The empirical status of empirically supported psychotherapies: assumptions, findings, and reporting in controlled clinical trials

Psychological Bulletin
Drew WestenHeather Thompson-Brenner

Abstract

This article provides a critical review of the assumptions and findings of studies used to establish psychotherapies as empirically supported. The attempt to identify empirically supported therapies (ESTs) imposes particular assumptions on the use of randomized controlled trial (RCT) methodology that appear to be valid for some disorders and treatments (notably exposure-based treatments of specific anxiety symptoms) but substantially violated for others. Meta-analytic studies support a more nuanced view of treatment efficacy than implied by a dichotomous judgment of supported versus unsupported. The authors recommend changes in reporting practices to maximize the clinical utility of RCTs, describe alternative methodologies that may be useful when the assumptions underlying EST methodology are violated, and suggest a shift from validating treatment packages to testing intervention strategies and theories of change that clinicians can integrate into empirically informed therapies.

References

Sep 1, 1977·The American Psychologist·M L Smith, G V Glass
Dec 1, 1992·Journal of Consulting and Clinical Psychology·T A Brown, D H Barlow
May 1, 1991·Archives of General Psychiatry·C G FairburnR A Hope
Feb 1, 1986·The American Psychologist·K I HowardD E Orlinsky
Jan 1, 1986·Behaviour Research and Therapy·C G FairburnP J Cooper
Jan 1, 1995·Journal of Clinical Epidemiology·A R Feinstein
Feb 1, 1995·Behaviour Research and Therapy·L G Ost, B E Westling
Jun 1, 1994·The British Journal of Psychiatry : the Journal of Mental Science·D M ClarkM Gelder
May 1, 1994·Archives of General Psychiatry·M K ShearA C Leon
Dec 1, 1993·Archives of General Psychiatry·M M LinehanH E Armstrong
Jun 1, 1993·Journal of Behavior Therapy and Experimental Psychiatry·B J CoxP S Lee
Nov 1, 1993·Journal of the American Academy of Child and Adolescent Psychiatry·J WixomD Westen
Nov 1, 1993·The Journal of Adolescent Health : Official Publication of the Society for Adolescent Medicine·L V Klerman
Jan 1, 1993·The American Journal of Psychiatry·D M GarnerM Eagle
Apr 1, 1993·Journal of Consulting and Clinical Psychology·E E Jones, S M Pulos
Dec 1, 1995·The American Psychologist·M E Seligman
Aug 1, 1996·Archives of General Psychiatry·K I HowardS M Saunders
Jul 1, 1996·Psychological Bulletin·J M WilliamsC MacLeod
Mar 1, 1996·Behaviour Research and Therapy·S BouchardC Godbout
Nov 21, 1997·Archives of General Psychiatry·L L Judd
Dec 24, 1997·Journal of the American Academy of Child and Adolescent Psychiatry·J A GraberJ Brooks-Gunn
Mar 7, 1998·Journal of Consulting and Clinical Psychology·D L Chambless, S D Hollon
Mar 13, 1998·Annual Review of Psychology·S MinekaL A Clark
Dec 8, 1998·The American Journal of Psychiatry·D Westen, L Arkowitz-Westen
Jun 16, 1999·Journal of Consulting and Clinical Psychology·N S JacobsonJ B McGlinchey
Aug 18, 1999·Journal of Consulting and Clinical Psychology·M FeeleyL A Gelfand
May 18, 2000·JAMA : the Journal of the American Medical Association·D H BarlowS W Woods
Jul 27, 2000·The American Journal of Psychiatry·W S AgrasH C Kraemer
Jul 27, 2000·The American Journal of Psychiatry·M ZimmermanJ I Mattia
Oct 19, 2000·The American Psychologist·L E Beutler
Jan 10, 2001·Annual Review of Psychology·R Rosenthal, M R DiMatteo
Jan 10, 2001·Annual Review of Psychology·D L Chambless, T H Ollendick

❮ Previous
Next ❯

Citations

Jan 15, 2011·European Child & Adolescent Psychiatry·Paul McArdleAnn LeCouteur
Apr 5, 2013·European Child & Adolescent Psychiatry·Stefanie J Schmidt, Benno G Schimmelmann
Nov 28, 2007·Administration and Policy in Mental Health·David A Chambers
Jan 7, 2010·Administration and Policy in Mental Health·Thomas L SextonSonja K Schoenwald
Feb 9, 2010·Administration and Policy in Mental Health·Thomas L Sexton, Susan Douglas Kelley
Feb 27, 2010·Administration and Policy in Mental Health·Richard A Van DornJ David Hawkins
Jan 6, 2011·Administration and Policy in Mental Health·Kimberly D BeckerEric L Daleiden
Jan 15, 2005·Clinical Child and Family Psychology Review·Steven W Evans, Mark D Weist
Jan 12, 2007·Health Care Analysis : HCA : Journal of Health Philosophy and Policy·Sandra J Tanenbaum
Jan 22, 2008·Journal of Abnormal Child Psychology·Jennifer Wyatt KaminskiCynthia L Boyle
Apr 19, 2005·Mental Health Services Research·Peter S JensenEliot Goldman
Sep 8, 2012·Prevention Science : the Official Journal of the Society for Prevention Research·John Kjøbli, Terje Ogden
Jul 11, 2006·Behavior Therapy·Debra L Safer, Emily M Hugo
May 17, 2005·Clinical Psychology Review·Sidney J Blatt, David C Zuroff
Oct 20, 2004·The American Psychologist·Drew Westen, Joel Weinberger
Dec 9, 2004·The American Psychologist·David H Barlow
Jan 27, 2006·The American Psychologist·Alan E Kazdin
May 25, 2006·The American Psychologist·UNKNOWN APA Presidential Task Force on Evidence-Based Practice
Nov 17, 2005·Journal of Consulting and Clinical Psychology·Tanya M MissirlianLeslie S Greenberg
Jul 11, 2006·Journal of Consulting and Clinical Psychology·Amanda Jensen Doss, John R Weisz
Jul 15, 2004·Psychological Bulletin·J Stuart Ablon, Carl Marci
Jul 15, 2004·Psychological Bulletin·Marvin R Goldfried, Catherine Eubanks-Carter
May 5, 2005·Psychological Bulletin·Paul Crits-ChristophSteven D Hollon
May 5, 2005·Psychological Bulletin·John R WeiszScott W Henggeler
Jan 27, 2006·Psychological Bulletin·John R WeiszSylvia M Valeri
May 31, 2012·Psychotherapy·Dina VivianBarry Wolfe
Apr 15, 2010·The International Journal of Clinical and Experimental Hypnosis·Barbara S McCann, Sara J Landes
Feb 5, 2010·Psychotherapy Research : Journal of the Society for Psychotherapy Research·Larry E Beutler
Jan 5, 2013·Psychotherapy Research : Journal of the Society for Psychotherapy Research·M Anne OakleyAlmuth Weigeldt
May 25, 2013·Psychotherapy Research : Journal of the Society for Psychotherapy Research·Giorgio A Tasca, Paulo P P Machado
Aug 13, 2013·Psychotherapy Research : Journal of the Society for Psychotherapy Research·Gregory L HerbertAmy R Murrell
Apr 14, 2006·Current Opinion in Psychiatry·Michael Bond
Jul 5, 2012·The Journal of Nervous and Mental Disease·John C MarkowitzKarina Lovell
Mar 1, 2007·Perspectives on Psychological Science : a Journal of the Association for Psychological Science·Scott O Lilienfeld
Jul 25, 2006·Archives of Disease in Childhood·P A McArdle
Jul 31, 2004·BMJ : British Medical Journal·Sandy Goldbeck-Wood, Peter Fonagy
Aug 25, 2007·Annual Review of Clinical Psychology·Ludy T Benjamin
Aug 25, 2007·Annual Review of Clinical Psychology·Richard M McFall
Mar 16, 2007·Journal of the American Psychoanalytic Association·Andrew J Gerber, Bradley S Peterson

❮ Previous
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