My textbook (and this blog) helps teach readers to become systematic, critical consumers of the information they find in the press and in journal articles. But a recent article on therapies for PTSD calls attention to another important realm: being a consumer of psychotherapies.
What do I mean by this? For one, if you plan to see a therapist or mental health counselor, you should be an educated consumer of their services--which treatments are the best?
Second, what if you plan to train to become a psychologist, therapist, or licensed profesional counselor someday? Which of the many types of therapy should you learn? Which should you practice?
The answer in both cases is: evidence-based treatments (also called "empirically supported therapies" "evidence-based practice" and "evidence-based psychotherapy"). Therapists should ideally use treatments that have been shown to work through rigorous scientific testing.There are some therapies out there for which there is no evidence. Trying an untested therapy might be like taking an expensive pill when you're not sure it works. When people are suffering, we know that it's critical for them to get treatment--but it's a good idea to look for the best treatment available.
A journalist at ScienceNews Daily interviewed psychologist Edna Foa, who developed and tested a therapy for PTSD called Prolonged Exposure therapy (PE). In this therapy,
...patients approach -- in both imaginary and real-life settings -- situations, places, and people they have been avoiding. The repeated exposure to the perceived threat disconfirms individuals' expectations of experiencing harm and, over time, leads to a reduction in their fear.
Over years of testing, PE and other forms of cognitive behavioral therapy have proved highly effective in addressing the distress and dysfunctional problems that trauma victims experience.
Dr. Foa and her collaborators are in the news because of a recent article they wrote, which concluded that
...the majority of mental health professionals do not use such evidence-based treatments (EBTs) when working with patients suffering from PTSD.
Many clinicians believe that good psychotherapy should be individualized and should focus on the underlying causes of one's problems and symptoms. But studies show scant evidence that psychodynamic therapy -- which focuses on such issues as difficult childhood relationship with parents -- effectively eases PTSD symptoms, according to the report.
Unfortunately for those who are suffering, there's a large gap between what clinical scientists know and what therapists practice in their offices. And as you read in Chapters 1 and 2, just because a therapist thinks a technique works based on his or her experience with it, that does not mean that the therapy is truly effective. Personal experience has no comparison group!
What can you do? For one, if you're looking into psychotherapy for yourself or a friend, ask potential counselors if they use evidence-based therapies. If you or a friend suffer from PTSD, look around for a therapist who uses an evidence-based therapy like PE or cognitive-behavioral therapy. My colleagues Dr. Tim Fowles and Dr. Ryan Beverige recommend the following websites, which list interventions and indicate their supporting evidence.
The Substance Abuse and Mental Health Services Administration (SAMHSA; U.S. Dept. of HHS) maintains lists more than 280 interventions with information about the intervention and its supporting evidence:
And there is also this list from the APA:
And if you're considering becoming trained as a counselor or psychologist someday, ask your professors and mentors if the therapies they are teaching you are evidence-based. Research shows us which therapies are better than others--wouldn't you want to learn the ones that actually have been shown to work?