CLINICAL INNOVATION AND EVALUATION - INTEGRATING PRACTICE WITH INQUIRY

We explore the complex interplay of clinical discovery and controlled evaluation, demonstrating how experience in the applied arena provides invaluable insights and ideas about the complexity of the human condition and of ways to intervene effectively. Case studies have features that earn them a firm place in psychological research, and to ignore their potential contributions is to limit severely the kind of knowledge that can be generated by more systematic modes of inquiry. Some limitations of group designs in comparative therapy research are also reviewed, again highlighting the importance of idiographic analyses of single cases. Innovation and creative advancement are most readily nurtured via immersion in clinical/applied work, but at the same time the nature of that work is inevitably shaped by theories and hypotheses that clinicians bring into the applied setting. These abstractions are themselves influenced by the clinician's interpretations of data, which interpretations are molded by theoretical and metatheoretical preconceptions. In this complex and interactive fashion, clinical innovation is part of a non-linear network of forces that includes personal biases, professional allegiances, epistemological assumptions, theoretical preferences, and familiarity with and use of certain bodies of data.