The push towards Evidence-Based Therapy is a movement in psychology that aims to track the efficacy of treatment plans, with the goal of providing clients with treatments that have solid evidence backing their effectiveness.
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, and recommendations will be provided for further reading on Evidence-Based Therapy.
This article contains:
What is Evidence-Based Therapy? A Definition
Evidence-Based Therapy (EBT), more broadly referred to as evidence-based practice (EBP), is any therapy that has shown to be effective in peer-reviewed scientific experiments. According to the Association for Behavioral and Cognitive Therapies, evidence-based practice is characterized by an:
“[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 one of the ‘preferred’ approaches for the treatment of psychological symptoms”.
In relevant literature, 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).
Recently, this definition has 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 where the effectiveness of the treatment is in large part determined by the patient’s investment and belief in the efficacy of the treatment.
To sum up these discussions, we can think of Evidence-Based Therapy or practice as referring to psychotherapy practices that have research that been proven effective rather than based solely on theory.
The Goals and Benefits of Evidence-Based Therapy
Two of the main goals behind evidence-based practice are:
- increased quality of treatment, and
- increased accountability.
Meeting these goals will make it more likely that patients will only pay for and undergo treatments that have shown to be effective (Spring, 2007). Research has shown that Evidence-Based Therapy is indeed cost-effective (Emmelkamp et al., 2014), likely due to the decrease in time spent receiving treatment compared to those undergoing treatment plans which may or may not be effective.
In fact, some commentators have even argued that, along with the push for Evidence-Based Therapy, subscribers to EBT should also promote therapy that has shown to be cost-effective as well as clinically effective (Castelnuovo et al., 2016).
These commentators have also stressed that caution must be taken to ensure that this does not result in treatment plans that are only cheap because they are ineffective (or of unknown effectiveness) in other words, there should be an emphasis on EBT being both clinically effective and cost-effective, not just one of the two.
Some recent literature has also argued that the therapist has more of an impact on treatment effectiveness 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.
If adopted, this approach would likely involve tracking a therapist’s success rate and ensuring that they continue to provide proof of their effectiveness, just as one would assess the effectiveness of a certain treatment plan. This idea is still in its infancy, but it may prove to be a popular one in the coming years.
Examples of Interventions Used in Evidence-Based Therapy
There are dozens, if not hundreds, of scenarios in which one or more therapies have been shown to effectively treat psychological symptoms.
Listing them all would make for an extremely long read; instead, consider these examples and continue looking for more in the areas that interest you.
1. Acceptance and Commitment Therapy
Acceptance and Commitment Therapy (ACT) has been shown to be effective in the treatment of anxiety disorders, depression, addiction, and certain physical health issues (A-Tjak et al., 2015).
A recent meta-analysis of 39 randomized controlled trials (RCT, often called the “gold standard” of determining clinical effectiveness) found that ACT was more effective than either placebo or what the researchers called “treatment as usual,” or the standard treatment for such issues; however, ACT was not found to outperform cognitive behavioral therapy.
2. Cognitive Behavioral Therapy
Cognitive Behavioral Therapy, or CBT, is perhaps the most well-known and widely accepted form of treatment for many psychological issues.
In recent years, several independent meta-analyses have found solid evidence for the effectiveness of CBT in treating anxiety (Carpenter et al., 2018), depression (in all treatment delivery formats; Cuijpers, Noma, Karyotaki, Cipriani, & Furukawa, 2019), psychosis (Hazell, Hayward, Cavanagh, & Strauss, 2016), Body Dysmorphic Disorder (BDD; Harrison, de la Cruz, Enander, Radua, & Mataix-Cols, 2016), and eating disorders (Linardon, Wade, de la Piedad Garcia, & Brennan, 2017), among other psychological issues.
Due to its wide-reaching effectiveness, CBT is a commonly used treatment for a variety of ailments.
Although CBT is a big commitment, requiring a large investment of both time and resources (not to mention effort and energy on behalf of both therapist and patient), it has been so effective for so many disorders, which has led some researchers to explore the possibilities 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.
3. Dialectical Behavior Therapy
Dialectical Behavior Therapy (DBT) is also an evidence-based treatment, as it has been shown to be effective for relieving the symptoms and improving outcomes for 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).
As a side note, DBT may benefit more than just patients with BPD; there is also evidence that DBT may be an effective treatment for other psychological issues, including patients struggling with intellectual disabilities, but more research is needed to determine its effectiveness (McNair et al., 2017).
4. Mindfulness-Based Cognitive Therapy
Mindfulness-Based Cognitive Therapy (MBCT) has been found to be effective in reducing relapse rates of Major Depressive Disorder (MDD) (Lilja et al., 2016).
As noted earlier, CBT research has proven it as effective for the treatment of both MDD and generalized anxiety disorder (GAD), along with several other disorders (Gratzer & Goldbloom, 2016); however, the addition of mindfulness to cognitive therapy may boost its effectiveness in some situations.
The Five Best Books on Evidence-Based Therapy
If you want to explore the more in-depth discussions of Evidence-Based Therapy and how to incorporate it into your own practice, consider picking up these five books on EBT.
1. Psychodynamic Therapy: A Guide To Evidence-Based Practice – Summers, R.F., Barber, J.P. (2012).
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.
Available on Amazon.
2. Clinician’s Guide to Research Methods in Family Therapy: Foundations of Evidence-Based Practice, First Edition – Williams, L., Patterson, J., Edwards, T.M. (2014).
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.
Available on Amazon.
3. Evidence-Based Practice of Cognitive-Behavioral Therapy, Second Edition. – Dobson, D., Dobson, K.S. (2016).
This book discusses the literature surrounding CBT and also how to incorporate these findings into a clinical practice. Any therapist who uses or wishes to use CBT will get a lot out of this book.
Available on Amazon.
4. Casebook of Evidence-Based Therapy for Eating Disorders, First Edition – Thompson-Brenner, H (Ed.). (2015).
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.
Available on Amazon.
5. The Evidence-Based Practitioner: Applying Research to Meet Client Needs, First Edition – Brown, C. (2016).
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.
Available on Amazon.
A Take-Home Message
When it comes to any treatment plan for any sort of problem, your major concern is probably about the effectiveness of the treatment. Although questions about cost-effectiveness, ease of compliance with the treatment, and the treatment’s impact on your lifestyle may be high on your list, the most important question to ask is probably “But does it actually work?”
The field of therapy can only become stronger from this push for evidence-based techniques and practices. The more this movement is embraced, the better off patients and clients will be.
What are your thoughts on this topic? Would you engage in a form of treatment that was not backed by scientific evidence? Have you benefited from non-EBT treatments? How much evidence do you think is required for something to be officially “EBT?” Let us know in the comments.
- About Psychological Treatment. (u.d.). Association for Behavioral and Cognitive Therapies. Retrieved from http://www.abct.org/Help/?m=mFindHelp&fa=WhatIsEBPpublic.
- 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
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- 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
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- 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