What the heck is evidence-based and why is it in every therapist's bio?

If you've ever looked for a therapist before, you might notice the term "evidence-based" popping up in almost every single bio. It usually looks something like: "I practice evidence-based therapies like CBT, ACT, EMDR, or DBT." But what does this actually mean?

A lot of people think evidence-based practice is JUST the specific type of therapy and whether it's effective. But there are actually many different types of therapy that are evidence-based, so it is not just what tool is used, but how it is used.

A therapist who actually uses evidence-based practice is mixing three things together: the best available research, their own clinical expertise, your personal preferences, culture, and unique characteristics.

The Three-Legged Stool

A really great way to understand this is by picturing a three-legged stool. If you take away any of the legs, the stool falls over. To get truly evidence-based care, you need all three:

Leg 1: The Best Available Scientific Evidence

An evidence-based therapist will use types of therapy that have been highly studied and have stood the test of time. They will look to trusted scientific groups, like the APA Division 12, NICE guidelines, APA clinical practice guidelines, or The Cochrane Library, for guidance and updates on what methods are working, for what, and when.

Interestingly enough, this isn't always just about the specific type of therapy. It is also about incorporating what the latest and most robust research says about what makes therapy effective in general.

The Dodo Bird Effect: In psychotherapy research, there is a famous concept called the Dodo Bird Effect. It is named after the Dodo bird in Alice in Wonderland who declared, "Everybody has won, and all must have prizes." Believe it or not, the research shows there actually isn't much of a difference between different types of therapy and how well they work! Instead, it is the similar factors shared across all therapies that account for the biggest amount of change in your therapy.

An evidence-based therapist will intentionally incorporate these proven, shared factors. For example, they will do a really good job of developing and maintaining a strong therapeutic alliance, because research shows that this component is the largest contributor to making meaningful change in therapy.

At the same time, even with the Dodo Bird Effect, certain therapies can be harmful in specific situations. An evidence-based therapist will know exactly when a certain type of therapy should not be used.

Leg 2: The Values and Preferences of the Client

Evidence-based therapy is completely adapted to you! Your preferences and contributions to this process are extremely important. A good therapist will truly hear you and work with you to adapt different therapies to your life, building a tailored strategy for change.

Leg 3: The Provider’s Clinical Experience

This leg is all about the therapist's ability to blend Leg 1 and Leg 2 together. It is how a therapist makes decisions and adapts treatments in the moment. It is their ability to look at the big picture and move evidence out of a research lab and into the real world with you.

What This Means for You

If you are currently in the process of finding a therapist and you're reading through all their bios trying to find the best fit for you, now you know exactly what you should expect when a therapist says they are evidence-based!

You aren't just getting a rigid textbook script. You are getting a therapist who balances the latest science with your unique voice and their clinical experience to give you the best care possible.

References

1. Sackett, D. L., Straus, S. E., Richardson, W. S., Rosenberg, W., & Haynes, R. B. (2000). Evidence-based medicine: How to practice and teach EBM (2nd ed.). Churchill Livingstone. (This is the foundational text introducing the three-legged stool model of evidence-based practice).
2. Luborsky, L., Singer, B., & Luborsky, L. (1975). Comparative studies of psychotherapies: Is it true that "everyone has won and all must have prizes"? Archives of General Psychiatry, 32(8), 995-1008. (The classic study detailing the "Dodo Bird Effect" and the importance of common factors in psychotherapy).
3. American Psychological Association Presidential Task Force on Evidence-Based Practice. (2006). Evidence-based practice in psychology. American Psychologist, 61(4), 271–285. (The official APA definition confirming that evidence-based practice must integrate research, clinical expertise, and client characteristics).
4. Wampold, B. E. (2015). How important are the common factors in psychotherapy? An update. World Psychiatry, 14(3), 270-277. (Further research demonstrating that shared therapeutic elements, like the alliance, heavily outweigh specific technical models).