20 Pros and Cons of Evidence-Based Practices in Mental Health Treatment
By: © Mary Bowles, PsyD, LMFT 
4/30/2025

1. EBPs improve outcomes through proven methods, but they can take years to validate, delaying access to newer, potentially more effective therapies.
2. They provide standardization and consistency across providers, yet this can limit adaptability for individual client needs, especially in culturally diverse, unique, or complex cases.
3. Using EBPs enhances accountability and credibility, but relying solely on them often ignores emerging treatments that haven’t yet completed the lengthy research cycles.
4. Insurers often require EBPs for reimbursement, although they frequently deny coverage for innovative, effective treatments that lack formal designation as “evidence-based.”
5. EBPs encourage therapist training and professional development, but they can reduce clinical flexibility and stifle creativity and connection when rigidly applied through manuals and scripts.
6. The term 'evidence-based' can boost client confidence, though overuse may discourage people from seeking alternative care if an EBP fails, causing them to give up rather than pursue better-fitting therapy or a more compatible therapist.
7. EBPs align mental health with medical best practices, yet unlike in physical health (e.g., a broken leg), failure of an EBP often leads clients to abandon treatment, not recognizing that not just therapy type, but therapist fit and skillset, rapport, and personal style also play a key role in success.
8. EBPs offer a research-supported foundation for clinical decision making, but they may not reflect real-world complexity or co-occurring issues not studied in trials.
9. They streamline training for new clinicians, yet this can result in mechanical delivery when deeper therapeutic insight is required.
10. They make therapy outcomes more measurable to the therapist, though what’s measurable isn’t always what’s most meaningful and determined to be effective to the client.
11. They promote confidence among stakeholders and funders, but this external pressure can lead therapists to prioritize compliance over client-centered care.
12. EBPs are often grounded in randomized controlled trials, yet such trials typically exclude complex cases or marginalized populations and often do not consider drop-out rates in those trials.
13. They encourage replication and scientific rigor, although this may suppress exploratory practices and innovation in therapy and may ignore the date informing outliers.
14. They help ensure a minimum standard of care, but this can also create a false ceiling, discouraging the pursuit of more personalized or integrative methods.
15. They increase access to interventions that have broad applicability, yet they often underrepresent neurodivergent individuals or those with atypical presentations, which also contributes to further marginalization of those populations.
16. They improve interdisciplinary communication through shared terminology, though this can alienate clients unfamiliar with clinical jargon or research language.
17. They may reduce the likelihood of harmful or untested interventions, but they can inadvertently stall the adoption of promising approaches still in early development.
18. They offer therapists structure in complex clinical cases, yet this can become a crutch, replacing deeper relational or intuitive engagement.
19. They can enhance therapist confidence in treatment plans, although over-reliance can create rigidity when cases require creativity or deviation and leave clients feeling ignored and disconnected.
20. They support outcome-driven care and system accountability, but they can shift focus away from relational depth, emotional nuance, and subjective measures for healing.