Psychological Treatments

The American Psychological Association (APA) has identified “best research evidence” as a major component of evidence-based practice (APA Presidential Task Force on Evidence-Based Practice, 2006). This resource contains a list of psychological treatments with published evidence of efficacy as determined by a review of criteria established by the Society of Clinical Psychology (SCP). The information provided in this list is intended to be combined with clinician expertise and patient values and preferences for determining the optimum approach for treating a patient’s psychological condition. The information is presented so as to a wide audience, including the general public, clinicians, educators, researchers, and students.

There are two versions of criteria reflected in this list. The first set of criteria was established by Chambless & Hollon (1998) and deem the evidence for a treatment as strong, modest, or controversial based on a systematic review of published randomized controlled trials (RCTs) or their logical equivalents. The second and current set of criteria was established by Tolin et al. (2015) and deem the evidence for a treatment as very strong, strong, weak, or having insufficient evidence based on a systematic review of published meta-analyses of RCTs. The purpose of the revised criteria was to bridge the gap between the Chambless & Hollon Criteria, developed two decades earlier, and the development of the APA evidence-based treatment guidelines underway.

Some of the psychological treatments on the list have been updated with the current Tolin et al. criteria, whereas others await evaluation and are rated based on the Chambless & Hollon Criteria. Because updating the list with the current criteria will take time, the professional community is invited to submit proposals for updating a specific treatment by applying standardized methods established by the SCP Committee on Science and Practice. Those interested should refer to the SCP’s Manual for the Evaluation of Psychological Treatments Using the Tolin Criteria.

SCP has been at the forefront of identifying and disseminating empirically-supported psychological treatments. Both the previous “Chambless” criteria and newer “Tolin” criteria were developed specifically to evaluate psychological treatments and thus are not appropriate for interventions that fall outside of this scope. However, until 2023, neither set of criteria operationally defined a psychological treatment; rather, eligibility for evaluation using these criteria was implied. The absence of a clear definition raised the potential for non-psychological practices (e.g., pharmacology, exercise, brain stimulation) and pseudoscientific practices that defy science to invade the system and receive equal consideration as practices grounded in psychological principles. Of note, both non-psychological and non-scientific approaches may show statistically significant effects in randomized controlled trials relative to a comparison condition but for reasons not based on psychological principles. To address this issue, the SCP Board of Directors convened an expert task force charged with establishing an operational definition of psychological treatment. The process was rigorous and involved a literature review, several task force meetings, and a 30-day period of public commentary on the proposed definition by SCP members followed by revision and finalization. The task force concluded with the following operational definition:

A psychological treatment is an intervention consisting of specific actions between a person or persons and a mental health professional or designee, with the intent of engaging cognitive, emotional, behavioral, or interpersonal processes, in the service of modifying health or functional outcomes, and whose core assumptions about its procedures and mechanisms of change are founded in psychological science and consistent with scientific understanding.

An intervention consisting of specific actions: Here, psychological treatment is characterized, in part, as specific, planned actions. This characterization helps differentiate psychological treatment from the broader practice of psychotherapy.

between a person or persons and a mental health professional or designee: There may be one or many recipients of a psychological treatment, such as in individual, couples, family, or group treatment. The definition does not require that the person delivering the treatment be a psychologist, nor is it assumed that if a psychologist is delivering the treatment it must therefore be psychological. It is acknowledged that in some jurisdictions the term “psychological” is reserved for the actions of psychologists, and that practice is not emulated here. In addition, a mental health professional might designate another individual to carry out the intervention, such as when laypersons are trained to deliver specific treatments. The change in provider from (for example) a psychologist to a trained layperson does not mean that the treatment is no longer psychological. Completely self-administered treatments, such as bibliotherapy, however, do not meet this criterion. The definition implies evaluating the process and outcome of the treatment and adjusting the treatment accordingly, which is not possible in many self-administered treatments such as bibliotherapy. While there is a developing realm of treatment delivered by computer programs, future SCP efforts might involve convening a separate working group to determine whether such computer programs should be considered a “designee.”

with the intent of engaging cognitive, emotional, behavioral, or interpersonal processes: This speaks to the issue of treatment mechanisms (not outcomes). Specifically, psychological treatments are posited to engage psychological processes. This differentiates psychological from (for example) medical treatments, which might strive to address the same outcomes, but via different (non-psychological) mechanisms.

in the service of modifying health or functional outcomes: This is the desired outcome (not mechanism). Although many of these health outcomes will be related to mental health conditions, the definition leaves room for psychological treatments that affect physical health, marital satisfaction, social functioning, and other outcomes.

and whose core assumptions about its procedures and mechanisms of change are founded in psychological science: Not all psychological treatments will be empirically derived or empirically supported, but the core assumptions about how the treatment works must be based on the science of psychology.

and consistent with scientific understanding: A psychological treatment cannot violate known scientific principles, either those from the science of psychology or those from other branches of science such as biology, chemistry, or physics.

Readers who wish to read more are encouraged to revisit this page for a link to a forthcoming article prepared by members of the task force that is currently under review.

The current list of evaluated psychological treatments does not include all treatments that are empirically supported. Many of the treatments on this list have been evaluated according to the Chambless & Hollon (1998) criteria. Because the committee is a volunteer only board, the committee has not historically had the person power or funding to regularly revise existing ratings. As a result, some treatments were reviewed years ago, and a current rating of “modest” or “weak” may not reflect more recent research.

In addition, there are some treatments that have been developed with strong evidentiary support that are not on this list. If a treatment is not on this list, it does not necessarily mean that the treatment lacks evidence. A lack of treatments on this site specific to a diagnosis does not necessarily mean that there are no evidence-based treatments. It may simply be that the treatment has not yet been reviewed by the committee. If you are a psychological researcher interested in helping to evaluate a psychological treatment (i.e., one that satisfies the aforementioned definition) for consideration on this list, please read about the process here.

Previous Criteria (Chambless & Hollon, 1998)

STRONG: Criteria are met for what Chambless & Hollon (1998) termed “well-established” such that well-designed studies conducted by independent investigators converge to support a treatment’s efficacy. It is possible for this threshold to be met through a series of carefully controlled single-case studies.

MODEST: Criteria are met for what Chambless & Hollon (1998) termed “probably efficacious treatments” such that one well-designed study or two or more adequately designed studies support a treatment’s efficacy. It is possible for this threshold to be met through a series of carefully controlled single-case studies.

CONTROVERSIAL: Studies of a given treatment yield conflicting results or if a treatment is efficacious but claims about why the treatment works are at odds with the research evidence.

Current Criteria (Tolin et al., 2015)

VERY STRONG: High quality evidence that treatment improves symptoms and functional outcomes at post-treatment and follow-up; little risk of harm; requires reasonable amount of resources; effective in non-research settings

STRONG: Moderate to high quality evidence that treatment improves symptoms or functional outcomes; not a high risk of harm; reasonable use of resources

WEAK: Low or very low quality evidence that treatment produces clinically meaningful effects on symptoms or functional outcomes, gains from the treatment may not warrant resources involved

INSUFFICIENT EVIDENCE: No meta-analytic study could be identified or existing meta-analyses are not of sufficient quality .

This website is for informational and educational purposes. It does not represent the official policy of Division 12 or the American Psychological Association, nor does it render individual professional advice or endorse any particular treatment. We recommend a consultation with a mental health professional for an accurate diagnosis and discussion of various treatment options. When you meet with a professional, be sure to work together to establish clear treatment goals and to monitor progress toward those goals. Feel free to print information from this website and take it with you to discuss your treatment plan with your therapist. Even treatments that have scientific support will not work for everyone, and carefully monitoring your progress will help you and your therapist decide when it is time to try a different approach.