Evidence-Based Practices and Cultural Responsiveness

  • Robert Allan
Part of the Focused Issues in Family Therapy book series (FIFT)


This chapter will provide a review of the guidelines for evidence-based practices (EBP) and some of the strengths and challenges associated with the EBP project. EBPs have become a part of the research and clinical landscape for couple and family therapists. Developing evidence-based practices is seen as a natural progression of our field, a maturing of sorts from anecdotal clinical reports to conceptual and methodological sophistication of couple and family therapy research and clinical practices. The challenges associated with integrating science into the practice of therapy through EBPs have always been controversial, resulting in frequent, passionate, and at times divisive debates in the field. While the EBP guidelines established by Division 43 of the American Psychological Association reference “contextual efficacy” at the third and most advanced level for determining an EBP, little is known about how this translates to cultural responsiveness. This chapter will first clarify what the current guidelines are and explore how the fields of couple and family research have explored culture.


Evidence-based practice Couple therapy Marriage therapy Family therapy Cultural responsiveness 


  1. Alegrıa, M., & McGuire, T. (2003). Rethinking a universal framework in the psychiatric symptom–disorder relationship. Journal of Health and Social Behavior, 44, 257–274. CrossRefPubMedGoogle Scholar
  2. Alexander, J. F., Sexton, T. L., & Robbins, M. S. (2000). The developmental status of family therapy in family psychology intervention science. In H. A. Liddle, D. A. Santisteban, R. F. Levant, & J. H. Bray (Eds.), Family psychology intervention science (pp. 17–40). Washington, DC: American Psychological Association.Google Scholar
  3. Allan, R., & Johnson, S. M. (2016). Conceptual and application issues: Emotionally focused therapy with gay male couples. Journal of Couple & Relationship Therapy ., (Online first).
  4. Allan, R., & Ungar, M. (2014). Developing a measure of fidelity for an ecological approach to family therapy. Journal of Family Psychotherapy, 25(1), 1–16. CrossRefGoogle Scholar
  5. American Psychological Association. (1995). Task Force on Promotion and Dissemination of Psychological Procedures, Division of Clinical Psychology, Training in and dissemination of empirically-validated psychological treatments: Report and recommendations. The Clinical Psychologist, 48, 3–23.Google Scholar
  6. American Psychological Association, Division 44/Committee on Lesbian, Gay, and Bisexual Concerns Joint Task Force on Guidelines for Psychotherapy with Lesbian, Gay, and Bisexual Clients. (2012). Guidelines for psychological practice with lesbian, gay, and bisexual clients. American Psychologist, 67(1), 10–42. CrossRefGoogle Scholar
  7. Baker, C. N., Arnold, D. H., & Meagher, S. (2011). Enrollment and attendance in a parent training prevention program for conduct problems. Prevention Science, 12, 126–138. CrossRefPubMedGoogle Scholar
  8. Barrera, M., Castro, F. G., Strycker, L. A., & Toobert, D. J. (2013). Cultural adaptations of behavioral health interventions: A progress report. Journal of Consulting and Clinical Psychology, 81, 196–205. CrossRefPubMedGoogle Scholar
  9. Bernal, G., Jiménez-Chafey, M. I., & Domenech Rodríguez, M. M. (2009). Cultural adaptation of treatments: A resource for considering culture in evidence-based practice. Professional Psychology: Research and Practice, 40, 361–368. CrossRefGoogle Scholar
  10. Burke, K. (1954). Permanence & change: An anatomy of purpose. Los Altos, CA: Hermes Publications.Google Scholar
  11. Canino, G., & Alegria, M. (2008). Psychiatric diagnosis—Is it universal or relative to culture? Journal of Child Psychology and Psychiatry, 49, 237–250. CrossRefPubMedPubMedCentralGoogle Scholar
  12. Carlson, T. S., McGeorge, C. R., & Toomey, R. B. (2013). Establishing the validity of the affirmative training inventory: Assessing the relationship between lesbian, gay, and bisexual affirmative training and students’ clinical competence. Journal of Marital and Family Therapy, 39(2), 209–222. CrossRefGoogle Scholar
  13. Castro, F. G., Barrera, M., & Holleran Steiker, L. K. (2010). Issues and challenges in the design of culturally adapted evidence-based interventions. Annual Review of Clinical Psychology, 6, 213–239. CrossRefPubMedPubMedCentralGoogle Scholar
  14. Chambless, D. L., Sanderson, W. C., Shoham, V., Bennett Johnson, S., Pope, K. S., Crits-Christoph, P., … McCurry, S. (1996). An update on empirically validated therapies. Unpublished manuscript retrieved from
  15. Clark, W. M., & Serovich, J. M. (1997). Twenty years and still in the dark? Content analysis of articles pertaining to gay, lesbian, and bisexual issues in marriage and family therapy journals. Journal of Marital and Family Therapy, 23(3), 239–253. CrossRefPubMedGoogle Scholar
  16. Comas-Dıaz, L. (2006). Latino healing: The integration of ethnic psychology into psychotherapy. Psychotherapy: Theory, Research, Practice, Training, (4), 436–453.
  17. Coulter, S. (2011). Systemic family therapy for families who have experienced trauma: A randomised controlled trial. British Journal of Social Work, 41(3), 502–519. CrossRefGoogle Scholar
  18. Elliott, R. (1998). Editor’s introduction: A guide to the empirically supported treatments controversy. Psychotherapy Research, 8(2), 115–125. CrossRefGoogle Scholar
  19. Gambrill, E. (2010). Evidence-informed practice: Antidote to propaganda in the helping professions? Research on Social Work Practice, 20(3), 302–320. CrossRefGoogle Scholar
  20. Gilgun, J. (2005). Evidence-based practice, descriptive research and the resilience-schema-gender-brain functioning (RSGB) assessment. British Journal of Social Work, 35(6), 843–862. CrossRefGoogle Scholar
  21. Griner, D., & Smith, T. B. (2006). Culturally adapted mental health intervention: A meta-analytic review. Psychotherapy: Theory, Research, Practice, Training, 43, 531–548. CrossRefGoogle Scholar
  22. Hammersley, M. (2004). Some questions about evidence-based practice in education. In G. Thomas & R. Pring (Eds.), Evidence-based practice in education (pp. 133–149). New York, NY: Open University Press.Google Scholar
  23. Henke, T., Carlson, T. S., & McGeorge, C. R. (2009). Homophobia and clinical competency: An exploration of couple and family therapists’ beliefs. Journal of Couple and Relationship Therapy, 8(4), 325–342. CrossRefGoogle Scholar
  24. Henry, W. (1998). Science, politics, and the politics of science: The use and misuse of empirically validated treatment research. Psychotherapy Research, 8(2), 126–140. CrossRefGoogle Scholar
  25. Holmes, D., Murray, S. J., Perron, A., & Rail, G. (2006). Deconstructing the evidence-based discourse in health sciences: Truth, power and fascism. International Journal of Evidence-Based Healthcare, 4(3), 180–186. PubMedGoogle Scholar
  26. Laska, K. M., Gurman, A. S., & Wampold, B. E. (2013). Expanding the lens of evidence-based practice in psychotherapy: A common factors perspective. Psychotherapy, 51(4), 467–481. CrossRefPubMedGoogle Scholar
  27. Malterud, K. (2001). The art and science of clinical knowledge: Evidence beyond measures and numbers. Lancet, 358(9279), 397–400. CrossRefPubMedGoogle Scholar
  28. McKleroy, V. S., Galbraith, J. S., Cummings, B., Jones, P., Harshbarger, C., Collins, C., … Carey, J. W. (2006). Adapting evidence-based behavioral interventions for new settings and target populations. AIDS Education and Prevention, 18(4 Suppl. A), 59–73. CrossRefPubMedGoogle Scholar
  29. Meyer, I. H. (2013). Prejudice, social stress, and mental health in lesbian, gay, and bisexual populations: Conceptual issues and research evidence. Psychology of Sexual Orientation and Gender Diversity, 1(S), 3–26. CrossRefGoogle Scholar
  30. Midgley, N. (2009). Editorial: Improvers, adapters and rejecters the link between ‘evidence-based practice’ and ‘evidence-based practitioners’. Clinical Child Psychology and Psychiatry, 14(3), 323–327. CrossRefPubMedGoogle Scholar
  31. Morago, P. (2006). Evidenced-based practice: From medicine to social work. European Journal of Social Work, 9(4), 461–477. CrossRefGoogle Scholar
  32. Persons, J. B., & Silberschatz, G. (1998). Are results of randomized controlled trials useful to psychotherapists? Journal of Consulting and Clinical Psychology, 66(1), 126–135. CrossRefPubMedGoogle Scholar
  33. Plath, D. (2006). Evidenced-based practice: Current issues and future directions. Australian Social Work, 59(1), 56–72. CrossRefGoogle Scholar
  34. Ratts, M. J., Singh, A. A., Nassar-McMillan, S., Butler, S. K., & McCullough, J. R. (2015). Multicultural and social justice counseling competencies. Retrieved from
  35. Rock, M., Carlson, T. S., & McGeorge, C. R. (2010). Does affirmative training matter? Assessing CFT students’ beliefs about sexual orientation and their level of affirmative training. Journal of Marital and Family Therapy, 36(2), 171–184. CrossRefPubMedGoogle Scholar
  36. Ryder, A. G., Ban, L. M., & Chentsova-Dutton, Y. E. (2011). Towards a cultural-clinical psychology. Social and Personality Psychology Compass, 5(12), 960–975. CrossRefGoogle Scholar
  37. Schoenwald, S. K., & Hoagwood, K. (2001). Effectiveness, transportability, and dissemination of interventions: What matters when? Psychiatric Services, 52(9), 1190–1197. CrossRefPubMedGoogle Scholar
  38. Seedall, R. B., Holtrop, K., & Parra-Cardona, J. R. (2014). Diversity, social justice, and intersectionality trends in C/MFT: A content analysis of three family therapy journals, 2004–2011. Journal of Marital and Family Therapy, 40(2), 139–151. CrossRefPubMedGoogle Scholar
  39. Seligman, M. E. (1996). Science as an ally of practice. American Psychologist, 51(10), 1072–1079. CrossRefPubMedGoogle Scholar
  40. Seligman, M. E. P. (1995). The effectiveness of psychotherapy: The consumer reports study. American Psychologist, 50, 965–974. CrossRefPubMedGoogle Scholar
  41. Sexton, T., Gordon, K. C., Gurman, A., Lebow, J., Holtzworth-Munroe, A., & Johnson, S. (2011). Guidelines for classifying evidence-based treatments in couple and family therapy. Family Process, 50(3), 377–392. CrossRefPubMedGoogle Scholar
  42. Sexton, T. L., & Alexander, J. F. (2002). Family-based empirically supported intervention programs. The Counseling Psychologist, 30(2), 238–261. CrossRefGoogle Scholar
  43. Slife, B. D., Wiggins, B. J., & Graham, J. T. (2005). Avoiding an EST monopoly: Toward a pluralism of philosophies and methods. Journal of Contemporary Psychotherapy, 35, 83–97. CrossRefGoogle Scholar
  44. Smith, T., Domenech Rodrıguez, M. M., & Bernal, G. (2011). Culture. Journal of Clinical Psychology, 67, 166–175. CrossRefPubMedGoogle Scholar
  45. Sprenkle, D. H. (2012). Intervention research in couple and family therapy: A methodological and substantive review and an introduction to the special issue. Journal of Marital & Family Therapy, 38(1), 3–29. CrossRefGoogle Scholar
  46. Sprenkle, D. H., Davis, S. D., & Lebow, J. (2009). Common factors in couple and family therapy: The overlooked foundation for effective practice. New York, NY: Guilford Press.Google Scholar
  47. Staller, K. M. (2006). Railroads, runaways, & researchers: Returning evidence rhetoric to its practice base. Qualitative Inquiry, 12(3), 503–522. CrossRefGoogle Scholar
  48. Substance Abuse and Mental Health Services Administration. (2015). Racial/ethnic differences in mental health service use among adults. HHS publication no. SMA-15-4906. Rockville, MD: Substance Abuse and Mental Health Services Administration.Google Scholar
  49. Wendt, D., Jr. (2006). The unevaluated framework of APA’s policy on evidence-based practice in psychology (EBPP). The New School Psychology Bulletin, 4(1), 89–99.Google Scholar

Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  1. 1.University of Colorado DenverDenverUSA

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