Evidence-Based Psychotherapy: History

  • The phrase “evidence-based” wasn’t used until the 1980s
  • “Evidence-based medicine is the conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individual patients” (8:27)
  • Further work was done by the APA to make evidence-based psychotherapy the standard 

Academic Idealism vs Clinical Application

  • Ideally, this should be a very collaborative experience 
  • Based on the previous definition, this would require the therapist to be aware of a large number of components
  • Including the ability to inform the client of the current research. 
  • Also, this may create a power dynamic that can be contradictory 
  • Because the client sees the therapist as the professional they should listen to 
  • “I agree with the posturing of collaboration being kind of open. But then, immediately when you start looking at the application and embodiment of this posture, evidence-based therapies and psychotherapies coming from a medically-oriented paradigm gets muddy very quickly” (17:31)

Evidence-Based Psychotherapy: Advantages

  • EBTs are important because they can provide a template that can be built upon and tailored to each client
  • Additionally, therapists that use EBTs can save time and resources
  • EBTs are associated with more accountability
  • And enhancing the health and well-being of the public
  • Keep in mind, however, that if the research goal was to prove these advantages, the results could be problematic. 

Evidence-Based Psychotherapy: Challenges

“Sometimes we can’t quantify what it takes to treat a human.”

  • Predominately left-brained
  • It’s possible that therapists adhere less to EBTs over time
  • Additionally, therapists  may not be up to date on current research 
  • The outcomes of trials differed from real-world clinical practices
  • Because the controlled trials didn’t account for certain dynamics or co-morbidities 
  • Contrary to the trials’ focus, people may be coming to therapy to do more than just eliminate their symptoms
  • “Reliance on scientific research is problematic; as for many practices, the level of evidence required to be considered “evidence-based” is lacking or unattainable” (30:13)

Evidence-Based Psychotherapy: Misconceptions

  • EBTs are not “cookbook instructions” for therapists to practice 
  • But are more of a “map of potential routes” for the therapist to take 
  • Many think psychotherapy provided can never meet EBT standards

Evidence-Based Psychotherapy: Implementation and Application

“The art of therapy does not have to be in contradiction with the science of therapy.”

  • Objective perfection in psychotherapy is nearly impossible and likely unhelpful.
  • Rather, let’s aim for subjective curiosity and an invitation to practice in an evidence-based way.
  • Structured curiosity takes the posture of “yes and…”
  • It allows you to transcend and include, to go from left to right, from fidelity to flexibility.
  • The focus of Evidence-Based Psychotherapy may be shifting away from the product and toward the process 
  • There are various factors associated with optimal implementation:
    • Relationships 

      • A positive therapeutic relationship significantly contributes to the healing process
      • But, be wary of providing treatment that revolves around the therapists’ goals 
      • Additionally, there is no one-size-fits-all approach 
      • Therapist centric vs client centric 
    • Fidelity 

      • High fidelity is associated with good therapeutic outcomes 
      • Importantly, the core components of the EBT are implemented 
      • Yet, rigid application of fidelity reduces the usability of a particular psychotherapy
    • Flexibility

      • Flexible implementation is necessary 
      • This means deviating from the protocol in some ways 
      • Remember, it’s always client-dependent.
    • Context

      • The authenticity of the provider is important
      • Also, the applicability to the client
    • Provider 

      • The provider needs to consider what the client needs 
      • Additionally, connection needs continued learning 
      • Embracing curiosity and creativity is essential to the longevity of the practitioner’s spirit

Season 2 Articles

Did you know?  After full completion of Beyond Healing Institute’s Somatic Integration and Processing training, each participant can receive 21 NBCC hours. 

Beyond Healing Center

Beyond Healing Media

Interested in supporting a child? 

  • https://www.patreon.com/BurntOutEducator
  • 100% of the proceeds donated to the Burntout Educator will provide therapy for a child in the public school system
  • Not therapy capped at a certain number, but an open-ended relationship with a highly qualified therapist in the BHC network. 

Connect with us on social media: Facebook & Instagram


Executive Directors: Jennifer and Ryan Savage, Melissa Bentinnedi, Bridger Falkenstein
Hosts: Bridger Falkenstein, Caleb Boston, and  Melissa Benintendi
Filmographer: Tyler Wassam
Podcast Editor: Jamie Eggert
Original Music Composers: Bridger Falkenstein and Caleb Boston
Show Notes: Jamie Eggert & Jordan Murray