‘Gold standard’ psychological treatments may not be the best

In a new study, researchers question much of the scientific evidence underpinning therapies designated as “Empirically Supported Treatments,” or ESTs.

The research was led by a team at the University of Kansas and University of Victoria.

There are over 600 approaches to psychotherapy, and some are more effective than others.

Since the 1970s, people have been trying to figure out which are most effective using clinical trials just like in medicine, where some patients are assigned to therapy and some to a control group.

Division 12 of the American Psychological Association has a list of therapies with strong scientific evidence from these trials, called ESTs.

For years, ESTs have represented a “gold standard” in research-supported psychotherapies for conditions like depression, schizophrenia, eating disorders, substance abuse, generalized anxiety, and post-traumatic stress disorder.

But recent concerns about the replicability of research findings in clinical psychology prompted the re-examination of their evidence.

In the new study, the team found that while underlying evidence for a small number of empirically supported treatments is strong, the evidence was hard to replicate.

The finding doesn’t mean that therapy doesn’t work, but based on this evidence, it is hard to say if most therapies designated as ESTs do actually have better science on their side compared to the alternative, research-supported forms of therapy.

Some of these ESTs are widely implemented in big systems like the Veterans Health Administration. If scientists find evidence for them isn’t as strong as believed, it may be worth looking at.

The team advised clinicians and patients to continually evaluate progress in therapy and adjust therapy based more on patient progress than research evidence of a given therapy’s effectiveness.

The lead author of the study is Alexander Williams, program director of psychology and director of the Psychological Clinic for KU’s Edwards Campus.

The study is published in the Journal of Abnormal Psychology.

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