PSYCH481:

Introduction

This lesson will cover research as conducted by clinical psychologists.

Clinical psychology uses scientific methods and empirical studies to answer clinical issues. A fundamental aspect of clinical psychological research is a focus on mental illness that creates a foundation for the field (Pomerantz, 2020). Although there may be overlap in the way in which clinical psychologists and other kinds of psychologists conduct research, it's important to understand the foundations upon which mental illness is understood and treated.

Lesson Objectives

At the end of this lesson, you should be able to

• identify the basics of clinical research methods and how they are used to test clinical interventions,
• distinguish between different study designs that are used by clinical psychologists, and
• recognize the ethical issues inherent in clinical research with humans.

Lesson Readings and Activities

By the end of this lesson, make sure you have completed the readings and activities found in the Course Schedule.

Why Do Clinical Psychologists Do Research?

The most basic reason clinical psychologists conduct research is to understand mental illness (Pomerantz, 2020).

But, before we delve into the reasoning further, there are several important terms to know when discussing clinical psychological research:

• Treatment outcome refers to how well interventions (or treatments) work. Research in this area explores topics like whether or not a particular type of therapy is effective. In 1951, Hans Eysenck published a review of psychotherapy outcomes that suggested that many forms of therapy were not working or helpful to the patients (Pomerantz, 2020). This was a bombshell in the field that brought with it a lot of attention, generating a wealth of research into useful psychotherapy treatments. Treatment outcome research itself requires an understanding of the following terms (Pomerantz, 2020, pp. 501–505):
  • efficacy: Your textbook defines efficacy as "the success of a particular therapy in a controlled study conducted with clients who were chosen according to particular study criteria."
  • effectiveness: Effectiveness is "the success of a therapy in actual clinical settings in which client problems span a wider range and are not chosen as a result of meeting certain diagnostic criteria."
  • internal validity: Internal validity is "The extent to which the change in the dependent variable is due solely to the change in the independent variable."
  • external validity: External validity is "The generalizability of research results, or the extent to which a particular finding is valid for different settings and populations."

While clinical psychologists primarily conduct research to explore and further understand mental illness, they also research the following subjects (Pomerantz, 2020):

• assessment methods: Clinical psychologists might do research to create and improve assessment measures used with patients. There are many different ways to assess a patient: some measures are used to help diagnose, while some might be used to assess different types of personality or to distinguish between types of psychopathology. The development of these measures is an important type of research that clinicians may do.
• diagnostic issues: Clinical psychological research might explore various ways that mental disorders can be categorized, as well as the criteria necessary for a particular diagnosis.
• professional issues: Clinical psychologists might also conduct research about other psychologists—how they work, what they believe, or what kinds of professional challenges they face in their day-to-day work.
• teaching and training issues: Clinical psychological research related to training might ask questions about the best ways to educate those who are pursuing psychology as a career.

How Do Clinical Psychologists Do Research?

This page will provide a brief summary of important concepts related to clinical psychological research studies (covered in more detail in Pomerantz, 2020, pp. 137–143):

• experimental method: Most scientists, including psychologists, employ the scientific method when embarking on a research project, routinely following the same steps: deciding on the research question, observing events, and developing a hypothesis (which includes identifying an independent and a dependent variable). Once a hypothesis has been formed, it is empirically tested; interpretations of the results are reported in the study. This process is described in more detail on page 137 of your textbook.
• randomized controlled trial (or randomized clinical trial/RCT): An RCT is a study that randomly assigns participants to either an experimental or a control group. For example, researchers could want to examine whether a particular therapy for depression works. Patients who meet the diagnostic criteria for major depression would be randomly assigned to one of two groups; the experimental group would receive the therapeutic intervention, while the control group would not. Then, the groups are compared based on their baseline status (before the intervention) and on their status after receiving the therapy. RCTs are sometimes considered the gold standard for research, although some criticize their inability to replicate real-world problems.
• quasi-experiments: Some clinical psychological research questions don't lend themselves to traditional experimental design. (Typically, this happens when the researchers face many difficult-to-control variables.) In this type of scenario, a quasi-experimental design might be used. This design may not be as robust or as internally valid as a "true" experiment, but the data are important, especially when context makes a true experiment impossible.
• between-groups design: In studies using this design, comparisons are made between groups that get assigned to completely separate conditions and that receive different interventions. An experimental group receives the intervention, while the control group does not. 
• within-groups design: In studies using this design, subjects within a single group are exposed to a particular intervention, with their (often changing) results being gathered over time.
• analogue design: An analogue design approximates certain study elements when the "real thing" isn't available. It might be used when the target population isn't available or there aren't enough members of the target population to yield an adequate sample; approximations are accepted instead.
• correlational methods: Sometimes neither an experiment nor a quasi-experiment is possible, so correlational methods are used. There is no independent or dependent variable; rather, the associations between variables are observed, and inferences drawn from there. We cannot establish causality with a correlational study, but if a true experiment is impossible, correlational research still allows us to examine relationships between variables.
• case study: A case study is simply an in-depth examination of a single case or situation that can lead to more rigorous research.
• meta-analysis: A meta-analysis statistically examines and draws conclusions about a number of other studies. It's a way of combining multiple studies that all meet some criterion, which can help researchers draw firm conclusions from systematically exploring them.
• cross-sectional versus longitudinal design: A cross-sectional design examines a group of participants at a single point in time, whereas a longitudinal study follows the group over a long period of time.

Ethical Issues in Research in Clinical Psychology

The American Psychological Association (APA) has published ethical guidelines for psychologists, including standards for clinical psychologists who conduct research with human subjects. Some important aspects of these standards are listed here and in your textbook (Pomerantz, 2020, pp. 145–146):

• Researchers should obtain informed consent from prospective participants. The information they present should include the purpose and duration of the study as well as the participants' right to decline or withdraw (Standard 8.02).
• Researchers should not coerce participation by offering excessive or inappropriate rewards (financial or otherwise; Standard 8.06).
• Researchers should avoid using deception in their studies unless the prospective value of the research justifies its use and nondeceptive methods are not feasible. If deception is used, the researcher should explain it fully to participants as soon as possible and allow them to withdraw their data if they choose (Standard 8.07).
• If researchers discover that research procedures have harmed a participant, they should take reasonable steps to minimize the harm (Standard 8.08).
• Researchers should never fabricate or falsify data (Standard 8.10).
• Researchers should list themselves as authors of a study only when their contributions are justifiably substantial and the order of authorship reflects the relative contributions of the individuals involved (Standard 8.12).
• Researchers should share their data with other competent researchers who intend to reanalyze it for verification (Standard 8.14).

References

Pomerantz, A. M. (2020). Clinical psychology: Science, practice, and diversity (5th ed.). Thousand Oaks, CA: Sage Publications.