Browsing by Subject "Randomized controlled trial"

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A randomized controlled investigation of a compassion-based intervention for shame
(2023-06-22) Foulser, Anna Alban; Telch, Michael Joseph; Carlson, Caryn L; Hixon, John G; Swann, William B
Shame is a painful negative emotion involving negative evaluation of the self. There has been significant debate as to whether shame is private or public in nature. Shame consists of both internally-sourced shame, which involves negative evaluation of oneself as inadequate or flawed, and externally-sourced shame, which involves the perception of negative evaluation by others. Self-compassion, which includes self-kindness, common humanity, and mindfulness, has emerged as a promising intervention for reducing shame. Given that shame has an internally sourced component, it is unsurprising that one of the most effective interventions for shame is to change patients’ self-view by increasing self-compassion. However, externally-sourced shame, which results from one’s perception of negative evaluation of the self by others, may not be alleviated by self-compassion, which focuses on one’s self-view. In this dissertation, we examined the impact of a novel intervention for internally-sourced and externally-sourced shame using self-compassion and compassion from others, singularly and in combination. While internally-sourced shame decreased from pre-intervention to follow-up, there was no difference in change in trait shame across the four conditions. We also tested the impact of our intervention on real-time state shame. While self-compassion led to decreased levels of shame at post-intervention, this effect did not persist at follow-up, and compassion from others had no impact on changes in state shame at either time point. Taken together, our findings suggest that repeated shame induction leads to decreases in shame over time, and also provides support for self-compassion as an intervention for shame.
Randomized controlled trials to evaluate impact : their challenges and policy implications for medicine, education, and international development
(2012-12) Kahlert, Rahel C.; Ward, Peter M., 1951-; Treisman, Uri; Galbraith, James; Osborne, Cynthia; Roberts, Bryan
Policy makers in education and international development have lately gravitated toward the randomized controlled trial (RCT)—an evaluation design that randomly assigns a sample of people or households into an intervention group and a control group in order to measure the differential effect of the intervention—as a means to determine program impact. As part of federal regulations, the U.S. Department of Education and the U.S. Agency for International development explicitly declared a preference for the RCT. When advocating for adopting the RCT model as the preferred evaluation tool, policy makers point to the success story of medical trials and how they revolutionized medicine from Medieval charlatanry to a modern life-saving discipline. By presenting a more nuanced account of the role of the RCT in medical history, however, this study finds that landmark RCTs were accompanied with challenges, Evidence-Based Medicine had rightful critics, and opportunistic biases in drug trials apply equally to education policy and international development. This study also examines the recent privileged role of the RCT in education and international development, concluding that its initial promise was not entirely born out when put into practice, as the national Reading First Initiative exemplifies. From a comparative perspective, the RCT movements also encountered major RCT critics, whose voices were not initially heard. These voices, however, seem to have contributed to a swing of the pendulum away from RCT primacy back towards greater methodological pluralism. A major conclusion of this study is that policy makers should exercise great caution when using RCTs as a policy evaluation tool. This conclusion is arrived at via considering RCT biases, challenges, and limited generalizability; understanding its interpretive-qualitative components; and broadening the overall methodological repertoire to better enable evaluations of macro-policy interventions.