心理療法における「エビデンス」とは何か --Evidence-basedの概念の再検討を通して--

Abstract

Evidence-based Medicine(エビデンスに基づく医療; EBM)の概念は心理療法の領域にも⼤きな影響を及ぼし、Evidence-based Practice in Psychology(心理学におけるエビデンスに基づく実践; EBPP)という概念も生まれた。しかし、EBMやエビデンスの概念については理解の混乱や誤解があることが指摘され続けており、EBPPの概念はその誤解に基づく形で生まれ、後に軌道修正がなされたものの、心理臨床実践の観点から様々な問題点が指摘されている。本稿の目的は、①EBMの概念の再検討を通じて、その理念の本質とエビデンス概念について明らかにすること、②それに基づき、EBPPの問題点を明らかにすること、③心理臨床実践におけるエビデンスの概念を再定義することであった。その結果、3種類のエビデンスが抽出され、これらを基に、心理臨床実践におけるエビデンス概念が検討された。

The concept of evidence-based medicine (EBM) has had a significant impact on the field of psychotherapy, and the concept of evidence-based practice in psychology (EBPP) was developed. However, confusion and misunderstanding about the concepts of EBM and evidence continue to be noted, and EBPP was born out of these misunderstandings. Although it was later modified in some ways, various problems have been identified from the perspective of psychological clinical practice. The objectives of this paper were (1) to clarify the essence of the philosophy of EBM and the concept of "evidence" through a review of the concept of EBM, (2) to identify the problems of EBPP, and (3) to redefine the concept of "evidence" in psychological clinical practice. As a result, three types of evidence were extracted. Based on these findings, the concept of "evidence" in psychological clinical practice was scrutinized, and the type and nature of the evidence in psychological clinical practice was examined and clarified.