Professor Peter Fonagy, Freud Memorial Professor of Psychoanalysis
and Director of the Sub-Department of Clinical Health Psychology,
University College, London and Chief Executive, The Anna Freud Centre,
- How well is the use of psychological
therapies justified and are there evidence-based indications for
a choice of treatment?
- What is our evidence base for training
and service delivery models?
- So – taken together – do
we have ways of thinking about clinical problems that allow for
meaningful matching of therapies to clients?
Peter Fonagy, PhD, FBA, is Freud Memorial
Professor of Psychoanalysis and Director of the Sub-Department of
Clinical Health Psychology at University College London; Chief Executive
of the Anna Freud Centre, London; and Consultant to the Child and
Family Program at the Menninger Department of Psychiatry and Behavioral
Sciences at the Baylor College of Medicine. He is Chair of the Postgraduate
Education Committee of the International Psychoanalytic Association
and a Fellow of the British Academy. He is a clinical psychologist
and a training and supervising analyst in the British Psycho-Analytical
Society in child and adult analysis.
His work integrates empirical research with
psychoanalytic theory, and his clinical interests center around
borderline psychopathology, violence, and early attachment relationships.
He has published over 300 chapters and articles and has authored
or edited several books. His most recent books include Psychoanalytic
Theories: Perspectives from Developmental Psychopathology (with
M. Target); What Works for Whom? A Critical Review of Psychotherapy
Research (with A. Roth); Psychotherapy for Borderline Personality
Disorder: Mentalization-Based Treatment (with Anthony Bateman);
Mentalization-Based Treatment for Borderline Personality Disorder:
A Practical Guide (also with Anthony Bateman); Reaching the Hard
to Reach: Evidence-Based Funding Priorities for Intervention and
Research (with Geoffrey Baruch & David Robins), and Handbook
of Mentalization-Based Treatment (with Jon Allen).
Evidence-based medicine has brought many
blessings, but as with any effective treatment, there have to be
side-effects. There are many advantages in moving away from an authority
and rhetoric based approach to offering psychosocial treatment to
a rational choice based on good evidence for cause and effect relationships.
The misapplication of evidence-based medicine comes in areas where
knowledge is incomplete. The paper will identify some of the areas
of uncertainty and it will be argued that in these instances we
have to be cautious that our wish for immediate and complete understanding
does not obliterate our legitimate scientific stance of not knowing.