Other problems associated
with clinical trials
are to do with measurement and statistical power
(Roth & Fonagy, 1996). In personality disorder
treatment research, there are a variety of
important outcomes
that could be measured
such as self-harm, depression, hopelessness,
anger, and offending behaviour. Note that these
are not measures
of change in personality or
personality disorder status. Therapy tends to
focus on the patient’s presenting problems and
few individuals come to therapy asking for their
personality disorder to be changed.
Psychological therapy for a specific disorder may
be based on a recognisable
set of therapeutic
strategies and techniques but clinicians will tend
to base their interventions on an individualised
formulation of a patient’s problems rather than
diagnosis
per se
. It could therefore be argued that
psychological therapy
is based on an individual
and that the effectiveness of an intervention
should be assessed at a more individual-level
research design, such as single case designs.
However, this in itself raises other problems,
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