What is Evidence-Based Practice?

What do we mean by evidence-based practice? Evidence-based practice refers to mental and behavioral health treatments that are supported by research using the scientific method. That is, these treatments have stood up to scientific scrutiny in well-controlled tests.

Why is the scientific method important? Unfortunately, as human beings, we are terrible at dispassionately observing outcomes. We are biased toward seeing what we expect to see and are likely to dismiss information that disconfirms our preconceptions. This does not mean that scientists are less susceptible to bias than others; instead, the scientific method helps us to bypass out biases.

If something seems to be effective, isn’t that enough? History is littered with treatments that have reportedly resulted in “astonishing” and “groundbreaking” outcomes but which did not stand up to scientific scrutiny. For example, throughout many centuries, the greatest doctors of the era thought bloodletting was an effective treatment for a number of serious medical conditions such as pneumonia, cancer, and diabetes. These beliefs persisted for many years even after science showed this was not true.

I’ve heard that evidence-based treatments aren’t applicable to the “real world” because research is conducted under artificial conditions. All research studies have their limitations. Some therapists use this criticism as an excuse to practice whatever they want. If given the option, however, would you prefer to receive treatment that has been shown to work under controlled conditions or would you prefer to receive a treatment that has no research evidence for its effectiveness? At Portland Psychotherapy, we are aware of the limitations of science but value its strengths.

Does evidence-based mean that I have no say in treatment? At Portland Psychotherapy, we are committed to collaborative care. We do not begin treatment until we are certain we share the same goals. We use research evidence to flexibly guide treatment, rather than adhering to a specific protocol. We start with each client and ask what research evidence will best help the client meet his or her goals.

If treatment is evidence-based, does that mean everyone benefits from it? Sadly, no treatment is 100% effective, even the best treatments. If someone is not responding to treatment, we work hard to figure out other options. If you are not satisfied with the course of treatment, we are happy to refer you to other therapists that you may find helpful.