Where is the Evidence in South African Clinical Psychology?

Abstract

While a rich body of research exists to inform the practice of clinical psychology, South African mental health professionals have failed to incorporate empirical findings in their clinical work. This article argues that South African psychology has become increasingly devoid of an empirical base, to the detriment of the clients it purports to serve. A fundamental epistemological problem that faces clinical psychology is the credibility it bestows on non-falsifiable theories. As such, practitioners have been led to rely to an inordinate degree on so-called clinical intuition and experience. Yet, the application of both of these practices yields demonstrably inferior treatment outcomes when compared with actuarial methods of judgement and prediction, and empirically supported interventions. While the notion of empirically supported treatments and its emphasis on randomised controlled trials are not unproblematic, far worse is the practice of giving credibility to clinical practices based on folklore and theoretical dogma in the absence of evidence. The argument presented in this article is that if South African clinical psychology is to make itself relevant to the needs of contemporary society, it needs to abandon non-falsifiable theoretical tenets and adhere more vigorously to the criteria of evidence when dispensing clinical services.