Empirically supported treatments: Implications for training.

Abstract

This article discusses the role of empirically supported treatments (ESTs) in the training of clinical psychologists. Training in ESTs can be integrated in ways that vary depending on the level of training and setting. Predoctoral programs, internships, postdoctoral programs, and continuing education are discussed in regard to special challenges and sequencing of training. A preliminary set of guidelines for training in ESTS is suggested. A positive impetus for training in EST skills is the current Guidelines and Principles for Accreditation of Programs in Professional Psychology (APA, 1996) and its mandate regarding sufficient attention to the empirical basis of psychological methods:The relative emphasis a particular program places on science and practice should be consistent with its training objectives. However, all programs should enable their students to understand the value of science for the practice of psychology and the value of practice for the science of psychology, recognizing that the value of science for the practice of psychology requires attention to the empirical Karen S. Calhoun, Psychology Department, University of Georgia; Karla Moras, Department of Psychiatry, University of Pennsylvania; Paul A. Pilkonis, Western Psychiatric Institute and Clinic, University of Pittsburgh Medical School; Lynn P. Rehm, Department of Psychology, University of Houston.Preparation of this article was supported in part by National Institute of Mental Health Grant R21 MH52737. We thank Marsha D. Marcus for her contribution.Correspondence concerning this article should be addressed to Karen S. Calhoun, Psychology Department, University of Georgia, Athens, Georgia 30602. Electronic mail may be sent to kcalhoun@uga.cc. uga.edu.

Toward a more clinically valid approach to therapy research.

“…We agree with Calhoun et al (1998) that what is often absent in many manuals are therapeutic guidelines for what to do when confronted with in-session dilemmas. Work is currently underway to develop more clinically flexible manuals, including guidelines for what to do when one encounters problematic clinical situations (P. C. Kendall, personal communication, April 17, 1997).…”

“…Thus, we randomly assign Diagnostic and Statistical Manual of Mental Disorders ( DSM ) diagnosed patients to treatments and predetermine how many sessions will be needed to bring about clinically meaningful change. Of necessity, this all contributes to the gap between research and the way therapy is practiced in the real world, a point acknowledged by Calhoun, Moras, Pilkonis, and Rehm (1998) , DeRubeis and Crits-Christoph (1998) , and Kazdin and Weisz (1998) . Should insurance companies begin to use information on empirically validated or supported therapies to certify the type-and length-of interventions they deem reasonable, the research-practice gap may be closed for us by others.…”

“…The limitations of this categorical system are noted by Calhoun et al (1998) and have been underscored in a recent conference sponsored by the American Psychological Association on the development of a core assessment battery to be used in outcome research, in which the importance of using measures of more focal and dimensionalized symptoms and characteristics (e.g., worry) was underscored ( Strupp, Horowitz, & Lambert, 1997 ).…”

Empirically supported psychological therapies.

“…The wide range of implications are considered, and again a diversity of viewpoints was sought. The commentaries do not endorse a single-minded perspective but instead consider both the favorable and unfavorable issues facing the empirical evaluation and training of psychological therapy (e.g., Calhoun, Moras, Pilkonis, & Rehm, 1998 ;Davison, 1998 ).…”

Improving psychotherapeutic services via randomized clinical trials, treatment manuals, and component analysis designs

“…Addis (1997) and Calhoun, Moras, Pilkonis, and Rehm (1998), for example, suggested that much more attention needs to be paid to encouraging the flexible use of plans and strategies provided in treatment manuals. Many manuals inadvertently promote rule-governed behavior that may not be appropriate in all instances (i.e., when the client does X, the therapist should do Y).…”