Psychotherapeutic research and practice: Do we need to talk about ‘efficacy’?

In this article, we address how standardisation in psychotherapeutic research and practice can create a 'procrustean bed' which leads to conformity rather than an ethical response to what emerges in the moment. Articulated, three points of conflict in which we discuss how the therapist or researcher may be rendered 'ineffective' in the name of 'efficacy'. We explore some of the implications for idiosyncratic practices in psychotherapy, which are rooted in a foundation of ethics and philosophy, when the paradigm of empirically 'evidence-based practices' (EBP), which are rooted in measurement, takes centre stage and are overwhelmingly favoured in the industry of funded therapies. The first point of conflict is in relation to conversation itself; exploring the place of hermeneutics and interpretation within therapeutic dialogue and research. The second point explores what it means to take up a discovery-oriented stance and the implications this has for 'evidence'; further delving into the way our demand for 'evidence' may be impacting how psychotherapeutic research and practice is carried out. The final point aims to explore the infrastructure and work environment of funded therapies in the United Kingdom.