Lecture 15: Evidence-Based Practices

The integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences.

Evidence-based practice

What is the purpose of using evidence-based practices?

To ensure we are using the best-available empirical evidence to best help people.

What are examples of empirical evidence for evidence-based practices?

Effectiveness studies, effectiveness studies, and meta-analyses

Shared features of most therapy approaches associated with positive treatment outcome

common factors

Are problem severity, presence of personality disorder, and lower intelligence associated with more or less positive treatment outcome?

Less

Are positive treatment expectations associated with more or less positive treatment outcomes?

More

Are sex, race, ethnicity, and social class reliably related to treatment outcomes?

No

Is (mis)match of client/therapist on race/ethnicity associated with client preferences and clients' perceptions of therapists?

Yes

Are therapist empathy, warmth and genuineness associated with more or less positive treatment outcomes?

More

Is therapist experience (years, mental-health discipline, degree) related to treatment outcomes?

No

Is therapist age, sex, and ethnicity related to treatment outcomes?

No

Are full-time front-line service providers increasingly trained to master's or doctoral level?

Master's level

Are full-time front-line service providers increasingly trained within social-work, clinical, or counseling programs?

Social-work programs

Is therapeutic alliance associated with more or less positive treatment outcomes?

More

Do meta-analyses suggest that cultural adaptations of treatment approaches are associated with better, mixed, or worse outcomes?

Mixed

Do meta-analyses suggest that homework completion is a positive or negative predictor of CBT outcomes?

Positive

Are evidence-based treatment approaches associated with more positive or negative treatment outcomes?

Positive

For which major clinical disorder are a wide range of treatment approaches effective?

Depression

For which major class of clinical disorders is CBT clearly more effective than other approaches?

Anxiety disorders