Evidence-Based Psychotherapy: Where Practice and Research Meet By Carol D. Goodheart, Alan E. Kazdan and Robert J. Sternberg (Eds.)
Reviewed by Ronald E. Fox
Psychologists engaged in either practice, research or policy formulation who are concerned about which treatments truly represent good practice should make this book a part of their personal library. It is that timely and that good. Practitioners have been severely criticized by some scientists for eschewing scientifically proven therapies in favor of less valid techniques. The editors, each of whom has impressive credentials in practice, research and/or theory, have assembled some of best researchers, practitioners and educators available to take a fresh look at evidence-based practice (EBP) and provide a balanced perspective as to what it does and does not do for decisions about the most effective psychotherapies.
Part I deals with the practice perspective. It begins with an excellent discussion by Reed and Eisman of the history of EBP movement and how it sometimes impacts policy decisions on organized health care and the practice of psychology in ways that work to the detriment of both patients and the profession. Three chapters by Goodheart, Carter and Comas-Dias, all veteran practitioners, follow. These authors discuss the practical realities that commonly mitigate blind obedience to the requirements of EBP protocols --- a balance that those in practice often find lacking.
Part II consists of four chapters examining EBP from the research perspective. Practitioners faced with justifying their interventions with skeptical managed care minions will especially enjoy the opening chapter by Lambert and Archer. These authors provide an excellent review of the voluminous literature demonstrating the efficacy of the non-EBP interventions most commonly used in daily practice. The evidence summarized here can be excellent ammunition to justify the use of those interventions to managed care personnel when the clinician judges them to be indicated. Subsequent chapters by experienced researchers are especially helpful to clinicians in understanding the requirements of scientific research and how scientists’ reality differs from that of practitioners.
Part III on training, policy and cautions is especially strong. Here is the conceptual grounding that ties together and puts into perspective what has gone before. Trierweiler begins with an excellent discussion of the limitations of science and of the different role responsibilities of scientists and practitioners. It is an exercise in the explication of the role of critical thinking and of how science and statistics can best inform clinical work. Tanenbaum follows with a virtual tour de force on how we know what we know and why EBP is not the be-all and end-all of scientific knowledge. This chapter should be required reading for any scientist or practitioner involved in the use of EBP to create public policy or evaluate the evidence under girding clinical interventions. Such issues lie at the core of critical decisions regarding reimbursement, recommended clinical interventions, clinical decision-making and clinical training. Sternberg’s final chapter summarizes the cautions regarding EBP expressed by the volume’s authors and provides a nice perspective on important “frames” for future debates on EBP.
The editors have succeeded in presenting a balanced and nuanced view of EBP that shows understanding for both the requirements of science and the enduring realities of clinical practice. It is hard to see how scientists or practitioners would object to it. I recommend it most strongly.
