Randomized Controlled Trials

Randomized controlled trials (RCT) form the basis for translating research data into clinical practice and are the trademark of evidence-based practice. Random controlled trials are the standard of a scientific test for new medical interventions. RCT’s have predefined study samples built out of the target population and randomly assigned to different groups (placebo vs. new treatment). The observed effects of investigational treatments at defined time points constitute predefined endpoints. Pharmaceutical companies must meet this standard when working out levels of efficacy and safety that can be achieved by an experimental drug. It is important in a clinical trial to have randomization to prevent the results from being skewed. If the

The main difference in RCT’s design to evaluate a new drug than a design to evaluate a new form of couple’s therapy is that RCT’s for a new drug is unethical. Randomized controlled trials are powerful tools; however, the use of RCT’s are limited by ethical and practical concerns. Exposing patients to an intervention believed to be inferior to current treatment is often thought unethical. According to Liu & Wyatt (2011), in a 2009 evaluation of Scotland’s National Telecare Development Programme, the evaluation method of the RCT was rejected for ethical reasons; the York Health Economic Consortium deemed the evaluation method deliberately withheld a service with known benefits. Limiting RCT psychotherapy studies to populations with few comorbid problems do not reflect real-world clinical practice. Additionally, Shean (2014), stated that most individuals who present for treatment in clinical practice are excluded from studies because of restrictive criteria required by RCT designs. A central element of RCTs that participants being double-blinded can only be utilized in drug trials. What is in the drug can be hidden from the patients as well as the professional providing the medication. Another difference between drug RCT designs and couple’s therapy RCT designs is that participants are not randomly selected for the study and are not likely to be blind to the treatment condition; they are usually being referred to the study. Therefore the patient samples are not an accurate representation of the population. RCT’s are underpowered and require higher statistical power and less bias to determine differential effectiveness in psychotherapy. In a study conducted by Barkham, Moller & Pybis (2017), the researchers found that there is no certainty whether there is sufficient confidence in the results of RCTs for adult