Improving therapist interest in empirically supported treatments

There was a brief but interesting research article this past week on Interesting practitioners in training in empirically supported treatments, published in the Journal of Clinical Psychology. Despite a growing recognition of the importance of empirically supported treatments (otherwise known as evidence-based treatments), not all therapists are aware of these treatments or are willing and able to provide them. A good blog post from the Cleveland Center for Eating Disorders explains some of the reasons why.

Of course, all the training in the world isn't useful unless a therapist is interested in receiving that training. Speaking as someone with a research-oriented background, not a clinical one (nor even a psychological one), my first instinct would be to start by showing people the strength of the research base behind the treatment. What this paper found, however, is that most therapists responded more favorably to case studies rather than larger research studies.

Which, when you think about it, does make sense. Most therapists are more oriented towards people than they are towards large research studies (I'm the opposite, which helps explain why I'm not a therapist and never will be). This is neither good nor bad, it's just a general trend I've observed. Furthermore, case studies can provide more practical information in explaining how the therapy is carried out, how the patient responded, and what are some common pitfalls. This isn't to say that case studies should replace large research trials, just that they interest therapists more in empirically supported treatments.

For more information on empirically supported treatments, see both the Psychotherapy Brown Bag blog and this explanation from the American Psychological Association (they have information specifically on empirically supported treatments for eating disorders here).


Mike Anestis said...

Wow - this is an absolutely fascinating article. I may follow your lead and write about it next week as well.

The findings are important in that they support the comments made my people like Joan Cook of Yale University, who believes that presenting the evidence is not the best way to compel people to adopt an evidence-based approach. In fact, the "bells and whistles" associated with things like case studies and anecdotes, even though they are not scientific, might be an important component of increasing general scientific-mindedness. If data doesn't drive the way you think, than only seeing data might not be all that compelling, whether or not it should be.

Importantly, however, we should remember that not everyone who gets trained in ESTs practices them. In an article we discussed on PBB, researchers demonstrated that the majority of members of the Academy of Eating Disorders do not utilize ESTs in the treatment of EDs, even though many of them had extensive training in them. In other words, training is not necessarily the goal. We have to inspire training that is likely to result in actual implementation of scientifically-based approaches.

Thanks for posting this and for the link to PBB!

Carrie Arnold said...


Thanks for your comment. You're so right about the fact that many therapists don't always use the evidence-based methods they claim to. If you have a link to that study or blog post about AED members not using ESTs and wouldn't mind sharing it, that would be great.

I totally thought of you and your blog when I saw this study, by the way! :)

Carlos said...

Excellent post! It doesn't surprise me to hear that therapists are more persuaded by case studies and anecdotes than randomized controlled trials. When you're familiar with Persuasion, Rhetoric and logical fallacies (in this case, anecdotal fallacy: it shouldn't come to a surprise.

However, I agree with Mike Anestis that presenting case studies can be a very persuasive suppliment to presenting randomized controlled trials. However, I think it is also important to remind such therapists why relying solely on anecdotal evidence is not a good idea.

Anonymous said...

I believe professor Kristin von Ranson gave a presentation at the AED meeting two years ago about her research into the use of evidence based treatments by eating disorder professionals in Alberta. Her survey found that a majority of the responders admitted they do not use EBTs.
By the way, there was an interesting article in last Sunday's New York Times magazine (11/08/09) on efforts to bring EBTs to medicine generally. The doctor who was featured uses carrots and sticks, but mostly carrots.

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I'm a science writer, a jewelry design artist, a bookworm, a complete geek, and mom to a wonderful kitty. I am also recovering from a decade-plus battle with anorexia nervosa. I believe that complete recovery is possible, and that the first step along that path is full nutrition.

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