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July 2013

Evidence-Based Treatment and Usual Care: Cautions and Qualifications

Author Affiliations
  • 1Department of Psychology, Yale University, New Haven, Connecticut
JAMA Psychiatry. 2013;70(7):666-667. doi:10.1001/jamapsychiatry.2013.2112

Since the pioneering work on meta-analysis of psychotherapy encompassing hundreds of treatment outcome studies,1,2 scores of similar analyses have been published. Meta-analysis represents an important breakthrough by allowing the integration of multiple studies and evaluation of influences on treatment outcome (eg, characteristics of patients and methodological practices) that the individual studies themselves did not or could not address. The meta-analysis by Weisz et al3 addresses the question of whether evidence-based psychotherapies (EBPs) differ from usual clinical care and if so to what extent? This well-conducted analysis with novel data analyses shows that a class of interventions called EBPs is superior to a class of interventions called the usual clinical care for children and adolescents. My comments are directed to what we can and cannot conclude from the main findings and the context in which the key question might be considered.

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