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There are many controversies in the field of psychotherapy. Numerous debates remain ongoing, for example, about what treatments are (or are not) effective for certain disorders and what variables are responsible for change. Although these debates are of great conceptual and clinical significance, they fade in comparison to the gravity of the schism that is at the core of clinical and counseling psychology. While these disciplines, as well as many training programs in other mental health professions, are based on the scientist-practitioner model, it is well documented that psychotherapists are not frequently and substantially influenced by empirical findings when they conduct their case formulations, treatment plan, and implementations (eg, Cohen, Sargent, & Sechrest, 1986; Morrow-Bradley & Elliott, 1986).

There are a number of ways to explain the apparent indifference of clinicians toward psychotherapy research. To begin with, many scientific investigations are perceived as being limited in terms of their clinical relevance. The emphasis on internal validity, especially in traditional randomized controlled trials (RCTs), has sometimes come at a cost in terms of external validity. For instance, the focus on setting, a priori, the number of sessions and inclusion/exclusion criteria, among other constraints required for controlled research, may well reduce