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Evidence-Based Treatment in Mental Health: What Does It Mean?

Written by Evolve's Behavioral Health Content Team​:

Alyson Orcena, LMFT, Melissa Vallas, MD, Shikha Verma, MD, Ellen Bloch, LCSW, Lianne Tendler, LMFT, Megan Johnston, LMFT

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When your child was diagnosed with their mental health, substance abuse, or behavioral disorder, you probably started researching various therapies and medications. Friends and family members might have also come to you with their own recommendations, some of which may have sounded uncommon or non-mainstream. (Ahem, Bach flower remedies…we’re looking at you.)

As it turns out, you may be right to exercise caution when it comes to alternative or complementary therapy. Though people may swear certain treatments have worked for them, the evidence may be just that—anecdotal. Many times, these therapies only “work” through the placebo effect.

On the other hand, evidence-based treatment is supported by science. Dialectical Behavior Therapy (DBT), Cognitive Behavior Therapy (CBT), and others have been empirically shown to successfully treat many mental health disorders.

Qualities of Evidence-Based Treatments

  1. Scientific data supports its effectiveness. If a specific treatment is classified as “evidence-based,” it means that researchers have conducted well-designed studies showing its true success. Results in the lab and the real world show that the underlying methods in these evidence-based therapies significantly reduce illness symptoms or cure them altogether. These studies, published in peer-reviewed journals, usually feature a relatively large sample population, pre- and post-treatment analyses, and statistically significant results.
  2. They are highly structured. Clinicians who administer these treatments follow a well-defined protocol. They don’t just “make it up” as they go along or take guesses on how to proceed session by session. Therapists follow a treatment manual which dictates the number of sessions to offer, what to talk about and teach, and what techniques to use.
  3. They are goal-directed. Evidence-based treatments are well-defined; they aren’t designed to be open-ended. Since they focus on solutions instead of problems, evidence-based treatments usually end when the client meets the goals of therapy.

Examples of Evidence-Based Therapies

Applied Behavioral Analysis (ABA)

When a reward follows a behavior, people are more likely to continue that behavior. ABA applies this concept to bring about meaningful and positive change in behavior. Instead of blaming patients for their negative behaviors, ABA seeks to uncover the cause of the behavior, understand the reward, then change both the behavior and reward to those that are positive and life-affirming. ABA research has shown that positive reinforcement is a greater motivator than punishment. ABA is commonly used to treat eating disorders and autism spectrum disorders.

Behavioral Activation (BA)

Behavioral Activation is a component in behavioral therapies (like CBT, DBT, and ABA) or a standalone treatment in itself. It is an evidence-based treatment for depression. Behavioral Activation encourages teens to engage in activities that are likely to produce positive emotions. depressed teens participate in pleasant activities and accomplish small tasks, both of which have been proven by research to help lift one’s mood.

Cognitive Behavioral Therapy (CBT)

CBT focuses on making connections between thoughts, feelings, and actions. CBT believes that when people identify and adjust their negative thought patterns, they end up with positive changes in feelings and behavior. When people think of therapy in general, CBT is what comes to mind: talk, think, talk more, then apply the concepts from discussion to daily behavior.

Dialectical Behavior Therapy (DBT)

DBT works to achieve five primary goals: mindfulness, distress tolerance, emotion regulation, interpersonal effectiveness, and walking the middle path. This therapy seeks to change ineffective behavior patterns into effective ones in order to help people live “lives worth living.”DBT treats issues such as intense, overwhelming emotion, all-or-nothing thinking, and impulsivity, which are common among those with self-harming or suicidal tendencies.

Motivational Interviewing (MI)

Motivational interviewing is a client-focused treatment in which the therapist explores the patient’s ambivalence to change. According to research, MI is most successful for those who are hostile or ambivalent about changing their negative behaviors. Thus, it’s perfect for those who come to rehab centers unwillingly. By asking the patient specific questions in a curious (rather than confrontational) way, the clinician helps the adolescent become more intrinsically motivated to change on their own, naturally. MI is often used to treat substance abuse.

Seeking Safety

Seeking Safety is a relatively modern evidence-based treatment modality that treats dual diagnoses of post-traumatic stress disorder and substance abuse. Rather than delving deep into the recesses and details of the trauma, the present-focused treatment asks clients to envision what safety would look like in their lives. It then teaches the patient coping skills to achieve that vision. The goal is to help patients attain all-around safety in their relationships, behavior, and emotions.

Other Therapies

Note that this is not an exhaustive list of every evidence-based treatment available. Many experiential therapies, such as yoga, music, meditation, and exercise, have been proven by research to treat mental health and other emotional or behavioral issues. However, every experiential therapy varies on a case-by-case basis.

Additionally, some treatments may not yet be classified as evidence-based simply because not enough research has been conducted on them. Other times, ongoing research yields inconsistent results, so the proof is inconclusive. While they may not currently be evidence-based, they very well may be in the future, as further studies develop.

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