Monday, July 9, 2012

Empirically Supported Treatments

Psychology is a science.  As such, a typical psychology course (i.e., learning and memory, cognitive psychology) will review the classic and contemporary empirical research relevant to the area of investigation followed by an examination of the theories spawned by that research.  There is one area of study in psychology that does not fit well with the empirical research to theory organization.  Psychotherapy.   The reason it does not fit well with a research-theory approach is due to the lack of empirical research to support many of the existing theories.  There are 54 divisions of the American Psychological Association (APA) and only three of those divisions address the central theme of psychotherapy--clinical psychology, counseling psychology, and psychoanalysis.  Unfortunately, it is psychotherapy, the least scientific sub-field of psychology, which addresses issues most relevant to a Christian psychology.  The APA is aware of this inconsistency and is attempting to remedy it by identifying empirical research that supports theories of psychotherapy.  In his Manifesto for a Science of Clinical Psychology, McFall (1991) stated, “we must make a greater effort to differentiate between scientific and pseudoscientific clinical psychology and to hasten the day when the former replaces the later” (p. 76).  In an attempt to improve the credibility of psychotherapeutic systems, Division 12 (clinical psychology) of the APA has spent the past two decades collecting research regarding what it refers to as empirically supported treatments (EST’s).  While there was early identification of research supporting a few cognitive and behavioral treatments for a handful of obscure psychological issues, within the past few years solid empirical support for both cognitive and behavioral therapies has been identified for the treatment of more mainstream issues. 

The APA website’s frequently asked questions section acknowledges that many well-known forms of psychotherapy (i.e., psychodynamic, existential, person-centered, reality, etc.) are not listed as EST’s.  This concern is specifically addressed in a report (Chambless, 1993) adopted by the Division 12 Board of the APA which states, “In light of the large number of APA members who practice psychodynamic psychotherapy, in the interest of the profession and the public, we conclude that it is crucial that more efficacy evidence on the outcome of psychodynamic therapies for specific disorders be obtained if this clinically verified treatment is to survive in today’s market” (p. 2).  A decade later, in an update (Woody et al., 2005) on EST’s, it was found that “many widely used treatments have yet to be rigorously tested” (p. 5) and that most professional programs in counseling and psychology do not include training in the current list of EST’s.  The conclusion drawn is that graduate programs in counseling and clinical psychology have a long way to go before they will accurately represent the scientific basis of the discipline of psychology (p. 11). 

The existence of empirical support, or lack thereof, for any psychological theory should be of interest  concern to Christian practitioners.  The objective data produced by empirical research provides the validity for subsequent theories.  Without supporting research, a theory is nothing more than a philosophy.  As such, Christians practicing psychotherapeutic models lacking empirical support should critically examine their approach.  Those practicing cognitive and behavioral models should review the available research in an attempt to increase their effectiveness. 

While objective, empirical data validates a theory and lessens its inherent dangers to Christian practitioners, some guidelines are necessary.  Allow me to make a few personal observations regarding the way Christians should approach psychological data.  First, the objective data produced through scientific psychological research is typically consistent with Biblical teaching, if interpreted through the lens of Scripture.  God created humans and humans are the subjects that psychology attempts to understand.  Inasmuch as Scripture specifies the nature of the relationships of interest, it will be consistent with the empirical data gleaned from psychological research.  Second, there are two forms of error that are always present in experimental scientific research.  Systematic error is a result of the imperfect methodologies and affects the accuracy of the research.  Random error is a result of the uniqueness of the subjects being studied and affects the precision of research results.  To integrate the infallible Word of God and the science of psychology, with its inherent error, is like mixing oil and vinegar; you mix them together and it won’t be long till they separate again. 

This has led us to conclude that developing a distinctly Christian psychology is preferable to an integrative approach.  Furthermore, it is reasonable to conclude that psychological research should not be used to support Scripture, though Scripture can support psychological research.  It is better to view psychological research as data that has the potential to augment our understanding of Scripture.  Third, due to varying worldviews, both the subjective interpretation of data in general psychology and the theories of psychotherapy as a whole, may or may not be consistent with Biblical teaching.  As I stated in a previous article, psychology is not an enemy of Christianity, but some psychologists are.  Finally, God’s Word is not only sufficient; it is necessary in defining the current state of a human soul and providing direction for the redefinition of that soul.  Put another way, once sin entered into the world and infected the soul of man, God did not leave us in a state of limbo for thousands of years waiting for the birth of Wilhelm Wundt or Sigmund Freud, the fathers of psychology and psychiatry respectively, to save us.          

Every man has a soul, and general psychology provides insights that may guide us as we strive to live effectively.  However, if we truly want to develop the spiritual and earthly components of our souls and become what God originally intended us to be, we must seek direction from the Creator Himself.  Jesus came, not to take the life one has or remediate the life one has but to give abundantly more life, spiritual life, life that overflows (see John 10:10).  Only God’s Word can accurately define what one is and provide what is necessary to redefine one to become what God created her or him to be.


McFall, R.M. (1991). Manifesto for a science of clinical psychology. The clinical Psychologist, 44(6), 75-88.

Chambless, D.L. (1993, October). Task force on promotion and dissemination of psychological procedures: a report adopted by the division 12 board. American Psychological Association. Retrieved from

Woody, S.R., Weisz, J., & McLean, C. (2005). Empirically supported treatments: 10 years later. The Clinical Psychologist, 58(4), 5-11.

Jay Kidwell, PhD
Professor of Psychology
Cincinnati Christian University

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