Practice Based Evidence (PBE) and therapies: personal recommendations from the 30 years of the CORE system (Evidencia basada en la práctica (EBP) y psicoterapias: recomendaciones personales basadas en los 30 años del sistema CORE)

Abstract

Over the last 30 years we have seen two models of empirical evidence dominate funding for psychotherapies and for researching the psychotherapies. The first, still the dominant model, ‘Evidence-Based Practice (EBP)’ is based on Randomized Controlled Trial (RCT) evidence. More recently, Embedded Change Management (ECM) is the rising pre-paradigm, offering an alternative to EBP. I argue that neither model understands how evidence it is best shared between therapists as both are based on fundamentally flawed epistemologies and ideas of what constitutes pertinent evidence about the psychotherapies. Twenty-eight years ago, I was a co-creator of the CORE (Clinical Outcomes in Routine Exploration) system designed to support Practice-Based Evidence (PBE). I suggest that re-thinking the rather neglected PBE model at the heart of the original CORE system design might help change this situation. However, I recognize that the political models beneath both EBP and ECM create such vested interests within the ‘global North’ that real change will probably have to come from elsewhere.

Practice-based evidence: bridging the gap between research and routine clinical practice in diverse settings (Evidencia basada en la práctica: construyendo puentes entre la investigación y la clínica rutinaria en entornos diversos)

“…In the first article of this series, and in a personal, profound and honest tone, marked by his extensive experience as a clinician and researcher, Chris Evans (2022) challenges the reader with his critical reflections on the predominant models of research on psychological therapies. Based on the account of his own experiences as a clinician, he raises awareness of the importance for psychotherapists to monitor their routine practice and to have information about patients’ own processes.…”

“…En el primer artículo de esta serie, y en un tono personal, profundo y honesto, marcado por su extensa trayectoria como clínico e investigador, Chris Evans (2022) interpela al lector con sus reflexiones críticas acerca de los modelos de investigación predominantes sobre las terapias psicológicas. En base al relato de sus propias experiencias como clínico, sensibiliza respecto de la importancia para los psicote-rapeutas de monitorear su práctica rutinaria y contar con información sobre los procesos de los propios pacientes.…”