See Inside April/May 2006

Psychotherapy on Trial

Empirically supported therapies seek to bring the power of research-proven techniques to the therapist's office. So why are they controversial?

In the past half a century psychotherapy research has blossomed, with thousands of studies confirming its positive effects for a wide array of clinical problems, including depression, anxiety, eating disorders and sexual dysfunction. Yet in recent years, intense controversy over whether and how to put these findings into practice has erupted, further widening the "scientist-practitioner gap," the deep gulf that has separated many researchers and psychotherapists for decades.

The current debate centers on the growing use of empirically supported therapies, or ESTs, which are specific therapies for specific problems--for example, depression and bulimia--that meet certain criteria (such as a given number of well-designed studies showing positive effects) for treatment efficacy. Proponents have welcomed ESTs for their clear guidelines on what works for patients and their explicit manuals prescribing administration of treatment. Critics have sharply questioned ESTs on a number of grounds, namely, whether their research base is adequate, whether their one-size-fits-all approach can address the needs of individual patients, and whether their focus should be primarily alleviation of symptomatic distress or changes in underlying dispositions and vulnerabilities.

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