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In preparation for the Part II of the examination for the Membership of the Royal College of Psychiatrists (MRCPsych), I had to familiarize myself with the tenets of evidence-based medicine (EBM) as it now comprises a substantial part of the examination. Most publications and courses I came across seemed to focus on biological treatments; I was therefore delighted to come across this book, hoping that it would fill a substantial gap.
The book has its roots in a conference organized by the Psychotherapy Faculty of the Royal College of Psychiatrists. In the first chapter, two of the editors, Chris Mace and Stirling Moorey, set the tone by stating that the book ‘should ensure that a psychotherapist, whatever his or her interests, is not only better informed about the clinical implications of evidence-based practice but better able to recognize its strengths and weaknesses, and able to meet its requirements at the level of service organization’ (p. 1).
Following the introductory chapter, the book can be seen to be loosely divided into two parts; the first one focusing on the fact that evidence is a very complex concept in itself and it becomes even more so in the field of psychological treatments. The authors examine the meaning of evidence at length, looking at it from various points of view, including the law where John Jackson explores the nature of evidence in the judicial system and concludes that it is indeed very different from the scientific model with which we are familiar. This part of the book is very thought-provoking, challenging and polemical at times, inviting the reader to form their own views on the subject rather than spoon feeding them ready-made answers. It becomes clear that evidence in psychotherapy is diverse and can not be seen as homogenous; while powerful at its best, it also has serious limitations. In addition, the very nature of the psychological treatments creates major difficulties in conducting the gold standard of EBM, a randomized control