Assessment of Evidence-Based Psychotherapy Practices in Usual Care: Challenges, Promising Approaches, and Future Directions

Excerpt

In this special issue of Administration and Policy in Mental Health and Mental Health Services Research, we focus on measuring evidence-based practices in psychotherapy within usual care practice. Measuring evidence-based practices in usual care settings is important for at least three reasons. First, such measurement would help identify practices within usual care settings that are promising. For example, patients in usual care psychotherapy settings tend to have co-morbid mental disorders; whereas, our evidence base for psychotherapy is largely based on single disorders. Mixing strategies from more than one evidence-base may be effective in practice. Second, measuring evidence-based practices is essential for quality improvement interventions. Such measures could provide a baseline, as well as a comparative measure of change following quality improvement interventions that attempt to introduce more evidence-based care to patients. Third, understanding what clinical practices in usual care works best individually or in combination can help tailor graduate training programs to improve the pool of new professionals currently in training. Overall, developing measures of and understanding psychotherapy as it happens in the community is important for improving our mental health service delivery system. …