A healthy dose of criticism for randomized trials: comment on Westen, Novotny, and Thompson-Brenner (2004)

Abstract

D. Westen, C. M. Novotny, and H. Thompson-Brenner identified many important concerns in their critique of methods typically used in randomized controlled trials (RCTs) of psychotherapy outcome and by extension in methods of identifying empirically supported therapies (ESTs). Some of the concerns would be mitigated if empirical support of treatments were assessed multidimensionally (separating favorability of results from definitiveness of research methods used) and continuously rather than categorically. Other concerns can and should be addressed within the existing framework of RCTs and ESTs, including consideration of inclusion criteria other than a single Axis I condition, experimental evaluation of some of the procedural assumptions codified in psychotherapy manuals, and far more detailed reporting of RCT results.