The Tavistock and Portman clinics each existed prior to the formation of the NHS as resources which had clinical work and training at the core of their rationale. At the time such elite services saw every clinical session as a research enterprise which the clinicians tried to learn from and within which the clinicians tested existing theory and developed new theory. The methods used were careful completion of case notes, discussion amongst the clinicians and case presentations and reports in journals.
Though not currently what epitomised "research" both clinics have, through that stance, became the testing grounds of fundamental new ideas and practices in psychotherapy. The theoretical ideas are legion and the practices included such fundamentals as the introduction of group and family work and specific developments in that work. The Portman pioneered ideas about working with mixed groups of offenders and victims and the Tavistock led development of particular ways of working in groups and in a number of the key formative development of family therapy in Britain. Another fundamental development tightly linked to the Tavistock was in training: the use of infant observation as a training tool and its elaboration to organisational observation.
All those developments, which continue, took place within what would now be called "qualitative research" and we are now working developing qualitative methods. It also includes the creation of new techniques, including mathematical ones, to show the rigour, reliability and validity of some qualitative data. It also includes development of analytic and systemic qualitative methods through exploration of the similarities and differences between the clinical and infant observation methods, and the new methods of qualitative research such as grounded theory, discourse analyses and interpretative phenomenological analysis.
Quantitative research methods have traditionally been less immediately compatible with the clinical theories and practices of the Trust (see "Our unique approach to research" for more details). However, Bowlby set a strong lead in systematic reporting of the life histories of a case series with his classic paper "Forty Juvenile Thieves". This, and the more qualitative observational work of the Robertsons, also based in the Tavistock, on the reactions of children separated from their parents for routine hospital admissions, changed societal attitudes, hospital policies and formed the basis of one enormously influential clinical theory now called attachment theory.
Another pioneer of quantitative work in the Tavistock was David Malan whose comparative studies of group and individual therapies and whose studies of short term therapies also changed the shape of British psychodynamic therapies. Though Malan's comparative studies were the first comparative studies in the Tavistock and pioneering in the field at the time, they did not use randomised controlled methods.
One of the late Professor Kolvin's many contributions to research in the Trust was the first randomised controlled study here led by Dr. Judith Trowell and Professor Kolvin which compared group and individual therapies for children and adolescents who were survivors of childhood sexual abuse. Professor Kolvin also used detailed quantitative analysis of large developmental and other longitudinal databases to explore psychodynamic and other hypotheses about the developmental bases of child, adolescent and adult mental disorders and forensic problems. Dr. Trowell is currently leading a four centre randomised study of family and individual therapies for young people with depression. The Tavistock is the lead centre and the other centres are the Maudsley/Bethlem hospital in South London and both Athens and Helsinki. Cultural differences may be as interesting and marked in the findings as the main family/individual contrast.
Three other major threads in the last decade, alongside that work, have been the detailed developmental work on our core understanding of autism and related disorders by Professor Hobson and his colleagues in the DPRU and his work on with others on careful empirical exploration of ratings of adult psychopathology. Professor Stein, whose work with the Trust continues despite his move to the first Chair in Child Psychiatry at Oxford, continues Professor Kolvin's tradition of interest in personal and transgenerational developmental factors with longitudinal and RCT intervention studies particularly of eating disorders. Finally, Professor Richardson has also fostered the development of outcome and process work through the work of the PERU.
