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Evidence-Based Counseling & Psychotherapy

by

Aldo R. Pucci, MA, DCBT

(c) Copyright, 2005 by Aldo R. Pucci.  All Rights Reserved.

While it might seem to be the case, evidence-based psychotherapy is not new.  The term "evidence-based" can be defined two ways:

  • an approach to therapy emphasizes the pursuit of evidence on which to base its theory and techniques, as well as encourages its patients or clients to consider evidence before taking action; or
     

  • an approach to therapy is supported by research findings, and those findings provide evidence that it is effective.

In relation to the first definition, practitioners of virtually every approach to counseling or psychotherapy think that their approach is evidence-based (at least to some degree).  Each approach to psychotherapy is based on the assumption that it is correct in terms of its explanation of human behavior.  Therefore, practitioners of each approach believe that they have "evidence" that their approach is correct, or they would not waste their time practicing that approach.

However, cognitive-behavioral therapists seek to acquire evidence to determine the accuracy of their theories and effectiveness of their techniques. For example, cognitive-behavioral therapists believe that their explanation of human behavior (that "learned" behaviors and emotions are caused by one's thoughts)  is correct.  Rather than assuming that their theory is correct, they base this assumption on psychosomatic research that in fact proves that the assumption is indeed correct.

Cognitive-behavioral therapists take  into the therapy session this interest in  gathering evidence and assessing it.  CBT'ers ask questions to obtain a clear, accurate picture of the client's experience.  CBT therapists also look for evidence in relation to their clients' thoughts, and encourage clients to base thinking on the FACTS (the evidence).

Therefore, cognitive-behavioral therapy has always been "evidence-based" and will continue to be so whether or not there is an emphasis by managed-care or governmental agencies to be so.

However, not many approaches to counseling or psychotherapy are evidence-based in relation to the second definition.  Many approaches to psychotherapy do not lend themselves well to being researched and proven effective because they either utilize techniques that are vague and difficult to repeat with consistency, or the approach attracts practitioners that are not very interested in testing the effectiveness of it.

Cognitive-behavioral therapy is the most researched psychotherapeutic approach because:

  • each cognitive-behavioral approach has specific techniques that can be tested for effectiveness;

  • CBT encourages the development of specific goals that are measurable, and, therefore, can be researched;

  • cognitive-behavioral therapists (to varying degrees) are interested in the research and research process;

  • cognitive-behavioral therapists are not interested in techniques that "feel right" or "seem correct", but techniques that are effective.
     

A Cautionary Statement About Psychotherapy Outcome Research

Most psychotherapy outcome research is focused on short-term reduction of symptoms, and this is the reason why many "studies" find that cognitive-behavioral therapy is as effective as antidepressants in the treatment of depression.  This has been a pretty consistent finding.

However, cognitive-behavioral therapy is focused on "getting better" rather than "feeling better".  So while we are encouraged that clients improve their symptoms with cognitive-behavioral therapy, we are more interested in helping them with the underlying thoughts and core beliefs that caused their emotional distress, helping them rid themselves of problematic, inaccurate thoughts, and replacing them with thoughts that are healthy and accurate.

This emphasis on "getting better" helps clients to do well long-term.

Today, many treatment centers and facilities are very interested in having their staff trained in cognitive-behavioral therapy.  For information on in-house training options for CBT certification, please write me at
aldo@nacbt.org

For other information on training in cognitive-behavioral therapy, please visit
http://www.nacbt.org/workshops.htm

 

(c) Copyright, 2005 by Aldo R. Pucci.  All Rights Reserved.


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