Reviewer: Gary B Kaniuk, Psy.D.(Cermak Health Services)
Description: This book explores evidence-based practice (EBP) within psychotherapy, showing how difficult it is to evaluate treatment alternatives and how often scientific research is divorced from the actual clinical setting.
Purpose: According to the editors, "However, we believe it is nonetheless productive and fruitful to begin a reality-based progressive dialogue among mental-health professionals affected by the EBP movement. It is time for all of us to consider the views of professionals who work in areas of research or service delivery different from our own. Therefore, [this book] offers distinctive perspectives, seeks common ground, and reveals the areas where there are legitimate differences, unanswered questions, and promising avenues by which we may improve psychotherapy. The book met the editors' objectives."
Audience: According to the editors, the book is intended to engage a broad range of clinical researchers, practitioners, educators, and public policy advocates in a comprehensive discussion of key issues and arguments. Graduate students in clinical psychology, counseling psychology, and social work would also benefit greatly from this book. The editors and contributors are certainly credible authorities. Dr. Kazdin has published approximately 550 articles and chapters and has authored or edited 40 books. Dr. Sternberg is also a prolific author with over 1,000 journal articles, book chapters, and books. Dr. Goodheart is in private practice and is contributing faculty for the Graduate School of Applied and Professional Psychology at Rutgers University.
Features: The three sections in this book cover the practice perspective; the research perspective; and training, policy, and cautions. This well-written book provides a balanced approach to evaluating research and how difficult it is to "manualize" some psychotherapy. For example, the author of chapter one observes, "The greatest omission in EBP's consideration of the scientific basis for psychological interventions concerns factors related to the therapist and the nature of the treatment relationship, which have repeatedly been found to be among the strongest and most consistent predictors of psychotherapy outcomes." Another fascinating point comes in the training section, where the author states, "I would be delighted if good judgment were simply" the implementation of precise operations found in a well-designed, comprehensive, and incisive treatment outcomes literature. Later, he continues, "Psychology's science offers clues as to what might be happening in the clinical situation, but they are imprecise clues at best. In contrast to the natural sciences, psychology's methods carry less of the theory-empirical observation linkage workload than does psychologists' own good judgment." Chapter 11, "Evidence-Based Practice: Gold Standard, Gold Plated, or Fool's Gold" is really a fine way to end the book. It presents 25 cautions in the use of evidence-based practice, coming full circle in the discussion.
Assessment: This book does a good job of addressing the issue of evidence-based practice, something managed care health organizations have demanded for years. But all that glitters is not gold, as the book plainly states. There are shortcomings to EBP and this book elucidates them well. This is an important and timely publication, helping practitioners better evaluate what they are doing in terms of treatment. Ultimately, the beneficiaries will be the consumers, who are looking for the best treatment.