Psychotherapy : from eminence-based to evidence-based

Abstract EN

Modern psychotherapy began with the practice of psychoanalysis, which was based on Freud's essential principle of making the unconscious conscious.

Psychoanalysis was derived from case studies and personal opinion.

During the 1950s, Aaron T.

Beck attempted to provide psychoanalysis with research evidence.

His research failed to provide a research basis for psychoanalysis, but formed the ground for developing cognitive therapy.

The efficacy of cognitive therapy in the treatment of depression was demonstrated in randomized clinical trials (RCT) comparing it to placebo and to imipramine.

Cognitive therapy evolved into cognitive behavior therapy (CBT) by merging with behavior therapy, which had been developing since the 1920s.

Numerous types of CBT have gained widespread acceptance as primary treatments for numerous disorders.

Many CBT types have been tested by means of RCTs.

Systematic reviews of such RCTs uncover well designed and conducted RCTs.

Evidence-based practice can be based on the good quality evidence that is derived from such RCTs.

Systematic reviews also uncover badly done RCTs that cannot provide more than low quality evidence; an observation that is not limited to psychotherapy RCTs.

This state of affairs can be remedied and research can be well conducted.