Based on previous discussions regarding the evolution of psychology “as a science,” it is not surprising that much attention has been devoted to defining and comparing therapeutic interventions using an empirical approach. As in any field, developing, evaluating and optimizing therapeutic interventions is crucial not only in improving patient/client care, but in providing valuable insight regarding the causes, underlying mechanisms, pathological features, etc. of the condition in question. Given that the objective is to provide the highest quality of care, it seems valid to employ treatment strategies that are supported by evidence. According to Hunsley, evidence based practice as it relates to psychotherapy has received quite a bit of attention over the past couple of decades. While it can certainly be argued that evidence based practice is highly desirable in this context, it may be difficult to implement routinely, especially for persons with psychological conditions, where symptoms, responses to treatment, and definitions of improvement can be so variable and unpredictable.
Thus, it can be suggested that developing and evaluating outcome measures to determine clinical efficacy of new treatments in clinical trials, to monitor progress in clinical practice, and to modify treatment strategies could be the egg to the therapy’s [dream] chicken, or vice versa, if that makes any sense. Further, how can we decide which treatment is better if we do not know how to define “better?” How do we know if the treatment treats the problem, if more than one problem exist?