Creativity Within the Structure: Clinical Expertise and Evidence-Based Treatments
The emergence of EBT expanded the landscape of good psychotherapy to include clinically relevant science, specificity of clinical process based on comprehensive conceptual/theoretical principles, and the ability to systematically apply and adapt those principles within the complex relational context, in which all family therapy occurs. Yet, EBT has sparked a major debate in the field that is also represented in the discussion regarding clinical expertise. Many of the “either—or” discussions that surround EBT appear in the discussion of clinical expertise. The manuscripts in this issue also illustrate the diversity of perspective, lack of clarity, and even reluctance to integrate EBT and clinical expertise that exists in the field. In this paper we suggest that EBT provide a unique opportunity to bring together the best of clinical intervention science, professional knowledge, and clinical experience and translate them into the most effective systematic approach to helping clients. Using Functional Family Therapy (FFT) as an example, we illustrate how the EBT model provides the very scaffolding that allows for the emergence of clinical expertise.
KeywordsClinical expertise Family therapy Creativity
- Chi, M. T., Glaser, R., & Farr, M. J. (Eds.). (1988). The nature of expertise. Hillsdale, NJ: Erlbaum.Google Scholar
- Dawes, R. M. (1994). House of cards: Psychology and psychotherapy built on myth. New York: Free Press.Google Scholar
- Institute of Medicine. (2001). Crossing the quality chasm: A new health system for the 21 st century. Washington, DC: National Academy Press.Google Scholar
- Overholser, J. C. (2009). Clinical expertise: A preliminary attempt to clarify its core elements. Journal of Contemporary Psychotherapy. doi: 10.1007/s10879-009-9129-1.
- Rector, N. A., & Cassin, S. E. (2010). Clinical expertise in cognitive behavioural therapy: Definition and pathways to acquisition. Journal of Contemporary Psychotherapy. doi: 10.1007/s10879-010-9136-2.
- Roth, A. D., Fonagy, P., & Parry, G. (1996). Psychotherapy research, funding and evidence based practice. In A. D. Roth & P. Fonagy (Eds.), What works for whom? A critical review of psychotherapy research. New York: Guilford.Google Scholar
- Roth, A. D., & Pilling, S. (2007). The competencies required to deliver effective cognitive and behavioral therapy for people with depression and anxiety disorders. London: Department of Health.Google Scholar
- Sexton, T. L. (2009a). Functional family therapy: Traditional theory to evidence-based practice. In J. Bray & M. Stanton (Eds.), Handbook of family therapy. Washington, DC: American Psychological Association Press.Google Scholar
- Sexton, T. L. (2010, in press). Functional family therapy in clinical practice. New York, NY: Brunner Routledge.Google Scholar
- Sexton, T. L., & Alexander, J. F. (2002). Functional family therapy: An empirically supported, family-based intervention model for at-risk adolescents and their families. In F. W. Kaslow (Ed.), Comprehensive handbook of psychotherapy, Volume II: Cognitive-behavioral approaches (pp. 117–140). New York: Wiley.Google Scholar
- Sexton, T. L., & Alexander, J. F. (2004). Functional family therapy clinical training manual. Baltimore: Annie E. Casey Foundation.Google Scholar
- Sexton, T. L., & Alexander, J. F. (2006). Functional family therapy for externalizing disorders in adolescents. In J. Lebow (Ed.), Handbook of clinical family therapy (pp. 164–194). Hoboken, NJ: Wiley.Google Scholar
- Sexton, T. L., Alexander, J. F., & Gilman, L. (2004). Functional family therapy: clinical supervision training manual. Baltimore: Annie E. Casey Foundation.Google Scholar
- Sexton, T. L., Alexander, J. F., & Mease, A. L. (2003). Levels of evidence for the models and mechanisms of therapeutic change in couple and family therapy. In M. Lambert (Ed.), Handbook of psychotherapy and behavior change. New York: Wiley.Google Scholar
- Sexton, T. L., & Kelly, S, D. (in press). Finding the common core: Evidence-based practices, clinically relevant evidence, and core mechanisms of change. Administration and Policy in Mental Health and Mental Health Services Research. Google Scholar
- Sexton, T. L., & Turner, C. T. (in press). The effectiveness of functional family therapy for youth with behavioral problems in a community practice setting. Journal of Family Psychology.Google Scholar
- Shaw, B. F. (1984). Specification of the training and evaluation of cognitive therapists for outcome studies. In J. Williams & R. Spitzer (Eds.), Psychotherapy research: Where are we and where should we go? (pp. 173–189). New York: Guildford Press.Google Scholar