'Evidence-based' therapies are often perceived as trustworthy, but they may be ineffective for most patients. There is significant misinformation regarding their effectiveness, with high drop-out rates indicating that while some benefit, many do not find success. Psychotherapy research is complex and findings from randomized controlled trials may not apply to real-world clinical practices. Individualized treatment that considers patient characteristics is crucial, as some patients respond better to non-evidence-based approaches. Empirical research reveals that 'evidence-based' approaches require critical questioning when faced with individual patient experiences that differ from expected outcomes.
One might assume, in light of the strong claims for 'evidence-based' therapies and the public denigration of other therapies, that there must be extremely strong scientific evidence for their benefits. There is not. There is a yawning chasm between what we are told research shows and what research actually shows. Empirical research actually shows that 'evidence-based' therapies are ineffective for most patients most of the time.
However, evidence-based practices are not the problem. Rather, the misinformation, false assumptions, and projections placed on them are problematic. For example, many studies about evidence-based therapy show high drop-out rates, suggesting it was effective for some, yet ineffective for those who quit.
Psychotherapy outcome research is complex and nuanced, making it difficult to conduct and measure. Randomized controlled trials are considered the gold standard, but their findings often do not generalize to clinical practice.
When the patient's experience does not conform to what the evidence claims should happen, the 'evidence-based' approaches must be questioned for that individual. I have worked with people who did not respond to evidence-based approaches but did respond to 'non-evidence-based' treatments.
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