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Emphasis on the importance of identifying evidence-based practices increased markedly after publication of a 1995 APA Task Force white paper. The APA call to action resulted in lengthy lists of therapies that have been reported to be effective. This body of research has been the rationale and justification for proposals to change how psychotherapy training programs in psychology are evaluated and accredited, professional competence is assessed, licensure granted, and reimbursement policies are structured. Given the potentially restrictive proposals set forth on the basis of lists of “empirically validated therapies,” this paper describes methodological issues that should temper enthusiasm for adoption of training and certification restrictions based on this body of research. Several of these issues stem from a form of “circularity” inherent in design requirements of randomized control psychotherapy outcome studies. In effect, these requirements constrain the manner in which the psychological problems are defined, psychotherapy is practiced, and change is evaluated. Adoption of policies based on lists of empirically supported therapies will not legitimize the science of psychotherapy but rather limit how psychotherapy is conceptualized and practiced, stifle innovation and creativity in the field, and run counter to the welfare and interests of many individuals who seek psychotherapy services as well as many professionals. Alternative approaches to knowledge development based on the integration of process and outcome variables and the application of hermeneutics will allow for alternative and conceptually more informed approaches to describing and evaluating what actually occurs in most psychotherapy practices.