The Father of Science-Based Therapy

How often do you hear people say, "Psychology isn't science"? Truth is, like any other field of knowledge, it can be approached scientifically or...well...not. The geocentrists weren't scientists, but that doesn't mean modern astronomers aren't. Same goes for psychology.

Aaron Beck is one of my heroes in this regard, although I never actually remember his name, just his work. He developed cognitive-behavioral therapy (CBT), and The American Scholar has a great article on how his insistence on evidence of efficacy reshaped psychotherapy.

To understand why the introduction of scientific standards into the field of psychotherapy was groundbreaking, it is necessary to know what the scene looked like prior to Beck’s arrival. “From the early 1900s through the 1950s, people didn’t know what worked in psychotherapy and what didn’t,” says Donald Freedheim, professor emeritus of psychology at Case Western Reserve University and editor of A History of Psychotherapy. “There was a rule of thumb: about a third of patients got better, about a third got worse, and about a third stayed the same.” Without a reliable gauge of efficacy, therapeutic notoriety was conferred on those clinicians who, by sheer force of personality and persuasiveness of rhetoric, were able to attract the most acolytes, adherents, and patients. This “guru model” was precisely what Beck found unacceptable, and what he has dedicated himself to dismantling. He hasn’t been the only person to insist that psychotherapy rest on a foundation of replicable data—he wasn’t even the first—but he has been the position’s most dogged, visible, sophisticated, and influential proponent.

As a consequence, psychotherapy has been moving steadily from a model that is “eminence-based,” as a rueful saying has it, to one that is “evidence-based”—a powerful watchword in the field. Over the past several years, federal and state agencies in the United States and government-based health-care systems abroad have been spending hundreds of millions of dollars to disseminate psychotherapies for which there is a solid core of scientific evidence, while insurance companies have been encouraging the clinicians within their systems to practice “empirically supported therapies” (EST) above others. In short, more and more, Freud’s world of subterranean drives is becoming Beck’s world of scientific accountability.

Highly recommended reading. Thanks to Josh for the link.