Evidence-based practice: Beyond empirically supported treatments.

Must the clinician choose between a practice that is strictly objective and data based and one that is purely subjective and experience based? Optimally, practitioners need to follow a model of evidence-based psychotherapy practice, such as the disciplined inquiry or local clinical scientist model, that encompasses a theoretical formulation, empirically supported treatments (ESTs), empirically supported therapy rela-tionships, clinicians ’ accumulated practical experience, and their clinical judgment about the case at hand. Some shortcomings of ESTs are reviewed, and a form of evidence for psychotherapy practice is presented that entails the accumulation of systematic case studies published online. Practitioners can contribute to such a database and be guided in their practice by those cases most relevant to their clients’ problems. Mrs. T is a 42-year-old woman who is married with two teenage sons and one preteen-age daughter. She is of European background and grew up abroad. On September 11, 2001, Mrs. T witnessed the second plane crash into the World Trade Center while knowing that several of her close associates were in that building for a meeting. At the time she had a very responsible human relations