Why empirically supported psychological treatments are important.
Use interventions on the EST/EBP list and keep data visible—payers already require it.
01Research in Context
What this study did
Sanderson (2003) wrote a think-piece, not an experiment. The author looked at trends in psychology and predicted that payers and licensing boards would soon demand proof for every treatment.
The paper warned clinicians to drop habit-based methods and switch to interventions on the Empirically Supported Treatments (EST) list before rules changed.
What they found
The forecast was correct. Insurance, schools, and state boards now ask for data showing a method works.
Clinicians who stayed with old routines risk denial of payment or ethical complaints.
How this fits with other research
Contreras et al. (2022) updated the message for ABA. They replaced the general EST list with the field’s own Evidence-Based Practice (EBP) triangle: best data, client values, and clinical skill.
Tassé et al. (2013) showed the gap Sanderson (2003) worried about. A survey of rural Wyoming therapists found most said they used CBT for anxiety, yet few did exposure—the part that actually has evidence.
Vivanti et al. (2025) explained why the gap persists. Even when autism ESTs are strong, policy misalignment blocks use; clinicians must lobby for billing codes and guidelines, not just master techniques.
Why it matters
You now work under the rules Sanderson (2003) predicted. Pick goals tied to EST or EBP manuals, graph progress, and keep the graphs ready for audits. If you supervise, require the same from trainees.
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02At a glance
03Original abstract
The emergence of managed care and similar reimbursement systems that require greater accountability and the development of clinical practice guidelines have increased the importance of evidence-based clinical practice. As a result of these two trends, it appears as though the future of psychotherapy will require clinicians to deliver a psychological intervention that is supported by research. Such treatments exist for a variety of the most common presenting problems (e.g., anxiety disorders, depression) but to date have frequently gone unrecognized and underutilized. The current article will discuss the importance of identifying, promoting, and disseminating empirically supported therapies with an emphasis on the efforts of the American Psychological Association Society of Clinical Psychology's Committee on Science and Practice.
Behavior modification, 2003 · doi:10.1177/0145445503027003002