Something I don’t think is talked about enough in the EBT and EBP discourse is how and why certain approaches become evidence-based as opposed to others - and it doesn’t always come down to it being a superior treatment or practice, either. I see this a lot with CBT.

It feels cultish at times, honestly. I have my qualms with CBT, so I will be upfront about that but I’m not going to go into those qualms here. I mostly want to address how I’ve seen CBT often positioned as THE superior treatment for certain conditions.

A lot of times, it has to do with availability of funding to study that modality and ease of receiving said funding.

Certain approaches, like CBT, are shorter in duration which makes them less costly to study compared to other psycho therapies.

Since CBT is considered a shorter-term psychotherapy, it is preferred by insurance companies. Why? Not just because it’s evidence-based, but because it’s less $$$ for them.

CBT is also inherently easier to study compared to other psychotherapies - it is a straightforward

approach that is easily standardized and defined, making it easier to research.

CBT is also often researched/evaluated with easily accessible study groups, like college students, military, and veterans.

I’m NOT saying CBT isn’t effective.

There are many cultural healing practices that have significance and benefit, but aren’t considered evidence-based for many of the reasons I listed previously as well as the fact they are not as valued in a Eurocentric profession.

Is there will to seek EB for other approaches? Is there funding? Is the funding equitable? Is it obtainable? It’s not enough to say something is evidence-based. We must also look at the systems contributing to producing evidence. Leaving this out of conversations is disengenuous.