Zijn de resultaten van randomized clinical trials (RCT’s) naar de effectiviteit van cognitieve gedragstherapie generaliseerbaar naar de klinische praktijk?

According to clinical guidelines cognitive-behavior therapy is the treatment of choice for many disorders. These clinical guidelines are primarily based on the results of randomised clinical trials (RCTs). Although RCTs are generally considered the gold standard, most RCTs can be characterized as efficacy trials rather than as effectiveness trials. In this paper is discussed to which extent the results of randomized efficacy trials can be generalized to clinical practice. Results of effectiveness trials in clinical practice (‘Benchmark studies') are generally positive, although the effects are slightly less than those of efficacy trials. A review of recent RCTs published in Behaviour Research & Therapy en Behavior Therapy reveals that in most RCTs patients are treated who are often characterized by comorbid disorders. The modal therapist in recent RCTs is not more experienced than the modal therapist in mental health practice.