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Empirically Supported Psychological Treatments: The Challenge of Evaluating Clinical Innovations

Church, Dawson PhD*; Feinstein, David PhD; Palmer-Hoffman, Julie MA*; Stein, Phyllis K. PhD; Tranguch, Anthony MD, PhD§

The Journal of Nervous and Mental Disease: October 2014 - Volume 202 - Issue 10 - p 699–709
doi: 10.1097/NMD.0000000000000188
Review Articles

Clear and transparent standards are required to establish whether a therapeutic method is “evidence based.” Even when research demonstrates a method to be efficacious, it may not become available to patients who could benefit from it, a phenomenon known as the “translational gap.” Only 30% of therapies cross the gap, and the lag between empirical validation and clinical implementation averages 17 years. To address these problems, Division 12 of the American Psychological Association published a set of standards for “empirically supported treatments” in the mid-1990s that allows the assessment of clinical modalities. This article reviews these criteria, identifies their strengths, and discusses their impact on the translational gap, using the development of a clinical innovation called Emotional Freedom Techniques (EFT) as a case study. Twelve specific recommendations for updates of the Division 12 criteria are made based on lessons garnered from the adoption of EFT within the clinical community. These recommendations would shorten the cycle from the research setting to clinical practice, increase transparency, incorporate recent scientific advances, and enhance the capacity for succinct comparisons among treatments.

*National Institute for Integrative Healthcare, Fulton, CA; †Innersource, Ashland, OR; ‡Washington University School of Medicine, St Louis, MO; and §Columbia University College of Physicians and Surgeons, New York, NY.

Send reprint requests to Dawson Church, PhD, National Institute for Integrative Healthcare, 3340 Fulton RD #442, Fulton, CA 95439. E-mail:

© 2014 by Lippincott Williams & Wilkins