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Evidence-Based Approach in Psychotherapy: Why is it important?


According to the American Psychological Association (APA, 2006), evidence-based approach or practice is “the integration of the best available research results with clinical practice in the context of an individual’s characteristics, culture, and preferences.” In this respect, evidence-based practice is a way to approach empirical knowledge and make the most of research findings, helping to improve the effectiveness of the treatment services offered to individuals (Ollendick, 2014). Evidence-based practice is a clinical decision-making process that identifies the most suitable intervention, ensuring it’s relevant and applicable to each person’s unique circumstances and promoting continuity of development (Wampold, 1997). We can say that evidence-based practice is not specifically linked to a specific theoretical orientation or psychotherapy modality; it is a broader concept that implies a clinical framework. Driven by this, the psychotherapy modality used in the field of mental health must be based on objective foundations and scientifically reliable, regardless of theoretical orientation (Ollendick, 2014). Evidence-based practice utilizes the most effective intervention supported by research, taking into account the mental health professionals’ clinical experience, and considers and incorporates the individuals’ culture, values, and preferences in the selection of therapy modalities and interventions used during therapy. In this therapy sketch, we investigate the evidence-based practices and their importance in the mental health field.

Evidence-Based Approach

The evidence-based practice in mental health is an approach that aims to increase the efficiency of both professionals and individuals receive psychotherapy, including deciding on the appropriate treatment by taking into account the needs of the individual in the light of the most qualified research data and, when necessary, making personalized adaptations, tailoring with the flexibility brought by clinical expertise (APA Presidential Task Force on Evidence-Based Practice, 2006). There has been much evidence-based psychotherapy modalities used by mental health professionals for a long time, such as CBT, DBT, Gottman, psychodynamic therapy, and EMDR. In fact, the literature contains more than 20 distinct evidence-based psychotherapies. Let’s explore how these therapy modalities are referred to as “evidence-based”.

The APA published two guidelines in 1995, addressing principles and evidence-based policies in the field of mental health. Common emphasis in both publications is on efficacy, effectiveness, and utility (APA, 2002; APA Presidential Task Force on Evidence-Based Practice, 2006).

Efficacy

In the mental health field, efficacy refers to the scientific measure of whether a therapeutic method is effective under controlled conditions. Efficacy refers to the proven ability of a psychotherapy to reduce adverse symptoms or improve functioning under ideal conditions. According to the study by Tolin and colleagues, the efficacy of psychotherapy modalities is examined in two stages. In the first stage, mental health professionals evaluate structured, systematic review studies on the effectiveness of a particular psychotherapy by looking at the risks of bias. Then, the strength of the evidence needs to be reviewed practically by mental health professionals in the context of factors such as benefit, cost, harm, and effect size of the treatment, as well as the level of empirical support (very strong, strong, or weak) (Tolin et al., 2015). If we provide an example regarding specific therapy modalities, one leading review states that there are 269 meta-analyses on cognitive behavioral therapy (CBT). There are also large meta-analyses, including the largest meta-analysis of 409 randomized controlled trials.

Another method is randomized controlled trials. For example, in a randomized controlled trial, it is expected that the scores of participants who were diagnosed with anxiety disorder and received CBT for anxiety disorder on standardized scales assessing anxiety would be statistically significantly lower than the scores of participants with anxiety disorder who did not receive CBT. If such a result emerges, it can be said that there are findings that CBT is a psychological treatment method that is effective in reducing the anxiety symptoms of people diagnosed with anxiety disorder. Moreover, findings like these are compiled in meta-analysis studies to demonstrate the effectiveness of psychotherapy methodology (Wampold et al., 2011).

Efficacy vs Effectiveness

Effectiveness, on the other hand, refers to whether a psychotherapy modality improves functioning in real-world situations, not in controlled conditions. This type of research is vital for the broad applicability of the findings across various contexts, including home, school, occupational, and relational settings, to assess their efficacy as a general effect. As a result, effectiveness focuses on understanding the positive impact that interventions have on people’s lives. This generates valuable insights that truly benefit both individuals and therapists in their everyday clinical practice (Rosqvist et al., 2011).

To continue our example in efficacy, let’s say that you started therapy for your anxiety. You and your therapist decided to use CBT, specifically an intervention called graded exposure, which can help you confront situations that may trigger anxiety (APA, 2017). To do that, you and your therapist created an exposure hierarchy, ranking activities or situations that lead you to feel anxious by their level of difficulty. Over time, as you work in line with this hierarchy, you may notice that this intervention is effective in many areas of your daily life. For example, this can help you reduce the fear of giving a presentation at school. In your personal life, it may help express your needs. Or at work, it can help you to speak up in a meeting, to ask for support from a colleague, or to take on a new task.

Utility

In utility, a psychotherapy modality is not evaluated solely in terms of efficacy or effectiveness, but also in terms of its applicability in terms of cultural competence, costs, and other factors (Nathan, 2013).

If we take graded exposure as an example, you can learn this method to reduce her avoidance behavior in social situations and later adapt it to other conditions, such as public speaking, which demonstrates the technique’s adaptability to real-life situations. Over time, you can apply the step-by-step plans independently for future incidents. In this respect, we can say that graded exposure practice applies to various domains and is easily learned with the help of mental health professionals.

Examples of Modalities Used in Evidence-Based Approach

Cognitive Behavioral Therapy (CBT): Numerous research studies on CBT have been published in the literature since the 1980s. In a comprehensive meta-analysis published in 2025, Cuijpers et al. evaluated the effect of CBT in adults, including a total of 32,968 adult participants from 375 randomized controlled trials. Findings show that CBT is moderately to highly effective in panic disorder, social anxiety, generalized anxiety disorder, eating disorders, major depression, and obsessive-compulsive disorder.

Dialectical Behavioral Therapy (DBT): DBT has shown a powerful effect in controlled studies with individuals diagnosed with borderline personality disorder (BPD). A recent meta-analysis found significant reductions in suicidality and self-harm behaviors. A case series study from 2024 shows that DBT leads to long-term improvements in anger control, relational difficulties, and suicidal thoughts.

Psychodynamic Approach: Psychodynamic therapy is one of the therapies whose effectiveness has been systematically evaluated, particularly in the areas of recurrent depression, personality disorders, and relational difficulties. Psychodynamic therapy is highly adaptable to integrate other evidence-based therapies and can be used with both short-term structured models and long-term relational interventions. A review published in BMC Psychiatry in 2025 shows that short-term psychodynamic therapy is effective in reducing depressive symptoms and contributes to individuals’ insight (Malkomsen et al, 2025).

Gottman Method: John and Julie Gottman’s “Love Lab” research tracked more than 3,000 couples in Seattle over many years, revealing in detail which behaviors in marital relationships predict future separation and which dynamics preserve quality. The Gottman Method, developed based on these data, is one of the evidence-based couple therapies (Gottman, 2015). In addition, studies conducted in different countries show the impact of Gottman therapy on different cultures.

Why does it matter to mental health professionals?

Evidence-based practice approaches have various advantages for mental health professionals. Some of these advantages include evaluating the effectiveness of studies, making cost-benefit evaluations, and conducting treatments according to ethical standards. Additionally, evidence-based practice offers a framework for mental health professionals to make more informed decisions in their clinical work. This approach views the evidence-based method as a vital tool for sharing knowledge about the effectiveness of both general and specific therapy interventions. It acts as a driving force for implementing these interventions to ensure the highest level of support for individuals. That provides mental health professionals with a valuable resource to enhance their sessions. In addition, evidence-based intervention practices stimulate discussion of various professional issues and encourage therapeutic research to develop new methods (Tolin et al, 2015).

Why does it matter to the individuals receiving the therapy?

Evidence-based modalities have benefits for mental health professionals as well as significant benefits for the individuals receiving the therapy, as follows:

  • Ethical Standards: Ethical behavior is a common point of the evidence-based therapy modalities, which means they are designed to provide a safe, respectful, and non-judgmental space to talk. This protects your personal boundaries and avoids interventions that could harm you during the process. Additionally, accredited institutions train mental health professionals to utilize evidence-based modalities, and this knowledge is reinforced through supervision. This plays a role in supporting ethical processes.
  • Cost-Benefit Analysis: As mentioned above, evidence-based psychotherapies employ cost-benefit analysis during the research process, considering both the benefits to mental health professionals and the potential benefits to individuals who will benefit from the specific treatment modality. This approach also helps mental health professionals to utilize interventions that will prioritize well-being, safety, and accessibility. Moreover, even though all are based on scientific evidence, mental health professionals tailor specific interventions or integrate different evidence-based modalities according to each individual’s needs. With all of these, evidence-based psychotherapy modalities aim for an efficient therapy process where the benefits are high and the costs are affordable to individuals.
  • Knowing What to Expect: Evidence-based therapy methods typically employ structured approaches that provide a clear understanding of what to expect. This will help you understand the interventions used during therapy and their rationale. This might reduce your anxiety due to uncertainty and allow you to participate more confidently in the process.
  • Continuous Education: A key aspect of evidence-based therapy approaches is that knowledge is not a fixed but an ever-evolving process. As research progresses, new areas of learning open up for both professionals and individuals who receive therapy. Individuals can actively contribute to their own well-being by learning new methods during therapy, which gives them participation and autonomy in the process. Additionally, professionals update their therapeutic skills by closely following the scientific literature, so that they can offer a more tailored, individualized approach to each individual.
  • Alignment With Your Values: Evidence-based therapy approaches pay attention not only to what is efficient but also to how the person participates in the process, what they value, and how they relate to change. These approaches encourage a “tailored” approach and offer a broad perspective that is sensitive to the person’s life priorities, decision-making, and search for meaning.

To summarize, an evidence-based approach in therapy is an approach that utilizes methods proven effective through scientific research, combined with the mental health professional’s clinical expertise and the values of the individual receiving psychotherapy. This model takes into account not only the techniques that work, but also what works for whom, when, and in what context. Mental health professionals select or adapt the most appropriate method for each individual by following current data. In this way, the therapy process becomes safe, effective, and tailored to each individual.

Take aways

  • An evidence-based approach or practice is “the integration of the best available research results with clinical practice in the context of an individual’s characteristics, culture, and preferences.
  • There has been much evidence-based psychotherapy modalities used by mental health professionals for a long time, such as CBT, DBT, Gottman, psychodynamic therapy, and EMDR.
  • Researchers and mental health professionals develop evidence-based practices by studying efficacy, effectiveness, and utility.
  • Evidence-based practices inform the practice of mental health professionals in terms of ethical perspectives, data-oriented approach, cost-benefit analysis, and supporting individuals toward the best possible care.
  • Evidence-based practices ensure individuals meet ethical standards. They access data-driven and personalized treatments through tailored interventions, learning what to expect and choosing options that align with their values.

References

Wampold, B. E., Mondin, G. W., Moody, M., Stich, F., Benson, K., & Ahn, H. N. (1997). A meta-analysis of outcome studies comparing bona fide psychotherapies: Empirically,” all must have prizes.”. Psychological bulletin, 122(3), 203.

American Psychological Association. (2002). Criteria for evaluating treatment guidelines, 57(12), 1052–1059. https://doi.org/10.1037/0003-066X.57.12.1052

American Psychological Association. (2017). Exposure therapy. Retrieved from https://www.apa.org/ptsd-guideline/patients-and-families/exposure-therapy

APA Presidential Task Force on Evidence-Based Practice. (2006). Evidence-based practice in psychology. American Psychologist, 61(4), 271–285. https://doi.org/10.1037/0003-066X.61.4.271

Cuijpers, P., Karyotaki, E., de Wit, L., Ebert, D. D., & Hollon, S. D. (2025). Cognitive behavior therapy for mental disorders in adults: A unified protocol meta-analysis. JAMA Psychiatry, 82(3), 300–310. https://doi.org/10.1001/jamapsychiatry.2025.0300

DeCou, C. R., Comtois, K. A., & Landes, S. J. (2019). Dialectical behavior therapy is effective for the treatment of suicidal behavior: A meta-analysis. Behavior therapy, 50(1), 60-72.

Gottman, J. M., & Gottman, J. S. (2015). Gottman couple therapy.

Nathan, P. E. (2013). Efficacy, effectiveness, and the clinical utility of psychotherapy research. In The art and science of psychotherapy (pp. 69-83). Routledge.

Malkomsen, A., Wilberg, T., Bull-Hansen, B., Dammen, T., Evensen, J. H., Hummelen, B., … & Røssberg, J. I. (2025). Comparative effectiveness of short-term psychodynamic psychotherapy and cognitive behavioral therapy for major depression in psychiatric outpatient clinics: a randomized controlled trial. BMC psychiatry, 25, 113.

Ollendick, T. H. (2014). Advances toward evidence-based practice: where to from here?. Behavior Therapy, 45(1), 51-55.

Rosqvist, J., Thomas, J. C., & Truax, P. (2011). Effectiveness versus efficacy studies. In Understanding research in clinical and counseling psychology (pp. 319-354). Routledge.

Tolin, D. F., McKay, D., Forman, E. M., Klonsky, E. D., & Thombs, B. D. (2015). Empirically supported treatment: Recommendations for a new model. Clinical Psychology: Science and Practice, 22(4), 317.

While our physical offices are located in South Loop and Lakeview neighborhoods in Chicago, Illinois for in-person sessions, we also welcome and serve clients for online therapy from anywhere in Illinois and Washington, D.C. Clients from the Chicagoland area may choose in-office or online therapy and usually commute from surrounding areas such as River North, West Loop, Gold Coast, Old Town, Lincoln Park, Lake View, Rogers Park, Logan Square, Pilsen, Bridgeport, Little Village, Bronzeville, South Shore, Hyde Park, Back of the Yards, Wicker Park, Bucktown and many more.  

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At Roamers Therapy, our psychotherapists are here to support you through anxiety, depression, trauma and relationship issues, race-ethnicity issues, LGBTQIA+ issues, ADHD, Autism, or any challenges you encounter. Our psychotherapists are trained in Cognitive Behavioral Therapy, Dialectical Behavioral Therapy, Psychodynamic Therapy, Acceptance, and Commitment Therapy, Person-Centered Therapy, and Gottman Therapy. 

Whether you’re seeking guidance on a specific issue or need help navigating difficult emotions, we’re ready to assist you every step of the way.

Contact us today to learn more about our services and schedule a session with our mental health professionals to begin your healing journey. To get started with therapy, visit our booking page.

First, decide if you’ll be paying out-of-pocket or using insurance. If you’re a self-pay client, you can book directly through the “Book Now” page or fill out the “Self-Pay/Out-of-network Inquiry Form.” If you’re using insurance, fill out the “Insurance Verification Form” to receive details about your costs and availability. Please let us know your preferred therapist. If your preferred therapist isn’t available, you can join the waitlist by emailing us. Once your appointment is confirmed, you’ll receive intake documents to complete before your first session.

This page is also part of the Roamers Therapy Glossary; a collection of mental-health related definitions that are written by our therapists.

While our offices are currently located at the South Loop neighborhood of Downtown Chicago, Illinois, we also welcome and serve clients for online therapy from anywhere in Illinois and Washington, D.C. Clients from the Chicagoland area may choose in-office or online therapy and usually commute from surrounding areas such as River North, West Loop, Gold Coast, Old Town, Lincoln Park, Lake View, Rogers Park, Logan Square, Pilsen, Bridgeport, Little Village, Bronzeville, South Shore, Hyde Park, Back of the Yards, Wicker Park, Bucktown and many more. You can visit our contact page to access detailed information on our office location.