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date: 18 September 2019

Abstract and Keywords

This concluding chapter of the Oxford Handbook of Treatment Processes and Outcomes in Psychology describes the importance of breaking down research and practice silos in favor of a multidisciplinary and biopsychosocial approach regarding human physical and mental health. The chapter summarizes why we can have more confidence in treatments and interventions that “fit” within the context of converging lines of evidence across these multilevel systems. What multidisciplinary research tells us is that treatment does matter, as evidenced by multiple lines of research in animal models, particularly in fear-based and anxiety disorders. This research affirms that psychological/behavioral treatments are active and not reducible to nonspecific placebo effects. However, data indicate that placebo may prove valuable as a deliberately applied adjunct to psychological/behavioral and pharmacological treatments. Individual differences in self-regulation and temperament; genetic and epigenetic factors that influence resilience or maladaptive responses to adverse conditions; the buffering effects of social support; and how these factors may influence treatment process and outcomes are reviewed. Research evaluating pharmacological adjuncts to psychological/behavioral treatment underscores the complexity of delivering optimal treatment. Newer methodologies, such as neuroimaging, will assist in explicating the above complex interrelationships. This chapter also calls attention to research evaluating treatment outcomes, including dose response relationships and the importance of evaluating the therapist’s unique contribution to outcomes.

Keywords: multidisciplinary, biopsychosocial, silo, neuroimaging, placebo, treatment outcomes

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