Empirically Supported Treatment: Recommendations for a New Model

Abstract

Over the 20 years since the criteria for empirically supported treatments (ESTs) were published, standards for synthesizing evidence have evolved and more systematic approaches to reviewing the findings from intervention trials have emerged. Currently, the APA is planning the development of treatment guidelines, a process that will likely take many years. As an intermediate step, we recommend a revised set of criteria for ESTs that will utilize existing systematic reviews of all of the available literature, and recommendations that address the methodological quality, outcomes, populations, and treatment settings included in the literature.

Empirical Reality of Dialectical Behavioral Therapy in Borderline Personality

“…According to Chambless and Hollon,[1415] psychological therapies have to fulfill five criteria to be called as “Empirically Supported Treatments.” These are superiority or equivalence to established/another treatment in studies with good methodological rigor ( n = at least 30 per group); at least nine single-case design experiments showing efficacy; availability of manuals; clear specification of patient characteristics; and effects should be demonstrated by at least two independent teams. Ost argues in a review of study methodologies[13] that DBT randomized controlled trials (RCTs) have significantly less stringent research methodology than CBT studies and that they do not fulfill criteria for empirically supported treatments.…”

To what extent are cognitive behaviour therapy competencies incorporated into clinical psychology training? A national survey of Australian universities

“…A further issue relating to EBP is the debate surrounding what constitutes best evidence (Brownson, Baker, Deshpande, & Gillespie, ). EBP endorses the use of “empirically supported treatments” (ESTs), referring to interventions that demonstrate efficacy for treating specific psychological disorders through randomised controlled trials, reliable and valid outcome measures, and suitable data analysis (Tolin, McKay, Forman, Klonsky, & Thombs, ). Despite their strengths, ESTs can be restrictive in addressing the needs of clients with multiple or complex problems, and ethnic minority groups may be under‐represented in treatment efficacy studies (Tolin et al, ).…”

“…EBP endorses the use of “empirically supported treatments” (ESTs), referring to interventions that demonstrate efficacy for treating specific psychological disorders through randomised controlled trials, reliable and valid outcome measures, and suitable data analysis (Tolin, McKay, Forman, Klonsky, & Thombs, ). Despite their strengths, ESTs can be restrictive in addressing the needs of clients with multiple or complex problems, and ethnic minority groups may be under‐represented in treatment efficacy studies (Tolin et al, ). Further, there is now a movement away from packages that prescribe specific, within‐session interventions for clients, and towards individualised case‐formulation driven treatment packages that facilitate broadly applicable processes (Kazantzis, ), such as the unified protocol pioneered by Barlow (Barlow et al, ).…”

Bringing identification of empirically supported treatments into the 21st century.

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The author applauds the plan proposed by Tolin, McKay, Forman, Klonsky, and Thombs (2015) for bringing the methodology for identifying empirically supported treatments (ESTs) into the 21st century.She suggests that further attention is required to operationalize (a) what sorts of designs for effectiveness studies will be acceptable to the Committee on Science and Practice, (b) how data on improvement in functioning will be incorporated in the context of brief treatments, and (c) how complications in obtaining clean follow-up data for long-term outcomes will be addressed, and to specify (d) whether noninferiority to an existing EST is acceptable evidence of efficacy. She further cautions that meta-analyses can mask poorly designed studies and bias in their implementation that will require the Committee's careful scrutiny.

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“…The author applauds the plan proposed by Tolin, McKay, Forman, Klonsky, and Thombs (2015) for bringing the methodology for identifying empirically supported treatments (ESTs) into the 21st century.…”