Commentary: The Evolution of Evidence-Based Psychotherapy

What has been identified as a revolution actually represents an evolution, stemming directly from the basic behavioral tenets of the early to mid 20th century. Cognitive-behavior approaches within behavior therapy are not really new. As early as the 1950s a substantial number of behaviorists saw a clear role for cognition and relied on hypothetical constructs to explain behavior. There are at least two major challenges for cognitive-behavior approaches. The first is the assurance of the validity and reliability of the measurement of both outcome and the cognitive factors that are presumed to serve as mediators of the observed effects. As the cognitive factors being studied become more complex, the measurement of the variables of interest becomes more difficult. The second challenge is to be open to new paradigms and approaches that may bring into question well-established concepts. The preeminence of the cognitive-behavioral approach is directly related to the fact that its concepts and methods can be subjected to empirical scrutiny.