title: Evidence-Based Therapies, Evidence-Based Practice, and the Intersection of Nomothetic and Idiographic Foundations of Psychotherapy Research and Application: A Reply to Shean.
abstract: This article is a commentary on "Psychotherapy Outcome Research: Issues and Questions" by Glenn Shean (this issue). While we agree with a couple of Shean's points, such as over-reliance on diagnoses and lack of attention to global measures of quality of life and functioning, there are several very substantive points of disagreement. We argue that evidence-based therapies and evidence-based practice occupy a central role in developing effective and non-harmful therapies. Shean conflates evidence-based therapies and evidence-based practice in a way that is not representative of how science is intended to advance everyday treatment delivery. We further contest Shean's notion that reliance on empirically based research is limiting to clinicians and instead argue that it offers a helpful and pragmatic starting point for clinical decision making with each unique patient. Further, evidence-based practice, in contrast to evidence-based therapies, represents the model ideal for service delivery, rather than a slavish adherence to protocols employed in randomized clinical trials. Finally, we argue that both nomothetic and idiographic approaches are valid and important in the ongoing advancement of modern psychotherapy, a position wholly consistent with the evidence-based practice movement.
authors.affiliation: Rhode Island Hospital/Alpert Medical School of Brown University.
authors.forename: Brian
authors.initials: B
authors.lastname: Pilecki
authors.affiliation: Rhode Island Hospital/Alpert Medical School of Brown University.
authors.forename: Dean
authors.initials: D
authors.lastname: McKay
mesh_terms: D006801:Humans; D011613:Psychotherapy; D011788:Quality of Life
keywords: Evidence-based therapy; empirically supported treatments; randomized controlled trials