In the October 12 issue of Newsweek, an article written by Sharon Begley discusses the gap between clinical research and what actually happens in therapy rooms across the country. We have discussed the concept of empirically supported treatments for mental illness on PBB many times, but for those of you who are new to the site, let me give you a quick description:
- A therapeutic approach is considered empirically supported when its impact on a particular diagnosis is demonstrated through rigorous scientific studies. The better the study (e.g., randomized controlled study) and the more often the findings are replicated independently, the more empirical support the treatment is said to have. Division 12 of the American Psychological Association provides a strong summary of the relative scientific evidence behind different treatments for different diagnoses.
Unfortunately, there is a gap in this field. What we learn through science is not implemented into everyday practice with any regularity. This result - which is extremely frustrating and, in my opinion, entirely unethical - stems from many different sources.
- Researchers are extremely inept at marketing their products. We study these phenomena, write about them in esoteric journals, and then discuss them amongst ourselves at conferences attended almost entirely by like-minded individuals. Now, don't get me wrong...I'm a researcher, I publish studies in esoteric journals, and I attend conferences and enjoy them thoroughly. There's nothing wrong with that as long as it is not the only way we go about marketing our products to consumers who need them but know nothing about their existence.
- Many clinicians are untrained in scientific methods. For some, this reflects the fact that they were trained before science became integrated into the field. For others, this reflects the fact that they were trained at one of the many certified institutions that somehow still justify overlooking mountains of empirical research in an effort to perpetuate theories and therapies supported by absolutely no data. It is difficult to convince somebody trained extensively in a manner inconsistent with scientific pursuits that science is necessary. Such a revelation would invalidate years of hard work. In that position, I would likely be equally hesitant.
- Building off of point 2, the lack of understanding about science often leads to individuals clinging to beliefs that represent a fundamental misunderstanding of the phenomenon. Ideas like "we are all individuals, so group data tells me nothing," "different treatments work for different people so no treatment is better than any other" and "my experience tells me more than your research" reflect common misunderstandings of what we can learn from data, what scientifically-minded psychologists are advocating for, and how we go about measuring efficacy and effectiveness.
There are countless other reasons why this situation exists. Ultimately, however, I believe it is a battle of information. Until science makes its voice heard through the resources that people actually use and relate to, people will continue to listen to the voices of misinformation that populate television, radio, the internet, and sadly, many of our classrooms.
Great effort by Newsweek here and I look forward to reading the actual article in the November issue of Perspectives on Psychological Science.
In the meantime, I hope to hear your thoughts on the issue. I suspect many of you disagree with the proposed role of science in mental health care - perhaps even as vehemently as I agree with it - but hopefully we can have a civil discussion on the matter and help people reading this site to make informed decisions.
If you would like to learn more about empirically supported treatments, we recommend the following resources, all of which are available through our online store, which features a wide variety of books based entirely upon scientific investigation:
- A Guide to Treatments that Work by Peter Nathan and Jack Gorman
- Clinical Handbook of Psychological Disorders, Fourth Edition: A Step-by-Step Treatment Manual
by David Barlow
- Science and Pseudoscience in Clinical Psychology
by Scott Lilienfeld, Steven Lynn, and Jeffrey Lohr
- Cognitive Therapy Techniques: A Practitioner's Guide by Robert Leahy