Evidence-based practice in clinical psychology: The use of cognitive-behavioural therapy in a community setting

Background: At one end of the Evidence-based medicine and practice (EBTs) debate spectrum, guild associations, insurance companies and federal/state organizations push for practitioners to implement EBTs. On the other end of the spectrum, therapists have critiqued EBTs arguing that they are too structured and manual-guided, which may limit their effectiveness in usual clinical practice contexts. We sought to understand to what extent is EBT practiced by providers treating depressed adolescents. Methods: A total of 164 therapists were mailed packets and 84 responded by completing the study questionnaire packet (51.2% response rate). Therapists were mailed a packet of questionnaires referring to the treatment of their adolescent patient during the three months following the adolescent's inpatient hospitalization. Results: 40% percent of therapists reported their “most” preferred choice of treatment approach as CBT. We compared those that received CBT to all other therapies. Therapist-reported treatment approaches for depressed adolescents 50% of therapist reported half of their adolescent clients received CBT.Conclusion: CBT, an effective EBT, is being used by mental health providers in the community. In our study, 40% of therapists' choice of treatment was some form of CBT. Half of the depressed adolescent received CBT from their therapist and therapists reported greater functioning after 3 months of treatment.

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