What is the scientific meaning of empirically supported therapy?

Abstract

It is important to define precisely what is and is not meant by "empirically supported treatments,"rigorously based on what is actually known about the nature of experimental therapy research. The criteria for empirically supported treatments merely allow conclusions about whether treatments cause any change beyond the causative effect of such factors as placebo or the passage of time.Applied implications are limited, due to external validity and to the fact that applied decisions are influenced by cost-benefit analyses. Creating increasingly effective therapies through between-group designs is best done by controlled trials specifically aimed at basic questions about the nature of psychological problems and the nature of therapeutic change mechanisms. Naturalistic research is important for external validity but is valuable only if it uses scientifically valid methods to address basic knowledge questions.We love scientific research. There is a type of precisian and beauty that is not present in other ways of acquiring knowledge. Empirical relationships discovered from carefully conducted experimental studies stand as relative truths that show us how things are interrelated at a concrete level and how theories are in need of revision at the conceptual level. In both ways, they provide us with opportunities to perceive and behave in our worlds in increasingly accurate and adaptive ways.When we engage in the scientific enterprise, we agree to follow the same rules of evidence so that we or anyone else who knows these rules can agree on the knowledge so obtained. Of course, there remain numerous areas of potential debate in interpreting the results of any experimental investigation, how they comment on theory revision, and in what ways their demonstrated relationships apply to things beyond the specific questions and circumstances of the investigation. But because we agree in general on issues of measurement, design, methodology, statistics, and how these features affect what we can and cannot conclude, sufficient accord exists to allow confident and continuous progression of increasingly accurate knowledge from which increasingly useful applications can emerge. The history of psychological research (both basic research and therapy outcome research) on which the Task Force on Promotion and Dissemination of Psychological Procedures (1995) report and its updating article (Chambless et al., 1996) owe their foundation is a testimony to this.When the results of scientific studies are applied to new and important questions that may directly or indirectly affect clinical training, clinical treatment, and financial decisions about how to treat, it is useful for us to return to our roots in empirical

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“…sampling, study design, response rates, sample size, etc. ; readers interested in research design should see, for example, Campbell & Fiske 1959;Campbell & Stanley 1963;Borkovec & Castonguay 1998). The intent is to distill the core findings that are supported by evidence.…”

Pattern of change in prolonged exposure and cognitive-processing therapy for female rape victims with posttraumatic stress disorder.

“…Although comparisons of treatment with no-treatment conditions allow one to rule out the role of history, maturation, repeated testing, and statistical regression as explanatory factors for differences in treatment outcome, comparisons of treatment with placebo or a minimal-attention group allow one to conclude that something specific to the treatment condition, above and beyond the general therapeutic relationship, is responsible for therapeutic change (Borkovec & Castonguay, 1998).…”

Future directions in the treatment of anxiety disorders: An examination of theory, basic science, public policy, psychotherapy research, clinical training, and practice

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