Practice Based Evidence (PBE) and therapies: personal recommendations from the 30 years of the CORE system (Evidencia basada en la práctica (EBP) y psicoterapias: recomendaciones personales basadas en los 30 años del sistema CORE)

Abstract

Abstract Over the last 30 years we have seen two models of empirical evidence dominate funding for psychotherapies and for researching the psychotherapies. The first, still the dominant model, ‘Evidence-Based Practice (EBP)’ is based on Randomized Controlled Trial (RCT) evidence. More recently, Embedded Change Management (ECM) is the rising pre-paradigm, offering an alternative to EBP. I argue that neither model understands how evidence it is best shared between therapists as both are based on fundamentally flawed epistemologies and ideas of what constitutes pertinent evidence about the psychotherapies. Twenty-eight years ago, I was a co-creator of the CORE (Clinical Outcomes in Routine Exploration) system designed to support Practice-Based Evidence (PBE). I suggest that re-thinking the rather neglected PBE model at the heart of the original CORE system design might help change this situation. However, I recognize that the political models beneath both EBP and ECM create such vested interests within the ‘global North’ that real change will probably have to come from elsewhere.