Where is the evidence for “evidence-based” therapy? NEW AND UPDATED [pdf] 2017 by Jonathan Shedler. This article is adapted from the article below by J. Shedler.
KEY POINTS
It is widely asserted that “evidence-based” therapies are scientifically proven and superior to other forms of psychotherapy. Empirical research does not support these claims.
Empirical research shows that “evidence-based” therapies are weak treatments. Their benefits are trivial, few patients get well, and even the trivial benefits do not last.
Troubling research practices paint a misleading picture of the actual benefits of “evidence-based” therapies, including sham control groups, cherry-picked patient samples, and suppression of negative findings.
Where is the evidence for “evidence-based” therapy? [pdf] 2015 by Jonathan Shedler, Ph.D., The Journal of Psychological Therapies in Primary Care, Vol. 4, pp. 47–59.The efficacy of psychodynamic psychotherapy [pdf] 2010 by Jonathan Shedler, Ph.D., American Psychologist, American Psychological Association Vol. 65, No. 2, pp. 98–109."Hailed as a contemporary classic and studied in clinical training programs around the world, this is the paper that firmly established psychodynamic therapy as an evidence-based treatment" (American Psychologist, American Psychological Association)Abstract: Empirical evidence supports the efficacy of psychodynamic psychotherapy. Effect sizes for psychodynamic psychotherapy are as large as those reported for other therapies that have been actively promoted as "empirically supported" and "evidence based." Additionally, patients who receive psychodynamic therapy maintain therapeutic gains and appear to continue to improve after treatment ends. Finally, non-psychodynamic therapies may be effective in part because the more skilled practitioners utilize techniques that have long been central to psychodynamic theory and practice. The perception that psychodynamic approaches lack empirical support does not accord with available scientific evidence and may reflect selective dissemination of research findings.
I thank Mark Hilsenroth for his extensive contributions to this article;
Marc Diener for providing some of the information reported here; Robert
Feinstein, Glen Gabbard, Michael Karson, Kenneth Levy, Nancy McWilliams,
Robert Michels, George Stricker, and Robert Wallerstein for their
comments on drafts of the article; and the 500-plus members of the
Psychodynamic Research Listserv for their collective wisdom and support.
Correspondence concerning this article should be addressed
to Jonathan Shedler, Department of Psychiatry, University of Colorado
Denver School of Medicine, Mail Stop A011-04, 13001 East 17th
Place, Aurora, CO 80045. E-mail: jonathan@shedler.com
1 I use the terms psychoanalytic and psychodynamic interchangeably.
transcripts (note that the features listed below concern
process and technique only, not underlying principles that
inform these techniques; for a discussion of concepts and
principles, see Gabbard, 2004; McWilliams, 2004; Shedler,
2006a):
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