Jonathan Shedler - Where is the Evidence for Evidence-Based Therapy?

 Published On Jan 23, 2015

The term “evidence-based” has become a form of marketing, used to refer to brief therapies conducted by following instruction manuals (“manualized” therapy). It is widely claimed that these therapies have proven clinical effectiveness and are superior to traditional forms of psychotherapy. However, the scientific evidence indicates that these manualized treatments are unhelpful for most patients most of the time.

Research shows that a) the treatments help only a small fraction of patients, b) the benefits the patients receive are clinically trivial and fail to pass the “So what?” test, c) the benefits evaporate quickly, d) patients remain symptomatic after treatment, e) the majority of patients seek additional treatment for the same condition within six months, and f) traditional (e.g., psychodynamic) psychotherapy is at least as effective and confers longer-term benefits.

If anything, research shows that for the most common mental health conditions, the treatments promoted as “evidence based” have been empirically invalidated. Proponents of the treatments appear to conflate mere existence of research studies with scientific support, disregarding the actual findings of the studies and their clinical implications. The popularity of “evidence-based” therapies may represent a triumph of marketing over science.

Jonathan Shedler, PhD is known internationally as a psychologist, consultant, researcher, and author. He is best known for his article The Efficacy of Psychodynamic Psychotherapy, which won worldwide acclaim for establishing psychodynamic therapy as an evidence-based treatment. His research and writing are shaping contemporary views of personality syndromes and their treatment. He is author of the Shedler-Westn Assessment Procedure (SWAP) and numerous scholarly and scientific articles in psychology and psychiatry. He has over 20 years’ experience teaching and supervising psychologists, psychiatrists, and psychoanalysts.

Dr. Shedler lectures and leads workshops for professional audiences nationally and internationally, consults on psychological issues to U.S. and foreign government agencies, and provides clincical consultation and study groups by teleconference to mental health professionals worldwide. Dr. Shedler is a Clinical Associate Professor of Psychiatry at the University of Colorado School of Medicine and was formerly Director of Psychology at the University of Colorado Hospital Outpatient Psychiatry Department. When not teaching or practicing psychology, he is a certified professional ski instructor at Vail Ski Resort

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