Evidence-based practice in psychology
Also known as EBPP, Evidence-based practice, Empirically supported treatments
Choosing treatment from research, clinical expertise and the patient's own needs together.
At a glance
In plain words
Research evidence, Clinical expertise, The patient
See all 3Examples
A shared decision, Patient factors that matter, Context counts …
See all 7Where it comes from
Treatment lists, Not a complete list, A wider consensus
See all 3The tension
Specific treatments or shared factors?
Connections
Dodo bird verdict, Common factors theory and 8 others
See all 10
Also on this page: Key facts · Links · Sources · Related pages
- Evidence-based practice in psychology combines three things: the best research, clinical expertise and the patient.
- The patient side covers their characteristics, culture and preferences.
- The American Psychological Association adopted this definition in 2005.
- Lists of research-supported treatments help, but they are one input, not the whole decision.
Why it matters
- Useful for judging any therapy's claims, and for knowing why a good therapist does not just run a manual.
Key facts
- In short
- Integrating the best available research with clinical expertise, in the context of patient characteristics, culture and preferences1
- Started
- Adopted by the APA Council of Representatives in August 20051
- Core idea
- Three components: research evidence, clinical expertise, patient characteristics, values and context1
- Treatment lists
- APA Division 12 (Society of Clinical Psychology) lists treatments with published efficacy data2
- Ratings
- Current ratings (Tolin et al., 2015) are very strong, strong, weak or insufficient evidence2
- Criticism
- Results from population-level research may not apply to each individual3
In plain words
-
Research evidence1
Findings on treatments, assessment and problems, judged by systematic reviews, effect sizes and clinical significance.
-
Clinical expertise1
Skill in assessing, formulating cases, building relationships and tracking progress, including knowing one's own limits and biases.
-
The patient1
Their problems, strengths, culture, stage of life and preferences; a central goal is offering choice among effective options.
Examples
-
A shared decision1
For example, a psychologist tells a client with depression about two research-supported options, weighs the client's preference, agrees the plan with them, then tracks progress and changes course if it stalls.
-
Patient factors that matter1
Functional status, readiness to change and level of social support are known to relate to how therapy turns out.
-
Context counts1
The APA's examples of context include institutional racism and health-care disparities, and stressors such as unemployment or major life events.
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When others decide1
For children and youth, parents usually make the referral and choose the therapist and treatment, so decisions are made together with them.
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Treating the people around1
Some effective treatments work through others in the patient's life, such as parents, teachers and caregivers.
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Knowing when to get help1
Seeking consultation, or adjunctive or alternative services, when needed is listed as part of clinical expertise.
-
Untested is not ineffective1
A practice not yet studied in controlled trials should not be assumed to fail, though widely used practices should be rigorously tested.
Where it comes from
-
Treatment lists2
Division 12 first rated treatments by Chambless and Hollon's 1998 criteria ("well-established" when independent studies converge); those ratings are now archived.
-
Not a complete list2
The Society of Clinical Psychology says its list does not include every supported treatment, and archived ratings may be out of date.
-
A wider consensus3
An evidence-based practice consensus statement from a 2018 mental-health summit had 36 endorsing organisations by June 2019.
The tension
-
Specific treatments or shared factors?4
Bruce Wampold argued that the focus on empirically supported treatments neglected Common factors theory.
Connections
Related
- Dodo bird verdictTopicIf therapies are equal, mandating specific treatments matters less
- Common factors theoryTopicWampold argued research had overemphasised empirically supported treatments
- Comparative efficacy and tolerability of medications for attention-deficit hyperactivity disorder in children, adolescents, and adults: a systematic review and network meta-analysisPaperA network meta-analysis meant to guide treatment guidelines
- Effect sizeTopic
- The Efficacy of Cognitive Behavioral Therapy: A Review of Meta-analysesPaperA standard citation for CBT's evidence base
- Cognitive-behavioral treatment of chronically parasuicidal borderline patientsPaperMade DBT the first therapy shown effective for BPD in trials
- PsychotherapyTopicHow psychologists are asked to choose among therapies
- Research Methods in Clinical Psychology: An Introduction for Students and PractitionersBookHow the research behind evidence-based practice is done
- The efficacy of psychodynamic psychotherapyPaperDisputes which therapies count as evidence based
- The Great Psychotherapy Debate: The Evidence for What Makes Psychotherapy WorkBookArgues against judging therapies only by their specific ingredients
Links
Sources
- Policy Statement on Evidence-Based Practice in Psychology (APA) (opens apa.org)
- Psychological Treatments (Society of Clinical Psychology, APA Division 12) (opens societyofclinicalpsychology.org)
- Evidence-based practice (Wikipedia) (opens en.wikipedia.org)
- Common factors theory (Wikipedia) (opens en.wikipedia.org)
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