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The push for Evidence-Based Therapy is a movement in psychology that aims to track the efficacy of treatment plans so that clients only undergo treatments which have been proven to work.
This article will cover what Evidence-Based Therapy is, how it relates to the idea of evidence-based practice, and why it is important.
Finally, some examples of Evidence-Based Therapy will be discussed, as well as some helpful books on Evidence-Based Therapy.
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What is Evidence-Based Therapy? A Definition
Evidence-Based Therapy (EBT), also sometimes more broadly referred to as evidence-based practice (EBP) to encompass more fields of medicine, is any therapy based on peer-reviewed scientific evidence. According to the Association for Behavioral and Cognitive Therapies, evidence-based practice is defined by:
“[a]dherence to psychological approaches and techniques that are based on scientific evidence”.
The American Psychiatric Association and the American Psychological Association both consider EBT/EBP to be:
“‘Best Practice’ and ‘preferred’ approaches for psychological symptom treatment”.
Evidence-based medicine has also been defined as the:
“conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients” (Sackett et al., 1996).
This definition has since “expanded” to include “consideration of patients’ preferences, actions, clinical state, and circumstances” (Cook et al., 2017). This expansion of the definition is particularly important in the context of psychotherapy. For our purposes, we can consider Evidence-Based Therapy or practice to refer to psychotherapy practices which have been proven effective rather than purely based in theory.
The Goals and Benefits of Evidence-Based Therapy
Two of the main goals behind evidence-based practice are increased quality of treatment, as well as increased accountability, so that patients only pay for and undergo treatments which have been proven effective (Spring, 2007). Research has shown that Evidence-Based Therapy is indeed cost-effective (Emmelkamp et al., 2014). This makes sense since clients undergoing Evidence-Based Therapy likely spend less time receiving treatment than those undergoing treatment plans which have not been proven.
In fact, some commentators have even argued that the push for Evidence-Based Therapy must also promote therapy that has been proven to be cost-effective as well as clinically effective (Castelnuovo et al., 2016). These commentators have also stressed that this must not simply come to mean cheap treatment plans since a cheap, ineffective treatment plan does not help the client in any way. In other words, Evidence-Based Therapy must be clinically effective and cost-effective, not just one of the two.
Recently, certain literature has also argued that the therapist is more important than the therapy practices deployed, leading one paper to declare that “the time is overdue for the psychotherapy field as a whole to research and develop the idea of evidence based therapists” rather than simply focusing on Evidence-Based Therapy (Blow & Karam, 2017).
Proponents argue that since certain therapists are more effective for certain clients than other therapists (Kraus et al., 2016), therapists should then be held accountable for their effectiveness just like treatment plans are. This would consist of tracking a therapist’s success rate and ensuring that they continue to prove themselves as effective, just as one would a certain treatment plan.
Examples of Interventions Used in Evidence-Based Therapy
1. One example of Evidence-Based Therapy is art therapy for children who have Autism Spectrum Disorder (ASD) which offers:
“varied materials and opportunities for expression to enable various kinesthetic, creative as well as sensory means to communicate” (Van Lith et al., 2017).
2. Dialectical behavior therapy (DBT) is also an evidence-based treatment plan, as it has been proven effective for treating patients with both borderline personality disorder (BPD) and substance abuse (Linehan et al., 1999) as well as for patients with trichotillomania (Keuthen et al., 2011). There is also evidence that DBT may be an effective treatment for patients with intellectual disabilities, but more research is still needed (McNair et al., 2017).
3. For children with developmental coordination disorder (DCD), “task-oriented” interventions can be considered Evidence-Based Therapy while other common interventions such as “process-oriented” interventions or traditional physical and occupational therapies cannot be considered Evidence-Based Therapy (Withers et al., 2017).
In other words, interventions for DCD should target challenging tasks rather than the body parts used in these tasks. Despite this evidence, researchers found that while 70% of occupational therapists considered themselves familiar with the current literature in the field, only about half of these therapists were providing task-oriented (evidence-based) interventions.
This shows the importance of promoting Evidence-Based Therapy, despite the fact that it may seem like an obvious movement to some.
Evidence-Based Therapy for Depression and Anxiety
Mindfulness-based cognitive therapy (MBCT) has been proven effective for reducing relapse rates of Major Depressive Disorder (MDD) (Lilja et al., 2016). Cognitive-behavioral therapy (CBT) has also been proven effective for the treatment of both MDD and generalized anxiety disorder (GAD), along with several other disorders (Gratzer & Goldbloom, 2016). Since CBT requires “a major investment of resources and time” but has been proven to be effective for many disorders, certain researchers have shown interest in making CBT more accessible.
One such effort examined the feasibility of internet-delivered cognitive behavior therapy (IBCT), which found that ICBT can be effective in treating children and adolescents with anxiety and depressive symptoms (Vigerland et al., 2016). CBT is an effective, evidence-based treatment plan for a wide range of disorders, so making it accessible as possible should be a priority. ICBT is a crucial first step towards that goal.
The Five Best Books on Evidence-Based Therapy
If you want in-depth discussions of Evidence-Based Therapy and how to incorporate it into your own practice, these are five of the best books on Evidence-Based Therapy.
Summers, R.F., Barber, J.P. (2012). Psychodynamic Therapy: A Guide To Evidence-Based Practice. New York: The Guilford Press.
This is a good book for therapists who wish to practice evidence-based psychodynamic therapy. While psychodynamic therapy has been around for a long time, this book aims to incorporate new movements in psychology, including positive psychology, to provide an up-to-date picture of what Evidence-Based Therapy looks like when it comes to psychodynamic therapy. This makes it an especially good option for psychodynamic therapists who believe in the positive psychology movement.
Williams, L., Patterson, J., Edwards, T.M. (2014). Clinician’s Guide to Research Methods in Family Therapy: Foundations of Evidence-Based Practice, First Edition. New York: The Guilford Press.
This book is all about Evidence-Based Therapy for marriage and family therapists. It also focuses on applying the teachings of the book into one’s practice, so it can be an actionable book. Any marriage and family therapist who wants to incorporate Evidence-Based Therapy into their practice can start with this book.
Dobson, D., Dobson, K.S. (2016). Evidence-Based Practice of Cognitive-Behavioral Therapy, Second Edition. New York: The Guilford Press.
Since cognitive-behavioral therapy (CBT) is one of the strongest evidence-based therapies out there, it is important to include a book which discusses CBT specifically.
Thompson-Brenner, H (Ed.). (2015). Casebook of Evidence-Based Therapy for Eating Disorders, First Edition. New York: The Guilford Press.
As the title suggests, this book focuses on Evidence-Based Therapy dealing with eating disorders. It accomplishes this by focusing on a few case studies so that one can see what it looks like to deploy these evidence-based treatment plans in practice. This is an excellent option for anyone who deals with eating disorders and wants to learn through example.
Brown, C. (2016). The Evidence-Based Practitioner: Applying Research to Meet Client Needs, First Edition. Philadelphia, PA: F.A. Davis Company.
Finally, this book doesn’t focus on any particular disorders and doesn’t even focus on therapy itself. This is a guide to incorporating evidence-based practices for all sorts of medicinal fields, including doctors as well as therapists. While it is not written specifically for therapists, it does teach the reader step-by-step how they can incorporate evidence-based techniques into their own practice. This is an excellent option for anyone interest in Evidence-Based Therapy since it is not specific to a disorder and discusses the entire process of evaluating the literature to incorporating it into one’s practice.
A Take Home Message
When it comes to any sort of medicinal treatment plan, it is crucial for the techniques used to not only be evidence-based but to be continually evaluated and re-evaluated for efficacy. The Evidence-Based Therapy movement is a movement that centers the patient’s needs, including financial needs as well.
The field of therapy can only become stronger with a push for evidence-based techniques and practices, so the more the movement is embraced the better off that therapists and their clients will be.
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- Blow, A.J., Karam, E.A. (2017). The Therapist's Role in Effective Marriage and Family Therapy Practice: The Case for Evidence Based Therapists. Administration and Policy in Mental Health and Mental Health Services Research, 44(5), 716-723. doi:10.1007/s10488-016-0768-8
- Castelnuovo, G., Pietrabissa, G., Cattivelli, R., Manzoni, G.M., Molinari, E. (2016). Frontiers in Psychology, 7(1), 563. doi:10.3389/fpsyg.2016.00563
- Cook, S.C., Schwartz, A.C., Kaslow, N.J. (2017). Evidence-Based Psychotherapy: Advantages and Challenges. Neurotherapeutics, 14(3), 537-545. doi:10.1007/s13311-017-0549-4
- Emmelkamp, P.M.G., David, D., Beckers, T., Muris, P., Cuijpers, P., Lutz, W., Andersson, G., Araya, R., Rivera, R.M.B., Barkham, M., Berking, M., Berger, T., Botella, C., Carlbring, P., Colom, F., Essau, C., Hermans, D., Hofmann, S.G., Knappe, S., Ollendick, T.H., Raes, F., Rief, W., Riper, F., Van der Oord, S., Vervliet, B. (2014). Advancing psychotherapy and evidence-based psychological interventions. International Journal of Methods in Psychiatric Research, 23(S1), 58-91. doi:10.1002/mpr.1411
- Gratzer, D., Goldbloom, D. (2016). Making Evidence-Based Psychotherapy More Accessible in Canada. Canadian Journal of Psychiatry, 61(10), 618-623. doi:10.1177/0706743716642416
- Keuthen, N.J., Rothbaum, B.O., Falkenstein, M.J., Meunier, S., Timpano, K.R., Jenike, M.A., Welch, S.S. (2011). DBT-Enhanced Habit Reversal Treatment for Trichotillomania: 3-and 6-Month Follow-Up Results. Depression and Anxiety, 28(4), 310-313. doi:10.1002/da.20778
- Kraus, D.R., Bentley, J.H., Alexander, P.C., Boswell, J.F., Constantino, M.J., Baxter, E.E., Castonguay, L.G. (2016). Predicting Therapist Effectiveness From Their Own Practice-Based Evidence. Journal of Consulting and Clinical Psychology, 84(6), 473-483. doi:10.1037/ccp0000083
- Lilja, J.L., Zelleroth, C., Axberg, U., Norlander, T. (2016). Mindfulness-based cognitive therapy is effective as relapse prevention for patients with recurrent depression in Scandinavian primary health care. Scandinavian Journal of Psychology, 57(5), 464-472. doi:10.1111/sjop.12302
- Linehan, M.M., Schmidt, H., Dimeff, L.A., Craft, J.C., Kanter, J., Comtois, K.A. (1999). Dialectical Behavior Therapy for patients with borderline personality disorder and drug-dependence. American Journal on Addictions, 8(4), 279-292.
- McNair, L., Woodrow, C., Hare, D. (2017). Dialectical Behaviour Therapy [DBT] with People with Intellectual Disabilities: A Systematic Review and Narrative Analysis. Journal of Applied Research in Intellectual DIsabilities, 30(5), 787-804. doi:10.1111/jar.12277
- Sackett, D.L., Rosenberg, W.M.C., Gray, J.A.M., Haynes. R.B., Richardson, W.S. (1996). Evidence based medicine: what it is and what it isn't. BMJ, 312(1), 71-72. doi:10.1136/bmj.312.7023.71
- Spring, B. (2007). Evidence-based practice in clinical psychology: What it is, why it matters; What you need to know. Journal of Clinical Psychology, 63(7), 611-631. doi:10.1002/jclp.20373
- Van Lith, T., Stallings, J.W., Harris, C.E. (2017). Discovering good practice for art therapy with children who have Autism Spectrum Disorder: The results of a small scale survey. Arts in Psychotherapy, 54(1), 78-84. doi:10.1016/j.aip.2017.01.002
- Vigerland, S., Lenhard, F., Bonnert, M., Lalouni, M., Hedman, E., Ahlen, J., Olen, O., Serlachius, E., Ljotsson, B. (2016). Internet-delivered cognitive behavior therapy for children and adolescents: A systematic review and meta-analysis. Clinical Psychology Review, 50(1), 1-10. doi:10.1016/j.cpr.2016.09.005
- Withers, R., Tsang, Y.Y., Zwicker, J.G. (2017). Intervention and management of developmental coordination disorder: Are we providing evidence-based services? Canadian Journal of Occupational Therapy-Revue Canadienne D Ergotherapie, 84(3), 158-167. doi:10.1177/0008417417712285