Empirically supported psychological treatments: the challenge of evaluating clinical innovations

J Nerv Ment Dis. 2014 Oct;202(10):699-709. doi: 10.1097/NMD.0000000000000188.


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.

MeSH terms

  • Acupressure / standards
  • Adult
  • Cognitive Behavioral Therapy / standards
  • Combined Modality Therapy / standards
  • Evaluation Studies as Topic
  • Evidence-Based Practice / standards*
  • Humans
  • Implosive Therapy / standards
  • Meta-Analysis as Topic
  • Outcome Assessment, Health Care / methods
  • Outcome Assessment, Health Care / standards*
  • Practice Guidelines as Topic / standards*
  • Psychotherapy / standards*
  • Societies, Scientific / standards
  • Stress Disorders, Post-Traumatic / therapy
  • United States
  • Veterans / legislation & jurisprudence
  • Veterans / psychology