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First published 2000 by Routledge
11 New Fetter Lane, London EC4P 4EE
Simultaneously published in the USA and Canada
by Taylor & Francis Inc
325 Chestnut Street, 8th Floor, Philadelphia PA 19106
Routledge is an imprint of the Taylor & Francis Group
This edition published in the Taylor & Francis e-Library, 2001.
© 2000 Nancy Rowland and Stephen Goss, editorial matter and selection; the
contributors, individual chapters.
All rights reserved. No part of this book may be reprinted or reproduced or
utilised in any form or by any electronic, mechanical, or other means, now
known or hereafter invented, including photocopying and recording, or in any
information storage or retrieval system, without permission in writing from the
publishers.
British Library Cataloguing in Publication Data
A catalogue record for this book is available from the British Library
Library of Congress Cataloging in Publication Data
Evidence-based counselling and psychological therapies : research and
applications / edited by Nancy Rowland and Stephen Goss.
p. cm.
Includes bibliographical references and index.
1. Psychotherapy–Outcome assessment–Great Britain. 2. Mental health
policy–Great Britain. 3. Evidence-based medicine–Great Britain. 4. National
Health Service (Great Britain)–Administration. I. Rowland, Nancy, 1954– II.
Goss, Stephen, 1966–
RC480.75 .E95 2000
362.2'0941–dc21 00–021257
ISBN 0–415–20506–9 (hbk)
ISBN 0–415–20507–7 (pbk)
ISBN 0-203-13160-6 Master e-book ISBN
ISBN 0-203-18546-3 (Glassbook Format)
To my parents
Nancy Rowland
To Catriona, Andrew and Lynn
Stephen Goss

Contents
List of boxes ix
List of tables xi
List of contributors xiii
Preface xvii
JOHN GEDDES
PART 1
What is evidence-based health care? 1
1 Evidence-based psychological therapies 3
NANCY ROWLAND AND STEPHEN GOSS
2 The drive towards evidence-based health care 13
MARK BAKER AND JOS KLEIJNEN
3 Towards evidence-based health care 30
BRIAN FERGUSON AND IAN RUSSELL
4 Economics issues 44
ALAN MAYNARD
5 Evidence-based psychotherapy: an overview 57
GLENYS PARRY
viii Contents
PART 2
Generating the evidence 77
6 Randomised controlled trials and the evaluation of
psychological therapy 79
PETER BOWER AND MICHAEL KING
7 The contribution of qualitative research to
evidence-based counselling and psychotherapy 111
JOHN MCLEOD
8 Rigour and relevance: the role of practice-based
evidence in the psychological therapies 127
MICHAEL BARKHAM AND JOHN MELLOR-CLARK
PART 3
Synthesising the evidence 145
9 Systematic reviews in mental health 147
SIMON GILBODY AND AMANDA SOWDEN
10 Clinical practice guidelines development in
evidence-based psychotherapy 171
JOHN CAPE AND GLENYS PARRY
11 Getting evidence into practice 191
STEPHEN GOSS AND NANCY ROWLAND
Index 207
Boxes
2.1 Journals and databases 19
2.2 Articles, by country of origin 19
4.1 The Williams checklist for interrogating economic
evaluation 49
9.1 Family intervention for schizophrenia 151
9.2 Meta-analysis of treatment outcome for panic disorder 153
9.3 Stages in the systematic review process 157
9.4 Example of a hierarchy of evidence 160
9.5 Questions to guide the critical appraisal of a systematic
review 163
11.1 Ways in which practitioners can enhance their involvement
in EBHC 196

Tables
4.1 Types of economic investigation of health care 48
6.1 Types of randomised trial 89
8.1 Criteria defining clinical representativeness 130
8.2 Linear models of the efficacy–effectiveness continuum 132
9.1 Systematic reviews from the Cochrane Library 150
10.1 Recommendations for acute phase treatment 182
10.2 Quality criteria for assessing research reviews 184

Contributors
Mark Baker is the Medical Director of North Yorkshire Health Authority
and Honorary Visiting Professor at the University of York. He was
previously Regional Director of Research and Development for
Yorkshire Regional Health Authority and Director of the National
Research & Development Programme for Mental Health.
Michael Barkham is Professor of Clinical and Counselling Psychology
and Director of the Psychological Therapies Research Centre at the
University of Leeds. He has previously carried out controlled trials
into the efficacy of contrasting psychotherapies and is part of a
research group that has developed a new evaluation tool – the CORE
System. He has an abiding interest in a range of research methodologies
and their role in bridging the gap between research and practice.
Peter Bower is a psychologist and Research Fellow at the National Primary
Care Research and Development Centre (NPCRDC) at the University
of Manchester. He currently conducts research on the effectiveness
of psychological therapies in primary care, the relationship between
mental health specialists and primary care professionals, and the
doctor–patient relationship in general practice.
John Cape is Head of Psychology and Psychotherapy Services, Camden
and Islington Community Health Services NHS Trust. He convenes
the National Counselling and Psychological Therapies Clinical
Guidelines Steering Group, and is chair of the Management Board of
the British Psychological Society Centre for Outcomes Research and
Effectiveness.
Brian Ferguson is Professor of Health Economics at the Nuffield Institute
for Health, University of Leeds and Assistant Director (Clinical

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