Empirically Supported Treatments, Evidence‐Based Treatments, and Evidence‐Based Practice

Abstract

Accountability via the application of research to practice is the raison d'être of the empirically supported treatment (EST), evidenced-based treatment (EBT), and evidence-based practice (EBP) movements, and truly the zeitgeist of our time. The idea that clinical practice can be informed by empirical research, however, is not new and has been integral to psychology since the late 19th century, marked by Lightmer Witner's first psychology clinic in 1896 (see McReynolds, 1997). The Boulder Conference in 1949 formalized clinical psychology's commitment to an empirical base with the scientist-practitioner paradigm of training and practice. Since that time, EST, EBT, and EBP have all become commonplace acronyms within clinical psychology and across the mental health and substance abuse fields. Although basing practice on empirical findings and using treatments with demonstrated efficacy seems the only reasonable course of action, such a straightforward idea becomes increasingly complex when unfurled in the various social, political, economic, and other ideological contexts that influence the delivery of mental health services (Norcross, Beutler, & Levant, 2006). In truth, what constitutes evidence and how it should influence practice is, perhaps, the fiercest debate of our times. This chapter examines ESTs, EBTs, and EBPs and describes two fundamentally different approaches to defining and disseminating evidence (Littell, 2010)—one that seeks to improve clinical practice via the dissemination of treatments meeting a minimum standard of empirical support (EBT) and another that describes a process of research application to practice that includes clinical judgment and client preferences (EBP). We unfold the differences