The Theory-Practice Gap in Cognitive Behavioral Therapy: Reflections and a Modest Proposal to Bridge the Gap

Dobson, Keith S.; Beshai, Shadi

doi:10.1016/j.beth.2013.03.002

Cited by 32 publications

(25 citation statements)

References 40 publications

(41 reference statements)

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“…The exclusive focus on symptom reduction risks ignoring other potentially important clinical outcomes, such as functional impairment (Dobson & Beshai, ), despite the fact that functional concerns are a leading reason for individuals to seek treatment (Hunt & McKenna, ). Although symptom reduction and improvements in functioning are significantly correlated, there can be a mismatch after treatment (see Vatne & Bjorkly, , for review).…”

Section: Why Does the List Need To Be Revised?mentioning

confidence: 99%

“…Registration of clinical trials (e.g., at www.clinicaltrials.gov) is increasingly emphasized to address this problem, not only for pharmaceutical studies but also for studies of psychological interventions, although poor adherence to registration policies and poor quality of trial registrations have been problematic (Riehm, Azar, & Thombs, 2015). The exclusive focus on symptom reduction risks ignoring other potentially important clinical outcomes, such as functional impairment (Dobson & Beshai, 2013), despite the fact that functional concerns are a leading reason for individuals to seek treatment (Hunt & McKenna, 1993). Although symptom reduction and improvements in functioning are significantly correlated, there can be a mismatch after treatment (see Vatne & Bjorkly, 2008, for review).…”

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confidence: 99%

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Empirically Supported Treatment: Recommendations for a New Model

Tolin

McKay

Forman

et al. 2015

Clin Psychol Sci Pract

133

229

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Over the 20 years since the criteria for empirically supported treatments (ESTs) were published, standards for synthesizing evidence have evolved and more systematic approaches to reviewing the findings from intervention trials have emerged. Currently, the APA is planning the development of treatment guidelines, a process that will likely take many years. As an intermediate step, we recommend a revised set of criteria for ESTs that will utilize existing systematic reviews of all of the available literature, and recommendations that address the methodological quality, outcomes, populations, and treatment settings included in the literature.

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Section: Why Does the List Need To Be Revised?mentioning

confidence: 99%

mentioning

confidence: 99%

Empirically Supported Treatment: Recommendations for a New Model

Tolin

McKay

Forman

et al. 2015

Clin Psychol Sci Pract

133

229

View full text Add to dashboard Cite

show abstract

“…Greater understanding of the mechanisms of change would help to clarify which clients are likely to gain the most benefit from therapy and under which conditions. Secondly, a better understanding of mechanisms would help to close the theory-practice gap that has been identified as an impediment to the implementation of evidence-based psychological treatments (4,6,7). More broadly however, there remains a lack of understanding holistically the way in which psychological effects and biological mechanisms relate and emerge from one another (8).…”

Section: The Importance Of Understanding Mechanismsmentioning

confidence: 99%

Identifying Functional Mechanisms in Psychotherapy: A Scoping Systematic Review

et al. 2020

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The identification of fundamental mechanisms is an important scientific pursuit in many fields of enquiry. With regard to the development of psychological treatments, understanding the mechanisms through which change occurs such that psychological distress resolves, can enable us to develop more effective and efficient interventions. In the field of psychotherapy, mechanisms are often identified either statistically or conceptually. The most powerful and useful mechanisms, however, are functional rather than statistical or conceptual. More specifically, with regard to mechanisms relevant to psychotherapy, it is difficult to identify what any of these mechanisms actually do in a mechanistic sense. That is, the mechanics of putative mechanisms are generally unspecified. In order to obtain a rigorous and comprehensive account of the current mechanisms in psychotherapy, as well as to evaluate their usefulness, a systematic scoping review was conducted. The systematic scoping review did not yield any mechanisms that were expressed in functional terms. We argue that, in order for psychotherapy to improve its effectiveness and efficiency, the standard for what is accepted as a useful mechanism needs to be substantially raised. Only functional mechanisms that express plausible actions consistent with known biological processes should be used to inform therapeutic interventions.

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“…Baucom and Boeding (this issue) refer to this approach to case conceptualization and treatment planning as top-down thinking , because the theory serves as the basis for the clinical decision making process. In addition, a bottom-up approach could further strengthen the clinical relevance of a treatment approach by including an expert panel of clinicians in the development and evaluation team of a new treament, as suggested by Dobson and Beshai (this issue). This approach could capitalize on the practical experience of front-line clinicians and further counter some of the objections often raised against treatment manuals as being too rigid and inflexible for clinical use (Addis & Krasnow, 2000; Kazdin, 2000; Kendall, 1998).…”

Section: Clinical Practice Needs To Be Based On Theory Not Just Treamentioning

confidence: 99%

Bridging the Theory-Practice Gap by Getting Even Bolder With the Boulder Model

Hofmann

2013

Behavior Therapy

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Cognitive behavioral therapy is an effective treatment for virtually all psychiatric disorders. However, very few patients have access to it and few therapists are trained in the theory and practice of cognitive behavioral therapy. Based on the existing evidence and the articles of this series, the following recommendations are made: (1) all mental health care providers (including PsyD and social workers) need to be trained in the practice and theories of empirically-supported treatments, specifically cognitive behavioral therapy; (2) clinical practice also needs to be based on theory, not just treatment manuals; and (3) psychological treatments have to move beyond the DSM boundaries.

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The Theory-Practice Gap in Cognitive Behavioral Therapy: Reflections and a Modest Proposal to Bridge the Gap

Cited by 32 publications

References 40 publications

Empirically Supported Treatment: Recommendations for a New Model

Empirically Supported Treatment: Recommendations for a New Model

Identifying Functional Mechanisms in Psychotherapy: A Scoping Systematic Review

Bridging the Theory-Practice Gap by Getting Even Bolder With the Boulder Model

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