Editorial: Review and Commentary Section

Abstract

Is this the era of empirically supported practice? If it is not, it is up to us to make it so. Many of us were trained in the scientist–practitioner framework of the Boulder model, now almost 60 years old, which emphasized training in both research and practice for clinical psychologists, and which seems to make the implicit assumption that the ‘‘science’’ training would help to make the ‘‘practice’’ activities more empirically-based. Almost 60 years later, we now have a greater appreciation for the difficulties of translating research into practice. As complicated as it may be to integrate science and practice into a single career, it may be even more difficult to find ways to have science infuse our clinical activities so that the knowledge base of clinical psychology guides our clinical work whenever possible. Currently, the professional discussion in psychology about the process of making the research literature more relevant to practice has focused primarily on clinical treatment. Before, say, 1980, the problem in child clinical and pediatric psychology was both a lack of relevant treatment studies and of a methodological way to summarize disparate results when studies were available. That problem changed somewhat when metaanalyses in the 1980s (Casey & Berman, 1985; Weisz, Weiss, Alicke, & Klotz, 1987) demonstrated that child treatment ‘‘worked’’ overall, or at least that certain child treatments with certain problems were efficacious. As always, good research generated more research questions, and another scientist–practitioner ‘‘gap’’ came to the forefront, that between the ‘‘lab’’ and the ‘‘clinic.’’ We came to understand that ‘‘laboratory’’ treatment studies as conducted in randomized trials using manualized treatments under tightly controlled conditions showed far better results than did treatment as conducted routinely in clinic settings (Weisz, Weiss, & Donenberg, 1992). We began to appreciate that treatments could be efficacious (under laboratory conditions emphasizing internal validity), but not necessarily effective (as practiced in real clinical settings, with emphasis on external validity, sometimes with some sacrifice in internal validity; Hoagwood, Hibbs, Brent, & Jensen, 1995). We also began to appreciate the complexities of applying manualized treatment to everyday clinical practice, when the manuals addressed single disorders and espoused a single theoretical basis for treatment, and practitioners dealt with comorbid conditions and were eclectic in their theoretical orientation. We have not resolved these problems in clinical child or pediatric psychology, but the need to find ways to translate research into clinical practice is very much with us. As physicians began to talk about the important of