Professional Training Issues in Evidence‐Based Clinical Psychology

Abstract

The aspiration of evidence-based clinical psychology is to combine the best empirical research with the best therapeutic relationship and the most careful assessment and case formulation to produce the best outcomes for each individual client. The use of treatments that have the support of clinical trials is expected to improve client outcomes. Training in evidence-based clinical psychology adds training in empirically supported treatments (ESTs) and in the specific skills of evidence-based practice (EBP) to existing clinical psychology training programs. Training in the techniques of ESTs may provide new content for some clinical psychology programs but the methods of teaching are unlikely to be novel. The EBP requires a set of specific skills that assist clinicians to be better consumers of research. Following on from evidence-based medicine (EBM), EBP teaches clinicians specific skills in turning clinical information needs into answerable questions, devising and executing timely and targeted literature searches, critically appraising the results of searches, and integrating that information with other information about the specific client to decide on the optimal course of action. While there is little evidence about the effects of teaching EBP skills in clinical psychology, the evidence from other, mainly medical, professions is that didactic teaching may improve knowledge but has little impact on attitudes toward EBP or the use of EBP skills in clinical practice. Where there is evidence for changes in clinical practice the teaching methods are based around real clinical encounters and cases. Some authors have argued that maximum effect comes from adopting EBP skills throughout the clinical psychology curricula. After reviewing evidence about the effects of training in EBP, we discuss issues in adapting some of the excellent EBM teaching resources to clinical psychology and in providing continuing professional education. If individual clinical psychologists more frequently use treatments that have support from systematic reviews and clinical trials, it has been argued that their clients are more likely to attain better outcomes. While this reasoning has some appeal it is clear that high-quality experimental studies are needed to examine whether training in EBP adds to traditional clinical psychology training by producing better client outcomes. Keywords: evidence-based practice; clinical psychology graduate training; continuing education