Clinical Psychology

whether some approaches to psychotherapy are
more likely to produce benefit than other
approaches. Perhaps of greatest interest in clinical
psychology today is the question of whether
evidence-based treatments (i.e., psychotherapies
that have been shown to work better than no treat-
ment) are more efficacious, and are more effective,
than other therapies (Kazdin, 2008).
It is important to make a distinction, though,
between evidence-based treatment and evidence-
based practice (Kazdin, 2008).Evidence-based treat-
ment(EBT; originally called empirically supported
or empirically validated treatment) refers to those
interventions or techniques that have produced
significant change in clients and patients in con-
trolled trials. In other words, these interventions
have been shown to be efficacious by comparing
those that receive the treatment to those from a
control group. A treatment is deemed an EBT
based on efficacy studies supporting its positive
effects on patients. Evidence-based practice
(EBP)isabroadercategoryinthatitincludes
treatments informed by a number of sources,
including scientific evidence about the interven-
tion, clinical expertise, and patient needs and pre-
ferences (APA, 2006; Kazdin, 2008). So, EBP is
not the same as EBT; the latter designation
comes solely from the results of controlled clinical
trials (see Figure 11-1).

Evidence-based practice has always been a

topic of interest to health care providers; physi-

cians, nurses, and members of many other allied

fields have been interested in whether the treat-

ments they provided had demonstrated effects.

Clinical psychologists became especially interested

in this question in the 1980s and 1990s, however,

when health care reforms placed greater pressure

upon psychologists to demonstrate that their ser-

vices “worked.”Particularly important for psy-

chologists was whether the treatments that

clinicians provided were better or worse than the

treatments that could be provided in the fields of

psychiatry, social work, or many other mental

health disciplines (e.g., counseling, marriage and

family therapy, etc.).

However, some clinical psychologists resisted

the idea of evidence-based practice, arguing that

therapy was an“art”and the factors that changed

as a result of therapy would be difficult to define

and measure scientifically. Many thought that the

examination of certain therapeutic approaches as

compared to others would not be possible.

In 1995, the Society of Clinical Psychology, a

division of the American Psychological Associa-

tion, disseminated criteria to evaluate whether spe-

cific approaches to treatment had established

scientific support to suggest that they could reduce

psychological symptoms (see Table 11-1). Initially

Clinical

Expertise

Evidence

Based Practice

Evidence Based

Treatment

Patient

Characterisitics,

Values, Preferences

F I G U R E 11-1 Empirically based practice (EBP) is informed by information about evidence-based treatments
(EBTs), a clinician’s own expertise, and a patient’s own characteristics, values, and preferences.

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