Evidence-based practice: paradigm of the times
While the notion of psychology as an empirical science has been present throughout its history, a critical event in the United States of America (USA) began a process that is presently embodied in the widely-used colloquial (and controversial) term, ‘Evidence-Based Practice’. In 1995, upon the urging of the American Psychological Association’s Division 12 (Clinical Psychology) president, David Barlow, a task force developed criteria for the validation of psychological therapies/techniques utilizing methodologies similar to the Randomized Control Trials experimental standard used by the USA’s Food and Drug Administration to approve pharmaceuticals. This operational definition began an ongoing seismic conflict within the field as to what constitutes effective therapeutic work, with terms changing from ’empirically-validated treatments’ to ’empirically-supported treatments’ to, at present, ‘evidence-based practice’ or ‘best practices’. The conflict’s central tenet involves the inherent difficulty – some would argue impossibility – of generalizing from experimental research conditions and participants to everyday practice and consumers of psychological services who have little, if any, resemblance to subjects of research.
Gordon Paul’s 1967 question, What treatment, by whom, is most effective for this individual with that specific problem, under which set of circumstances, and how does it come about?
resonates loudly in reference to evidence-based practice. The premise of evidence-based practice is a complicated and political struggle in the USA and globally. The implications for the practice, training, education, supervision, and research of psychotherapy are incalculable. The importance of consumer feedback is essential to this paradigm, as too often their voices are excluded.
