Evidence-Based Therapies

What evidence is there that certain therapies work? How is this evidence managed? In this article, we take a look at what lies behind the main therapeutic currents currently used in consultation.
Evidence-Based Therapies

Last update: 04 July, 2022

Psychology, as a science that seeks to understand and address human behavior, needs to rely on dependable scientific data to move forward. For this reason, in recent years, more and more professionals have emphasized the importance of the practice of evidence-based therapies.

These kinds of psychotherapy are supported by controlled studies that show or question their effects on mental health. Despite this, not all mental health specialists practice them. As a matter of fact, some suggest that they’re reductionist.

On the other hand, other critics claim that their results are based on biased data. In this article, we’ll explore these psychotherapies and how reliable they are.

Evidence-based therapies

The term, evidence-based therapies, emerged to refer to treatments that were shown to be effective in clinical trials. This means that it’s possible to replicate and test their effects using the scientific method. Over time, the term began to be used in the field of psychology and psychotherapy.

Hans Eysenck, a renowned English psychologist, published an article on evidence-based psychotherapy in 1994. In this work, he pointed out that many treatments weren’t demonstrated to be more effective than the natural remission of the symptoms of a disorder or placebo. Hence, it was important to evaluate the results of the different available treatments through more rigorous methods.

Since then, it’s been essential for mental health professionals to review the evidence that supports or discredits an intervention. In this way, they’re able to select the best alternatives and apply them in clinical practice.

Man in psychological therapy

Evidence-based therapies according to the American Psychological Association (APA)

The APA suggests a classification that includes more than 80 different types of psychotherapy. The classification criterion is the quantity and quality of the evidence supporting these interventions. Therefore, it’s possible to find evidence-based therapies that are ‘strong’, ‘weak’, or with ‘insufficient evidence’.

It should be noted that all treatments are classified according to how efficient they are for particular conditions. This is because it’s not possible to apply the same treatment universally for existing pathologies.

Next, we’ll look at some examples of evidence-based psychotherapies.

1. Behavioral Activation (BA) therapy for depression

Behavioral activation (BA) for depression is based on the premise that this disorder generates abandonment of routines and isolation. Its goal is to increase the frequency with which the patient carries out actions that have rewards. In fact,  it could be said that their behavior is ‘activated’, avoiding lethargy, isolation, and loss of pleasure.

Simmonds-Buckley, Kellet, and Waller (2019) published a review on the efficacy of group BA in the treatment of depression. Behavioral activation therapy was found to have moderate-to-high effects on depressive symptoms in adults. Further research indicated that it was also effective in addressing depression in young people. However, more studies would be needed for this to be conclusive (Tindall et al., 2017).

2. Cognitive behavioral therapy for depression

Among the evidence-based therapies, the cognitive-behavioral approach is one of the most recommended. The therapies within this framework are mixed with the principles of behaviorism to address problems in thought and behavior.

Santoft et al. (2019) published a review on the efficacy of this therapy in depression in primary care. It was found to be an effective psychotherapy model, recommended for patients with moderate and mild depression.

3. Dialectical-behavioral therapy for borderline personality disorder (BPD)

Borderline personality disorder is a condition that causes difficulty in the regulation and expression of emotions. As a result, different behavioral problems such as self-harm or risk behaviors arise, with the aim of achieving relief. Dialectical-behavioral therapy is usually the preferred treatment for these cases.

A study was conducted to evaluate the efficacy of a five-week program of dialectical behavior therapy in patients with BPD. The results showed that the treatment does reduce symptoms. Indeed, the more that patients improve their emotional regulation, the more they benefit (Probst et al., 2019).

4. Acceptance and Commitment Therapy (ACT) for chronic pain

Chronic pain is a complex disorder that, in most cases, can’t be completely cured. That said, with evidence-based therapies, it’s possible to regulate patients’ symptoms and improve their quality of life. Thus, Acceptance and Commitment Therapy (ACT) is a really promising treatment for pain relief.

In simple words, ACT proposes that, by modifying patients’ expectations about pain relief, it’s possible to make it cause them less suffering. Following along these lines, Feliu-Soler et al. (2018) conducted a review of the available evidence in this field. They concluded that the evidence is promising, although more rigorous studies are needed.

Sad woman in therapy

5. Biofeedback

Biofeedback techniques provide the patient with data about their bodily functions, such as muscle movement. It’s generally believed that it’s not possible to control these types of reactions, but having information makes it easier to do so.

A publication detailed the situation of biofeedback in the treatment of various pathologies. It was found to be efficient in addressing multiple problems such as urinary incontinence or headaches. It was also found to be successful in treating conditions involving balance and fecal incontinence (Kondo et al., 2019).

Evidence-based therapies today

As mentioned earlier, evidence-based therapies tend to be considered the gold standard in psychotherapy. Indeed, many experts argue that the most ethical practice is to apply interventions that have previously been shown to be effective. This is done with the aim of guaranteeing that the treatments are useful and help improve the patient’s quality of life.

However,  recent studies suggest that evidence-based psychotherapy isn’t as robust as it might seem. Sakaluk et al. (2019) conducted a meta-review of the value of this group of therapies. They concluded that, in most of these therapies, the replicability and the value of the evidence was quite low. Therefore, they recommended improving the analysis processes for clinical trials.

In conclusion, although the concept of evidence-based therapies should be the gold standard, we’re still far from reaching it. Indeed, more rigorous evaluation methods need to be developed to ensure the quality of the data presented.

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