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Efficacy combined with specified ingredients: a new direction for empirically supported addiction treatment
Author(s) -
Magill Molly,
Longabaugh Richard
Publication year - 2013
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.12013
Subject(s) - addiction , psychology , randomized controlled trial , centrality , addiction treatment , clinical psychology , medicine , psychiatry , surgery , mathematics , combinatorics
Aims With the increased need for sanctioning behavioral addiction treatments to guide key stakeholders, focus has shifted to developing and applying criteria for establishing empirically supported treatments ( EST ). Among the many criteria offered, demonstration of incremental efficacy over a placebo or comparison in at least two independent randomized clinical trials ( RCTs ) has been the gold standard. While necessary, the present EST criteria are not sufficient. The present work: (i) argues for empirically supported specificity in behavioral addiction treatment, (ii) explores the limitations of empirical support for EST efficacy without evidence of specificity and (iii) discusses implications and recommendations for ultimately raising the bar for status as an EST . Methods The authors review relevant literature on EST s, evidence‐based practice and clinical trial design in the addictions and related disciplines. Results We clarify that the additional bar of specificity does not denote uniqueness in causal processes and we argue that specificity should not be inferred only via the nature of the experimental contrast. Rather, a treatment has specificity if its active ingredients are identified and validated empirically as predictors of subsequent treatment‐related outcomes. Within this new definition, there are implications for clinical research and other key stakeholders. Conclusions A heightened centrality of empirically supported addiction treatment ingredients moving forward will advance clinical knowledge and evaluation methodology at a far greater pace.