In a provocative discussion of evidence-based psychological practices (EBPPs), Mozdzierz, Peluso, and Lisiecki (2011) posit that the question for mental health practitioners is not can EBPPs be used, but under what circumstances and how should they be applied. Moreover, the authors suggest that in addition to the current empirical focus on EBPPs, other areas remain ripe for investigation, such as the factors that contribute to clinical expertise, what distinguishes clinical experts from non-expert practitioners, mechanisms of change and how to trigger such mechanisms, and how therapy works.

According to Mozdzierz et al., before EBPPs can or should be implemented, therapists must first connect and engage clients. With this in mind, the authors recommend that training programs emphasize the development of both linear (e.g., assessment of client’s potential for violence, diagnosis) and non-linear (e.g., multidimensional empathy, the varied ways in which therapists connect and engage with different clients) thinking in developing therapist-practitioners. Additionally, the authors clearly illustrate the differences between linear and nonlinear skills required at all stages of the therapeutic process, from diagnosis to evaluating outcome.

Mozdzierz et al. suggest that in addition to teaching specific techniques and microskills (i.e., linear skills), therapist training should impart an appreciation for the power of being authentic with another human being in the context of a professional relationship (i.e., nonlinear skills). Finally, the authors strongly recommend that therapists monitor the client experience of treatment effectiveness and the therapeutic alliance on an ongoing basis. Mozdzierz et al. are not suggesting that the trend toward EBPPs should be abandoned. Instead, their article serves as a reminder that counseling and psychotherapy remain “imperfect mixtures of science and art.” They conclude by stating that the evolution of EBPPs warrants those training psychologists to consider the value of human encounter and nonlinear thinking in producing therapists capable of using evidence-based interventions and knowing how and when to use them.

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David Phelps