Team and Projects

1. Ongoing Project: Evidence-Based Assessment and Psychotherapy: Outcome, Theory of Change, and Cost-Effectiveness. Ministry of Education and Research -Research of Excellence Program-(2006-2008)

Director:Dr. Daniel DAVID

Team-Postdoctoral Fellows:

Brief Description of the Ongoing Project:

Evidence-based medicine (EBM) is the integration of best research evidence, based on controlled clinical studies, with clinical expertise and patient values. When these three elements are integrated, clinicians and patients form a diagnostic and therapeutic alliance, which optimizes clinical outcomes and the quality of life. The number of articles on evidence-based practice has grown exponentially (from one publication in 1992 to about a thousand in 1998) and international interest has led to the development of six evidence-based journals (published in up to six languages) that summarize the most relevant studies for clinical practice and have a combined worldwide circulation of over 175,000 (CEBM, 2003).

Following the model of evidence-based medicine, at the request of the American Psychological Association (APA), the Task Force on Psychological Interventions has engaged in an on-going endeavor of reviewing the psychological treatment literature in search for psychosocial interventions that meet the criteria for evidence-based psychotherapy (i.e., empirically validated treatments), namely that prove to be efficient (i.e., they work in controlled conditions) and/or efficacious (i.e., they work in real life clinical settings) in randomized clinical trials or other types of clinical controlled studies. This task is far from being completed, and we expect the Task Force to continue issuing annual reports in the foreseeable future. The Task Force will publish a series of papers in special issues of the clinical journals regarding the development of this project. Of course, the list of the evidence-based treatments will be updated as new treatments are empirically evaluated (APA, 2003).

We are concerned that, compared to the USA, there is little contribution of the European research to the evidence-based psychotherapy movement (except the UK research). However, in a special issue of the Journal of Clinical Psychology, we (David, 2004) criticize the American Psychological Association’s concept of evidence-based psychotherapy. Thus, the American Psychological Association promotes the idea that an evidence-based psychotherapy is defined primarily by its efficient and/or efficacious techniques while ignoring the hypothesized theory of change. Although a good start in order to establish a scientific clinical practice, on the long run, if not improved, this is a potential harmful approach for the evidence-based psychotherapy movement (David, 2004). For example, although a treatment package can prove to be generally an efficient and/or efficacious intervention in various clinical trials, its hypothesized theory of change can be less validated; moreover, the treatment package may not be cost-effective and thus, it is less probable to be implemented in real clinical practice! Consequently, although clinicians are aware of the heuristic value of the concept of evidence-based psychotherapy, some of them compare this concept, in its current form promoted by the American Psychological Association, to classical mesmerism and even pseudoscience (e.g., McNally, 1999).

In a special issue of the Journal of Clinical Psychology, we suggest (David, 2004) that evidence-based psychotherapy should be primarily defined by both validated techniques (efficacy and/or effectiveness) and their corresponding theories of change; additionally, cost-effectiveness analyses should be employed to explore the potential implementation of an evidence-based psychotherapy in real clinical settings. This would be the only way of having a scientific component to both aspects of a psychotherapeutic system (techniques and their theories), expressed in – principles and guidelines of evidence-based practice – and a realistic estimate of its costs, which is fundamental in the era of managed care companies. Only by incorporating these new criteria we can seriously call a psychotherapeutic system, an implemental system of evidence-based psychotherapy (David, 2004).

Finding and disseminating such Principles and Guidelines of Evidence-Based Psychological Practice is the main objective of this project of the International Institute.

2. 2008-2009: Mechanism of change in the psychotherapy of affective disorders. Dr. Aurora Szentagotai.

3. 2009-2010: Personality disorders: Evidence-based assessment and interventions. Dr. Camelia Dindelegan.

For more information contact Dr. Daniel David at: Email: and/or visit the Department of Clinical Psychology and Psychotherapy at

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