methods.  In Kendall, P.C. et al. (Eds), Handbook of Research Methods in Clinical Psychology.  New York, Wiley.  (Chapter 14, Pp 330-363). Link.

Readings:
Seligman MEP. The effectiveness of psychotherapy: The Consumer Reports study. American Psychologist. Dec 1995;50(12):965-974. Link

Brock TC, Green MC, Reich DA, Evans LM. The Consumer Reports study of psychotherapy: Invalid is invalid. American Psychologist. 1996;51(10). Link

Hunt E. Errors in Seligman's "The effectiveness of psychotherapy: The Consumer Reports study.". American Psychologist. 1996;51(10). Link

Kotkin M, Daviet C, Gurin J. The Consumer Reports mental health survey. American Psychologist. 1996;51(10):1080-1082. Link

Seligman MEP. Science as an ally of practice. American Psychologist. 1996;51(10):1072-1079. Link

Mintz J, Drake RE, Crits-Christoph P. Efficacy and effectiveness of psychotherapy: Two paradigms, one science. American Psychologist. Special Issue: Outcome assessment of psychotherapy. Oct 1996;51(10):1084-1085. Link

Bonus article:
Are samples in drug trials representative of the larger clinical population?
Zimmerman M, Mattia JI, Posternak MA. Are subjects in pharmacological treatment trials of depression representative of patients in routine clinical practice? American Journal of Psychiatry. Mar 2002;159(3):469-473. Link

Main readings:
Horvath, P. (1988). Placebos and common factors in 2 decades of psychotherapy-research. [Review]. Psychological Bulletin, 104(2), 214-225. Link

Baskin, T. W., Tierney, S. C., Minami, T., & Wampold, B. E. (2003). Establishing specificity in psychotherapy: A meta-analysis of structural equivalence of placebo controls. [Article]. Journal of Consulting and Clinical Psychology, 71(6), 973-979. Link.

Kirsch, I., Moore, T. J., Scoboria, A., & Nicholls, S. S. (2002). The emperor's new drugs: An analysis of antidepressant medication data submitted to the U.S. Food and Drug Administration. Prevention & Treatment, 5(1). Link.

APA electronic journal Prevention & Treatment   special issue on Medications & placebos:
Stanton, A. L. (2002). Introduction to Kirsch, Moore, Scoboria, & Nicholls (2002) and expert commentaries. Prevention & Treatment, 5(1). Link.
Kirsch, I. (2002). Yes, there is a placebo effect, but is there a powerful antidepressant drug effect? Prevention & Treatment, 5(1). Link.
Antonuccio, D. O., Burns, D. D., & Danton, W. G. (2002). Antidepressants: A triumph of marketing over science? Prevention & Treatment, 5(1). Link.
Brown, W. A. (2002). Are antidepressants as ineffective as they look? Prevention & Treatment, 5(1). Link.
Greenberg, R. P. (2002). Reflections on the emperor's new drugs. Prevention & Treatment, 5(1). Link.
Salamone, J. D. (2002). Antidepressants and placebos: Conceptual problems and research strategies. Prevention & Treatment, 5(1). Link.
Hollon, S. D., DeRubeis, R. J., Shelton, R. C., & Weiss, B. (2002). The emperor's new drugs: Effect size and moderation effects. Prevention & Treatment, 5(1). Link.
Moerman, D. E. (2002). "The loaves and the fishes": A comment on "The emperor's new drugs: An analysis of antidepressant medication data submitted to the U.S. Food and Drug Administration.". Prevention & Treatment, 5(1). Link.
Kirsch, I., Scoboria, A., & Moore, T. J. (2002). Antidepressants and placebos: Secrets, revelations, and unanswered questions. Prevention & Treatment, 5(1). Link.

Two more methods focused papers, also addressing Meds & placebos:
Gaudiano, B. A., & Herbert, J. D. (2005). Methodological issues in clinical trials of antidepressant medications: Perspectives from psychotherapy outcome research. [Article]. Psychotherapy and Psychosomatics, 74(1), 17-25. Link.
Antonuccio, D. O., Danton, W. G., DeNelsky, G. Y., Greenberg, R. P., & Gordon, J. S. (1999). Raising questions about antidepressants. Psychotherapy and Psychosomatics, 68, 3-14. Link.

Lecture / discussion notes here.

Readings:
MacKinnon, D. P., Fairchild, A. J., & Fritz, M. S. (2007). Mediation Analysis. Annual Review of Psychology, 58(1), 593-614. Link.

Beauchaine, T. P., Webster-Stratton, C., & Reid, M. J. (2005). Mediators, moderators, and predictors of 1-year outcomes among children treated for early-onset conduct problems: A latent growth curve analysis. [Article]. Journal of Consulting and Clinical Psychology, 73(3), 371-388. Link

Stice, E., Presnell, K., Gau, J., & Shaw, H. (2007). Testing mediators of intervention effects in randomized controlled trials: An evaluation of two eating disorder prevention programs. [Article]. Journal of Consulting and Clinical Psychology, 75(1), 20-32. Link

Bonus Reading: the mediator classic.
Baron, R.M & Kenny, D.A. (1986).  The moderator - mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations.  Journal of Personality and Social Psychology, 1986, 51, 6, 1173-1182. Link.

• Using text, rating scales, and direct observations to assess what happens in psychotherapy.
• Process research and “common factors” in therapy
• Client and/or therapist differences in therapy behavior
• Intervention fidelity
• Mediators of therapeutic change: the therapeutic alliance, cognitive change in the client
• Textual and cognitive assessment within current cognitive psychology.

Readings:
Kazdin, A. E. (2007). Mediators and Mechanisms of Change in Psychotherapy Research. Annual Review of Clinical Psychology, 3(1), 1-27. Link.

Stiles, W.B. et al. (1999).  Treatment process research methods.    In Kendall, P.C. et al. (Eds.), Handbook of Research Methods in Clinical Psychology.  New York, Wiley.  (Chapter 15, Pp. 364-402). Link

Ablon, J.S. & Jones, E.E. (1999).  Psychotherapy process in the National Institute of Mental Health Treatment of Depression collaborative research program.  Journal of Consulting and Clinical Psychology, 67(1), 64-75. Link

Bonus Reading:
When does theory obstruct research progress? Does a strong theory impose a confirmatory bias that keeps us from new insights. Click here for an interesting piece by Anthony Greenwald on the Theory Disconfirmation Dilemma.
Greenwald, A. G., Pratkanis, A. R., Leippe, M. R., & Baumgardner, M. H. (1986). Under what conditions does theory obstruct research progress? Psychological Review, 93(2), 216-229.

• Control conditions

• Sampling

• "Manualization" and treatment integrity / therapist fidelity
• Single subject or case study v. multiple case study v. group comparison methods
• The NIMH study: Testing for therapist / site / condition effects.es in therapy behavior

Readings:
Elkin, I. et al. (1985).  NIMH Treatment of Depression Collaborative Research Program; Background and Research Plan.  Archives of General Psychiatry, 42, 305-316. Link

Elkin, I, et al. (1989).  National Institute of Mental Health Treatment of Depression Collaborative Research Program: General Effectiveness of Treatments.  Archives of General Psychiatry, 46, 971-983. Link

• True experimental v. quasi-experimental designs
• Basic issues in data: types of variables, measurement models, relations among variables
• Factor analysis methods & more on mediators & moderators
• Path analysis v. simple regression v. structural models
• Overview & basic uses of meta-analysis.
• Experimental v. multiple case study v. group comparison methods
• The NIMH study: Testing for therapist / site / condition effects in therapy behavior

Readings:
Farrell, A.D.  (1999).  Statistical methods in clinical research.    In Kendall, P.C. et al. (Eds), Handbook of Research Methods in Clinical Psychology.  New York, Wiley.  (Ch. 4, Pp. 72-106). Link

Durlak, J.A.  (1999).  Meta-Analytic research methods.  In Kendall, P.C. et al. (Eds), Handbook of Research Methods in Clinical Psychology.  New York, Wiley.  (Ch. 17, Pp. 419-432). Link

Shadish, W.R. et al. (1997).  Evidence that therapy works in clinically representative conditions.  Journal of Counseling and Clinical Psychology, 65(3), 355-365. Link

Readings:
Chambless, D. L., & Ollendick, T. H. (2001). EMPIRICALLY SUPPORTED PSYCHOLOGICAL INTERVENTIONS: Controversies a nd Evidence. Annual Review of Psychology, 52(1), 685-716. Link

Johnson, W. D., Diaz, R. M., Flanders, W. D., Goodman, M., Hill, A. N., Holtgrave, D., et al. (2008). Behavioral interventions to reduce risk for sexual transmission of HIV among men who have sex with men. [Systematic Review]. Cochrane Database of Systematic Reviews(3). Link

Bonus Readings:
The Journal of Consulting and Clinical Psychology (1998, 66(1), link here) had a special issue on this topic. The issue is a little dated by now, but does have some interesting papers.  Some of key articles (in my view) are listed below by first author and title.
Kendall, P.C.             Empirically supported therapies.
Chambless, D.L.       Defining empirically supported therapies.
Compas, B.E.           Sampling of empirically supported psychological treatments from Health Psychology.
Persons, J.B.            Are the results of randomized controlled trials useful to psychotherapists?
Borkovek, T.D.          What is the scientific meaning of empirically supported therapy?

• Measuring prevention outcome effects in longitudinal samples (from Tolan paper).
• Identifying "common factors" in community-oriented HIV prevention programs to facilitate dissemination (Ingram paper).

Readings:
Ingram, B. L., Flannery, D., Elkavich, A., & Rotheram-Borus, M. J. (2008). Common processes in evidence-based adolescent HIV prevention programs. [Article]. AIDS and Behavior, 12(3), 374-383. Link

Tolan, P. (1999).  Research methods in community based treatment and prevention.    In Kendall, P.C. et al. (Eds), Handbook of Research Methods in Clinical Psychology.  New York, Wiley.  (Chapter 16, Pp. 403-418). Link

• Overview of basic findings and research methods

• Systematic bias in terms of the concepts of "content validity" and method variance.
• Cultural sensitivity in recruitment, retention & publishing results, ethics of study incentives.

Readings:
Sue, S., Zane, N., Nagayama Hall, G. C., & Berger, L. K. (2009). The Case for Cultural Competency in Psychotherapeutic Interventions. Annual Review of Psychology, 60(1). Link

Rogler, L.H. (1999).  Methodological sources of cultural insensitivity in mental health research.  American Psychologist, 54(6), 424-433. Link

Adler, N.E et al. (1994).  Socioeconomic status and health: The challenge of the gradient.   American Psychologist. 49(1), 15‑24.  Link

Adler, N. E., & Snibbe, A. C. (2003). The role of psychosocial processes in explaining the gradient between socioeconomic status and health. Current Directions in Psychological Science, 12(4), 119-123. Link

Tomarken, A.J.  Methodological issues in psychphysiological research.  In Kendall, P.C. et al. (Eds), Handbook of Research Methods in Clinical Psychology.  New York, Wiley.  (Ch. 11, Pp. 251-275). Link

Gaynor, S.T. et al. (1999).  Applications of time-series (single subject) designs in clinical psychology.  In Kendall, P.C. et al. (Eds), Handbook of Research Methods in Clinical Psychology.  New York, Wiley.  (Chapter 13, Pp. 297-329). Link

Shiffman, S., Stone, A. A., & Hufford, M. R. (2008). Ecological Momentary Assessment. Annual Review of Clinical Psychology, 4(1), 1-32. Link