At Rula, we are committed to high-quality care rooted in evidence-based practices (EBPs). EBPs ensure that therapy is both effective and ethically grounded in the best available research, guided by clinical expertise, and attuned to individual client needs.
This article explains:
- What qualifies as an EBP
- Why Rula prioritizes EBPs
- Which EBP approaches are supported at Rula
- Emerging therapies with some empirical support
- What does not meet our EBP standards
- How to document EBPs in your clinical notes
- How EBPs relate to culturally responsive care and marginalized identities
What Are Evidence-Based Practices?
Evidence-based practices (EBPs) in mental health are treatments and interventions that have been proven effective through rigorous scientific research. According to the American Psychological Association (APA), EBPs integrate three essential components:
- Best available research
- Clinical expertise
- Patient characteristics, culture, and preferences
(Source: APA Presidential Task Force on Evidence-Based Practice, 2006)
EBPs are not one-size-fits-all protocols. They are a framework for integrating research-backed methods with real-world clinical insight and responsiveness to each individual’s lived experience.
Why Does Rula Prioritize EBPs?
Rula’s emphasis on EBPs is aligned with:
- Improved clinical outcomes (Cuijpers et al., 2016)
- Insurance and regulatory standards (SAMHSA, 2020)
- Our measurement-informed care (MIC) model, which tracks client progress and supports data-driven decision-making
- Using EBPs can provide structure and confidence in delivering consistent, quality care to patients
What Qualifies as an EBP at Rula?
We recognize the following evidence-based modalities as acceptable and encouraged in clinical work at Rula. These therapies have been validated by multiple sources, including the APA, SAMHSA’s Evidence-Based Practices Resource Center, and the National Registry of Evidence-based Programs and Practices (NREPP). Please note that this list is not intended to be exhaustive, given the evolving nature of research in the mental health field.
Cognitive and Behavioral Therapies
- Cognitive Behavioral Therapy (CBT)
- Dialectical Behavior Therapy (DBT)
- Cognitive Processing Therapy (CPT)
- Acceptance and Commitment Therapy (ACT)
- Behavioral Activation (BA)
- Exposure Therapy / Prolonged Exposure (PE)
- Rational Emotive Behavior Therapy
- Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT)
Extensive meta-analyses support these approaches for treating anxiety, depression, PTSD, and other conditions (Hofmann et al., 2012; Cuijpers et al., 2016).
Insight-Oriented and Relational Approaches
- Interpersonal Therapy (IPT)
- Mentalization-Based Therapy (MBT)
These models have demonstrated effectiveness for mood and personality disorders (Leichsenring & Rabung, 2011).
Family and Systems Approaches
- Structural Family Therapy
- Functional Family Therapy (FFT)
- Multisystemic Therapy (MST)
- Emotionally Focused Therapy (EFT)
Validated especially for youth behavioral concerns and couple/family distress (SAMHSA, 2020).
Child and Adolescent Approaches
- Parent-Child Interaction Therapy (PCIT)
- Trauma-Focused CBT (TF-CBT)
- Child-Centered Play Therapy (when used within an EBP framework)
These interventions are backed by large-scale studies and recommended by the National Child Traumatic Stress Network (NCTSN).
Couples Therapy Approaches
- Emotionally Focused Therapy (EFT)
- Integrative Behavioral Couple Therapy (IBCT)
- The Gottman Method
These are all supported by clinical trials and meta-analytic research (Christensen et al., 2004; Johnson et al., 1999; Monson et al., 2012; Baucom et al., 1998; Babcock et al., 2013).
Trauma-Informed Interventions
- Eye Movement Desensitization and Reprocessing (EMDR)
- Seeking Safety
- Narrative Therapy/ Narrative Exposure Therapy (NET)
- Internal Family Systems (IFS)
Recognized by WHO and APA for trauma-related conditions (WHO, 2013; Bisson et al., 2013).
Skills-Based and Brief Interventions
- Motivational Interviewing (MI)
- Solution-Focused Brief Therapy (SFBT)
Useful across diagnostic categories, particularly for clients seeking focused, short-term support (Miller & Rollnick, 2013).
Emerging Therapies with Some Empirical Support
These may not yet meet full EBP criteria but often have growing evidence and may be used as adjuncts to EBPs or within an integrative framework:
- Somatic Experiencing (SE):
- Targets the nervous system's response to trauma through body-based techniques. Some promising case studies and pilot trials exist, but it's not widely validated through controlled studies yet.
- Art Therapy / Music Therapy / Dance Movement Therapy:
- Often used with children, trauma survivors, or neurodivergent individuals. Can be powerful adjuncts, especially in nonverbal processing, but must be integrated thoughtfully within an EBP framework.
- Ecopsychology / Nature-Based Therapy:
- Incorporates nature exposure into therapeutic work. Evidence supports benefits of time in nature on mood and stress, but it's not a standalone EBP for clinical mental health treatment.
- Animal-Assisted Therapy:
- This is not currently a standalone EBP, but it is a growing, evidence-informed intervention that may enhance outcomes when integrated into a broader EBP framework (e.g., CBT, trauma-focused therapy).
- Mindfulness-Based Approaches:
- While Mindfulness-Based Stress Reduction (MBSR) and Mindfulness-Based Cognitive Therapy (MBCT) are evidence-based, other mindfulness-adjacent practices (e.g., breathwork, meditation coaching) may not have the same rigorous support.
Therapists are welcome to integrate these approaches when used in conjunction with a recognized EBP and with clinical justification. For example, using IFS-informed language within a CBT framework, or applying somatic skills during trauma-focused CBT. They should not be used as the sole theoretical orientation unless supported by sufficient evidence.
What Does Not Qualify as an EBP?
The following are not considered EBPs at Rula and should not be used as standalone treatments. Again, this is not considered to be an exhaustive list:
- Life coaching without clinical foundation
- Unstructured talk therapy with no identifiable theoretical model
- Energy healing, reiki, or chakra alignment
- Tarot, astrology, or spiritual counseling
- Any practice not supported by peer-reviewed studies or major psychological organizations
While clients may express interest in these practices, Rula clinicians must anchor their work in empirically supported treatment models appropriate to their licensure and clinical training.
How to Document Use of EBPs
To maintain clinical quality and meet payer standards, your documentation should clearly reflect the use of EBPs:
- Reference the primary EBP model in your notes (e.g., “Continued use of CBT to address cognitive distortions.”)
- Align treatment goals and interventions with EBP strategies
- Incorporate standardized assessments (e.g., PHQ-9, GAD-7) to inform treatment planning and demonstrate client progress
EBPs and Marginalized Identities: Culturally Responsive Application Matters
Evidence-based practices are most effective when applied with cultural humility and awareness of systemic inequities. Historically, clinical research has overrepresented white, Western populations, and many EBPs were not initially designed with marginalized communities in mind.
Rula encourages therapists to:
- Adapt EBPs thoughtfully, integrating cultural context and affirming clients' identities
- Attend to how race, gender identity, sexual orientation, immigration status, disability, and other factors shape therapeutic engagement
- Use EBPs not rigidly, but as flexible tools within a culturally attuned, trauma-informed approach
In short: Evidence-based care must also be identity-affirming care. We encourage therapists to apply EBPs through an inclusive lens, consistent with APA multicultural guidelines and other fields’ code of ethics (APA, 2017).
If you’re unsure whether an approach is considered evidence-based or want to enhance your practice, please reach out to quality@rula.com.
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