In this Issue

Butting heads

When developing or modifying treatment plans for a client, on what do you place greater emphasis: clinical experience or empirical evidence?

By Emily Edwards

“An intern who uses an empirically informed treatment will generally fare better than a seasoned clinician using a treatment based solely (and arrogantly) on his or her ‘experience’ alone. Fortunately, however, as clinical experience grows, so does knowledge of and experience with using the empirical literature to inform treatment.” 

Robin MacFarlene, PhD
Psychological Assessment Expert, New York

“The line between clinical experience and empirical evidence is specious. Any direct observation constitutes empirical evidence, including those that may be filtered through theoretical background or clinical training.” 

Shane Owens, PhD, ABPP
Psychologist, New York

“If there is significant evidence out there to support my modification, then I go for the evidence. For instance, if I have a patient coming in with a substance use disorder and I learn that they have co-occurring HIV or chronic pain, I will use the lit to inform my conceptualization and intervention. Clinical experience leads me to turn to the literature more, I think, because the more you learn the more you realize how much you don't know, and the more facile you have become in targeting the right question to frame what you don't know, and how to find it.” 

Sabrina Esbitt, MA
Psychology Intern, New York

“I oversee programs providing short-term services to employees of a law enforcement agency with over 9,000 employees. We serve all department employees, officers and civilians. Because there is little empirical evidence on this specialized population, I have to determine how well available empirical evidence applies to our clientele. Since I have always looked to empirical evidence to inform clinical decision-making, I view this as an integration of both and not one versus the other. At this point in my career, I rarely find advances in empirical evidence that is significantly different than what I have experienced as a clinician. Typically new evidence allows me to incrementally improve the services we provide.”

Frances Douglas, PsyD
Department of Public Safety, Texas