Why many clinical psychologists are resistant to evidence-based practice: Root causes and constructive remedies

Lilienfeld, Scott O.; Ritschel, Lorie A.; Lynn, Steven Jay; Cautin, Robin L.; Latzman, Robert D.

doi:10.1016/j.cpr.2012.09.008

Cited by 297 publications

(338 citation statements)

References 119 publications

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“…The Boulder Conference of 1949 led to the development of the scientist-practitioner concept; a highly influential model espousing that research and practice should co-exist (DiLillo & McChargue, 2007;Lilienfeld, Ritschel, Lynn, Cautin, & Latzman, 2013). EBP represents an important development of the scientist-practitioner model since it is able to integrate the concepts of science and practice within a conceptually richer framework (DiLillo & McChargue, 2007).…”

Section: Evidence Based Practice (Ebp)mentioning

confidence: 99%

“…In terms of weighting EBP tenets, consensus exists that all three facets are critical for defensible evidence-based practice (APA Presidential Task Force on Evidence Based Practice, 2006; Lilienfeld et al, 2013;Thyer & Pignotti, 2011). The EBP model proposes that research evidence may be viewed along a continuum in which best-designed research studies (i.e., randomized controlled trials or meta analyses) should be afforded more weighting within clinical decision making than research designs that hold more room for interpretation or error (e.g., correlational designs; Ghaemi, 2009;Lilienfeld et al, 2013;Thyer & Pignotti, 2011).…”

Section: )mentioning

confidence: 99%

“…The three central principles of EBP are that: (1) research evidence is fundamental to guiding good practice, (2) clinical expertise and decision making should be used when applying research to clinical situations and in situations in which research is ill-fitting or unavailable, and (3) client individuality in the form of preferences and values should be considered when allocating interventions (Lilienfeld et al, 2013;Spring, 2007). In terms of weighting EBP tenets, consensus exists that all three facets are critical for defensible evidence-based practice (APA Presidential Task Force on Evidence Based Practice, 2006; Lilienfeld et al, 2013;Thyer & Pignotti, 2011).…”

Section: )mentioning

confidence: 99%

“…The EBP model proposes that research evidence may be viewed along a continuum in which best-designed research studies (i.e., randomized controlled trials or meta analyses) should be afforded more weighting within clinical decision making than research designs that hold more room for interpretation or error (e.g., correlational designs; Ghaemi, 2009;Lilienfeld et al, 2013;Thyer & Pignotti, 2011). As Lilienfeld et al (2013) Lilienfeld et al (2013) provides the example of a client experiencing anxiety disorder who refuses the best available empirically supported treatment (i.e., behavioral flooding) as a result of intense fear necessitating the psychologist to select another empirically supported but slightly less efficacious treatment (i.e., graded exposure) that will ultimately ensure client engagement.…”

Section: )mentioning

confidence: 99%

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Where has all the psychology gone?

Gannon

Ward

2014

Aggression and Violent Behavior

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(2014) Where has all the psychology gone? A critical review of evidence-based psychological practice in correctional settings. Aggression and Violent Behavior., 19 (4 WHERE HAS ALL THE PSYCHOLOGY GONE?2! Abstract Evidence-Based Practice (EBP) is the gold standard for effective clinical psychological practice. In this review we examine the basic tenets of EBP and consider how-in the context of psychological treatment provision-EBP is able to subsume the overarching guiding theory of offender rehabilitation adopted by correctional policy makers and psychologists worldwide (i.e., the Risk-Need-Responsivity Model, RNR;Andrews & Bonta, 2010a). We also examine ways in which, under the backdrop of RNR, EBP tenets are typically being neglected by correctional psychologists. We examine three key aspects of EBP currently being neglected by correctional psychologists: (a) individualized and flexible client focus, (b) the therapeutic alliance, and (c) psychological expertise. We also highlight two highly related issues responsible for psychologistsÕ neglect of EBP within corrections. The first relates to the dual-relationship problem.That is, the tension that psychologists experience as a result of engaging in psychological practice whilst also obliging the risk and security orientated policies of correctional systems. The second relates to psychologistsÕ response to this tension. In short, psychology, as a discipline appears to have acquiesced to the dual-relationship problem.In our view, this constitutes a ÔcrisisÕ for the discipline of correctional psychology and for the provision of best practice treatment within correctional settings. We offer several recommendations for injecting EBP back into correctional psychology for the individual, psychology as a discipline, and correctional policy makers.Key words: Evidence Based Practice, Risk Need Responsivity, Corrections, SciencePractice Gap. WHERE HAS ALL THE PSYCHOLOGY GONE? 3!Where has all the Psychology Gone? A Critical Review of Evidence-Based Psychological Practice in Correctional SettingsThe role of the correctional or forensic psychologist has evolved steadily from decades of struggle between punishment and rehabilitation proponents. Ultimately, the psychologist has secured an important role in contemporary western world corrections.Yet despite correctional psychology having evolved over many decades, we believe that the correctional psychology discipline is facing a crisis. In this manuscript, we highlight one fundamental aspect underpinning this crisis-that is, the correctional psychologistsÕ mounting neglect of Evidence Based Practice (EBP). The lack of attention to EBP within such a highly important field is potentially harmful not only to the profession of psychology but also to society who must inevitably deal with the devastating effects of re-offending associated with inadequate psychological treatment.In this manuscript, we examine (1) the development of the modern day correctional psychologist; paying particular attention to the highly popular Risk Nee...

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Section: Evidence Based Practice (Ebp)mentioning

confidence: 99%

Section: )mentioning

confidence: 99%

Section: )mentioning

confidence: 99%

Section: )mentioning

confidence: 99%

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Where has all the psychology gone?

Gannon

Ward

2014

Aggression and Violent Behavior

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“…Se ha dicho que la historia de la Medicina es la historia del efecto placebo, dado que la inmensa mayoría de las terapéuticas aplicadas carecían de principios activos y se basaban, como queda dicho, en la superstición, la fe, la esperanza, etc. tanto del paciente como del mé-dico (Lilienfeld, Ritschel, Lynn, Cautin & Latzman, 2013;Wojciechowski, 1984).…”

Section: Péutica Médicaunclassified

Diseño a doble ciego y el uso de placebos psicológicos en investigación de resultados en psicoterapia: Es posible? Un estudio piloto de viabilidad

Cazabat¹

2014

Interd

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ResumenEl uso de placebos y diseños a doble ciego ha cumplido un papel crucial en la investigación clí-nica en Medicina. Su aplicación a la investigación de resultados en psicoterapia ha sido controversial. Muchos autores niegan la posibilidad de su aplicación debido a que el terapeuta debería conocer la condición del procedimiento aplicado. Se presenta detalladamente un estudio en el que se utilizó un procedimiento placebo correspondiente a EMDR (Eye Movement Desensitization and Reprocessing -Desensibilización y Reprocesamiento por Movimientos Oculares) con un Diseño Experimental de Caso Único. Los objetivos fueron los siguientes: poner a prueba la viabilidad de la implementación de un placebo de tipo psicológico en EMDR y la aplicación de un diseño a doble ciego en el estudio de resultados en EMDR.Se seleccionaron tres pacientes que sufrían de Trastorno por Estrés Postraumático. Se estableció una línea de base de la sintomatología presentada. Luego, los sujetos fueron asignados ale atoriamente a tres condiciones experimentales durante tres sesiones: (a) aplicación del protocolo EMDR sin ningún tipo de estimulación con auriculares en silencio (placebo 1), (b) aplicación del protocolo EMDR con estimulación bilateral auditiva simultánea (no alternada) (placebo 2) y (c) aplicación del protocolo estándar de EMDR con estimulación auditiva bilateral alternada (tratamiento activo).Tales procedimientos resultaron igualmente creíbles para el paciente y para el terapeuta. Es to permitió el desarrollo de un diseño de investigación a doble ciego para la investigación de resultados en EMDR. Finalmente, se discuten algunas posibles aplicaciones e implicancias de la introducción del uso de placebos psicológicos y diseño a doble ciego en la investigación en psicoterapia.Palabras clave: Investigación de resultados en psicoterapia; Doble ciego; Placebo psicológico; EMDR; Diseño experimental de caso úni co. ABSTRACTDouble blind design and placebos have been of crucial importance in medical clinical research. Their use in outcomes research in the field of psychotherapy has been controversial, though. Their feasibility in such case has been denied by many authors based on the assumption that the psy -

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