Invitation to a dialogue between researchers and clinicians about evidence-based behavioral medicine

Background. Evidence-based behavioral medicine (EBBM) aims to improve the process through which best scientific research evidence can be obtained and translated into best clinical decisions regarding behavioral treatments to improve health. Purpose: The objective was to examine some legitimate concerns raised by both clinicians and researchers about the evidence-based movement. Methods: This article begins with a discussion of clinicians' fears that EBBM devalues clinical judgment and the therapist-patient relationship, will be used to restrict practice, is unnecessary, and is based on research that is irrelevant to clinical decision making. Next we consider researchers' worries that EBBM neglects evidence not based on randomized controlled trials and ignores causal mechanisms. Results: We find that these fears, although understandable, largely reflect misinterpretations of the evidence-based movement. Further it is suggested that behavioral medicine is in a unique position to enhance the evidence-based movement by encouraging increased attention to treatment mechanisms and to knowledge translation. Conclusions: Clinicians, researchers, and, importantly, the public will benefit from the evidence-based movement by having a health care system that is built on solid grounds of evidence in determining which treatments should constitute the standard of care. A full partnership between clinicians and researchers is called for to generate the practical, rigorous evidence base needed to take behavioral health treatments to the next level of scientific support and implementation.