w3: Theory&Practice Flashcards
The APA’s Triad model: Evidence-Based Practice (EBP)
Definition: The integration of best available research, clinical expertise, and patient characteristics, culture, and preferences in making decisions about care.
Core Aspects:
Best Research Evidence: Empirical data from controlled trials, observational studies, or qualitative research.
Clinical Expertise: Judgement and skills developed through experience, enabling flexibility and adaptation.
Patient Characteristics: Individual needs, values, and cultural contexts.
Example: Choosing between CBT or medication for a patient based on research evidence, therapist experience, and patient preference
Clinical Expertise
Definition: The practitioner’s skill in integrating evidence and tailoring interventions to individual patients.
Key Elements:
Sensitivity to timing, framing, and pacing of interventions.
Ability to build effective therapeutic relationships.
Example: Adjusting therapy techniques for a shy teenager versus an outgoing adult
Phronesis
Definition: Practical wisdom involving ethical judgement and the ability to make context-sensitive decisions.
- bridges theoretical knowledge with real-world applications.
Philosophical Basis: Derived from Aristotle’s intellectual virtues (episteme, techne, phronesis).
Example: Deciding whether to prioritise immediate symptom relief or long-term behavioural change for a patient
Philosophical Basis Phronesis
Aristotle distinguished three types of intellectual virtues:
Episteme: Theoretical knowledge or scientific understanding, aimed at universal truths.
Techne: Technical knowledge or skills, used to produce something (craftsmanship).
Phronesis: Practical wisdom, which is the ability to act ethically and effectively in specific contexts
in psychology, while episteme underpins theoretical models of human behaviour and techne applies to the use of diagnostic tools or therapeutic techniques, phronesis is crucial for navigating the ethical and contextual complexities of psychological practice.
styles of thinking
Definition: Specific approaches to reasoning and evidence use in psychology, shaped by epistemological traditions.
types:
- statistical thinking
- thinking in cases
statistical thinking
Definition: Analysing phenomena using group-level data and probabilistic reasoning.
Strengths: Identifies trends and generalisable patterns.
Limitations: Lacks precision for individual cases.
Example: Determining that 20% of patients with high stress develop depression, but this may not apply to a specific individua
Thinking in Cases
Definition: Understanding and reasoning about phenomena by focusing on unique, individual circumstances.
Process:
Observing patient behaviours and reactions.
Using theoretical frameworks and personal experience to construct explanations.
Example: A therapist using narrative therapy to explore a client’s personal story of grief
Extending the Lab- Latour 1983
Latour (1983) describes the process of “extending the lab” as recreating laboratory conditions in the real world:
Insulation: Maintaining control over external influences to preserve the validity of the results.
Example: Psychotherapy sessions act as “insulated” environments where external distractions are minimised.
Scripting: Specifying instructions to configure users and ensure outcomes.
Example: A CBT manual for therapists prescribes structured session protocols
Critique in Psychology:
Unlike physical sciences, psychological interventions often fail to recreate such insulation and scripting outside the lab, making real-world application more challengin
Scripting
Definition: Prescribing specific actions or procedures to ensure desired outcomes from interventions.
Purpose: Minimises variability in implementation.
Example: A CBT manual providing step-by-step instructions for therapists
Insulating Processes
Definition: Creating controlled conditions to reduce external influences and ensure reliable intervention outcomes.
Example: Designing a therapy session to shield patients from environmental distractions
Heterogeneity
Definition: Acknowledging the variability in patient characteristics and responses to interventions.
Implication: Calls for flexible and personalised approaches.
Example: Tailoring treatments for patients with comorbid disorders
Situating Interventions
Definition: Ensuring interventions are delivered in appropriate contexts for maximum effectiveness.
Key Practices:
Aligning interventions with patients’ real-life environments.
Using cues and training to integrate interventions naturally.
Example: Mindfulness training delivered during workplace stress-reduction programmes
Critique of APA’s model (Willemsen, 2016)
- says it mirrors Aristotle’s categories of knowledge
- APA’s emphasis on research evidence sidelines the importance of phronesis
- EBP overly relies o generalisable, population-data (RCTs) & ignores variability in individual cases
- critique of ‘flexibility and interpersonal skills’ - questions how relational kills (unique and context driven) can be integrated into a system focused on generalised evidence
- patient characteristics- argues that while this is important the APA doesn’t outline how to operationalise patient-centered approaches.
Latours Critique on gap b/w theory & practice
Latour (1987) argues that there is no true gap between theory and practice.
Instead, science creates a network where theory is integrated with practice through specific processes.
Translation: Real-world problems are brought into the lab and transformed into small-scale, controllable processes.
Network Creation: Scientific facts only travel through the network of aligned actors (both human and non-human) that the laboratory creates
- Science draws the world into the lab.
- Creates a network.
- And then extends the lab.