Last summer I was sitting in a professional conference obtaining the necessary CEU's my LPC license requires. The speakers in the lectures kept referring to "evidence based" approaches to mental health treatment. In a nutshell, the term "evidence based" refers to methods that have measured up to the scrutiny of scientific research.
Nationwide, the term evidence based and best practice are liberally sprinkled throughout mental health discussions. The American Psychological Association adheres to this policy. While the policy reads well and makes sense to me, I think there are some developing unintended consequences.
While good at first blush, the implementation of evidence based practices has the potential to intrude on therapy sessions, effectively dumbing down what goes on in treatment. This is because those in control of the mental health delivery system / government, adhere to a top down method. A "one size fits all" system is good for those making reports and plugging data into spreadsheets, but unnecessarily limits what a therapist can do with a person seeking help.
There are things science cannot measure and there are variables that cannot be accounted.
I am not against "evidence based" methods, however, there is much more to therapy than what science can measure. A therapist is an artist. He/she weaves the knowledge derived from training, observation, peer discussions, and continued learning into a unique personality and philosophical point of view. That unique individual cannot be replicated anymore than one could reproduce a Beethoven, Babe Ruth, or Rembrandt. All therapists are not necessarily famous artists, but they are artists.
How do you measure devotion, love, compassion, hate, lust, ambition, indifference, perception, prejudice in an individual? How do you measure that in a therapist? How do you measure it in a patient? How do you measure the effect it has for outcome. How do you measure the outcome?
Inter-rater reliability and statistical impressions of self-report surveys to study the therapeutic process are like using a magnifying glass to observe atoms.
Research is not God to be worshiped nor is it the Devil to fear. It is a tool to use by skilled and sound individuals. Science has given us knowledge and breakthroughs in thought and understanding. Science has also been used to skew public opinion and to make money.
So I have written all of that to say this: Just because something does not have the "evidence based" stamp of approval on it does not mean it is ineffective or useless. It does not mean it works either. That is where a skilled therapist comes in. We do not want to shun something that may be effective, just because we do not have a proper yardstick with which to measure.
Forcing mental health professionals to only use the "evidence based" methods takes effective tools out of the hands of skilled craftsmen
The guise of doing what is best for everyone results in doing what is mediocre at best for everyone.
Here's to the art of therapy, the artists who practice it, and to those who come seeking relief from their suffering.
Until the next time
John Strain