Braking the bandwagon: scrutinizing the science and politics of empirically supported therapies

A formative evaluation of two evidence-based psychotherapies for PTSD in VA residential treatment programs

Between July 2008 and March 2011, 38 U.S. Department of Veterans Affairs (VA) residential treatment programs for posttraumatic stress disorder (PTSD) participated in a formative evaluation of their programmatic services, including evidenced-based treatments (EBTs). Face-to-face qualitative interviews were conducted with over 250 staff by an independent psychologist along with onsite participant observations. This evaluation coincided with a national VA dissemination initiative to train providers in two EBTs for PTSD: prolonged exposure (PE) and cognitive processing therapy (CPT). A substantial proportion of eligible (based on professional background) residential treatment providers received training in PE (37.4%) or CPT (64.2%), with 9.5% completing case consultation or becoming national trainers in each therapy respectively. In semistructured interviews, providers reported that their clinical programs had adopted these EBTs at varying levels ranging from no adoption to every patient receiving the full protocol. Suggestions for improving the adoption of PE and CPT are noted, including distilling manualized treatments to essential common elements.

Empirically supported treatments in psychotherapy: towards an evidence-based or evidence-biased psychology in clinical settings?

THE FIELD OF RESEARCH AND PRACTICE IN PSYCHOTHERAPY HAS BEEN DEEPLY INFLUENCED BY TWO DIFFERENT APPROACHES: the empirically supported treatments (ESTs) movement, linked with the evidence-based medicine (EBM) perspective and the "Common Factors" approach, typically connected with the "Dodo Bird Verdict". About the first perspective, since 1998 a list of ESTs has been established in mental health field. Criterions for "well-established" and "probably efficacious" treatments have arisen. The development of these kinds of paradigms was motivated by the emergence of a "managerial" approach and related systems for remuneration also for mental health providers and for insurance companies. In this article ESTs will be presented underlining also some possible criticisms. Finally complementary approaches, that could add different evidence in the psychotherapy research in comparison with traditional EBM approach, are presented.