The Evidence-Based Assessment in Psychotherapy Study

The Evidence-Based Assessment in Psychotherapy (EBAP) study is a research project aiming to apply and extend state-of-the-art evidence-based principles to improve psychotherapy treatment outcomes. Additionally, it seeks to enhance our understanding of how elements of the relationship between patient and therapist influence the therapy process and outcome. The EBAP study is funded by the European Union's Horizon 2020 research and innovation programme under the Marie Skłodowska-Curie Actions (grant agreement No 101030608). It involves collaboration among the University of Pavia (Italy), the University of North Carolina at Chapel Hill (USA), and the Institut d'Investigacions Biomèdiques August Pi i Sunyer (Barcelona, Spain).

• Developing and evaluating an evidence-based assessment (EBA) approach to individual psychotherapy. A significant and growing body of research indicates that the EBA 2.0 model leads to substantial improvements in diagnostic accuracy ^[1], treatment matching ^[2], and outcomes ^[3] across various disorders. However, clinical research on EBA 2.0 has thus far primarily concentrated on prediction and prescription phases, with a focus on child and adolescent samples. The EBAP study aims to concentrate on the process and outcome phases of the EBA 2.0 model and to extend its application to adult patients. EBA will be integrated with models of the therapeutic relationship, reintroducing humanistic and emotional dynamics into the treatment process, with sophisticated considerations of the therapy relationship and its connection with treatment outcomes. This integration ensures that EBA is not reduced to a mere algorithm or another "specific" ingredient. When patients reflect on what helped them in their psychotherapy, they often cite the relationship with their therapists as the key factor, rather than the effectiveness of particular techniques or methods ^[4].

• Implementing EBA in real-world psychotherapeutic settings. The primary goal of this aim is to conduct a randomized controlled trial to assess how EBA influences the process (e.g., rapport, treatment continuity) and outcomes, with secondary objectives exploring how patient, therapist, and process characteristics moderate the effects of the EBA approach on therapeutic alliance and outcomes.

• Alberto Stefana
• Paolo Fusar-Poli
• Eduard Vieta
• Eric Youngstrom

• Stefana, A., Fusar-Poli, P., Vieta, E., & Youngstrom, E. A. (2024). The effectiveness of a novel web-based intervention for enhancing therapeutic relationship and treatment outcome in adult individual psychotherapy: Randomized controlled trial and analysis of predictors of drop-out. JMIR Mental Health. https://doi.org/10.2196/63234
• Stefana, A., Vieta, E., Fusar-Poli, P., & Youngstrom, E. A. (2024). Enhancing psychotherapy outcomes by encouraging patients to regularly self-monitor, reflect on, and share their affective responses toward their therapist: Protocol for a randomized controlled trial. JMIR Research Protocols, 13, e55369. https://doi.org/10.2196/55369
• Stefana, A., Fusar-Poli, P., Vieta, E., & Youngstrom, E. A. (2024). Patients’ perspective on the therapeutic relationship and session quality: The central role of alliance. Frontier in Psychology, 15. doi: https://doi.org/10.3389/fpsyg.2024.1367516
• Stefana, A., & Youngstrom, E. A. (2024). Erotic feelings towards patients in the psychotherapy session: Investigating their relationship with the characteristics of the therapist, the patient, and the treatment. Sexual Abuse, 36(6), 692-713. doi: https://doi.org/10.1177/10790632231190081
• Stefana, A., Fusar-Poli, P., Vieta, E., Gelso, C. J., & Youngstrom, E. A. (2024). Development and validation of an 8-item version of the Real Relationship Inventory–Client form. Psychotherapy Research. doi: https://doi.org/10.1080/10503307.2024.2320331
• Stefana, A., Fusar-Poli, P., Vieta, E., & Youngstrom, E. A. (accepted for publication). Evaluating the psychometric properties of the 24-item and 12-item Real Relationship Inventory-Client forms. PLoS One.
• Stefana, A., Fusar-Poli, P., Vieta, E., & Youngstrom, E. A. (2024). Assessing the patient’s affective perception of their psychotherapist: validation of the in-Session Patient Affective Reactions Questionnaire. Frontiers in Psychiatry, 15, 1346760. https://doi.org/10.3389/fpsyt.2024.1346760
• Stefana, A., D’Imperio, D., Dakanalis, A., Vieta, E., Fusar-Poli, P., & Youngstrom, E. A. (2024). Probing the impact of psychoanalytic therapy for bipolar disorders: A scoping review. International Forum of Psychoanalysis, 33(1), 51-56. https://doi.org/10.1080/0803706X.2022.2097307
• Stefana, A., Langfus, J. A., Vieta, E., Fusar-Poli, P., & Youngstrom, E. A. (2023). Development and initial validation of the in-session patient affective reactions questionnaire (SPARQ) and the rift in-session questionnaire (RISQ). Journal of Clinical Medicine, 12(15), 5156. https://doi.org/10.3390/jcm12155156
• Stefana, A., Fusar-Poli, P., D’Imperio, D., Choplin, E., Dakanalis, A., & Vieta, E. (2023). Mapping the psychoanalytic literature on bipolar disorder: A scoping review of journal articles. Brazilian Journal of Psychiatry, 45(1), 71–83. https://doi.org/10.47626/1516-4446-2022-2765
• Stefana, A., Fusar-Poli, P., Vieta, E., & Youngstrom, E. A. (2023). Therapeutic relationship elements and therapy session outcomes: Protocol for a longitudinal study of the patient’s perspective. Open Research Europe, 4(3),133. https://doi.org/10.12688/openreseurope.16466.2

1. ↑ Rizvi, S. L., Hughes, C. D., Thomas, M. C., & Carpenter, K. M. (2018). How well does DBT work in the real world? A meta-analysis of dialectical behavior therapy for the treatment of mood disorders, posttraumatic stress disorder, and other clinical populations. Journal of Clinical Child & Adolescent Psychology, 47(1), 161-175. https://doi.org/10.1080/15374416.2018.1498401; Salcedo, S., Gold, A. K., Sheikh, S., Marcus, P. H., Nierenberg, A. A., & Deckersbach, T. (2017). Development of an individualized behavioral intervention for the treatment of mood disorders. Journal of Clinical Child & Adolescent Psychology, 46(5), 511-522. https://doi.org/10.1080/15374416.2016.1274684; Salcedo, S., Gold, A. K., Marcus, P. H., Sheikh, S., Kim, J., Nierenberg, A. A., & Deckersbach, T. (2018). Behavioral interventions in bipolar disorder: A systematic review of their efficacy. European Child & Adolescent Psychiatry, 27(11), 1491-1498. https://doi.org/10.1007/s00787-018-1216-9; Raiker, J. S., Freeman, A. J., Frazier, T. W., & Youngstrom, E. A. (2017). Accuracy of informant-report in identifying symptoms of pediatric bipolar disorder: A meta-analysis. Journal of the American Academy of Child & Adolescent Psychiatry, 56(5), 401-409. https://doi.org/10.1016/j.jaac.2017.02.007; Van Meter, A. R., Burke, C., Youngstrom, E. A., Faedda, G. L., & Correll, C. U. (2016). Bipolar disorder risk calculator: A meta-analytic review of clinical applications. Journal of Clinical Child & Adolescent Psychology, 47(sup1), S161-S175. https://doi.org/10.1080/15374416.2016.1220313
2. ↑ Yatham, L. N., Kennedy, S. H., Parikh, S. V., Schaffer, A., Beaulieu, S., Alda, M., ... & Bond, D. J. (2013). Canadian Network for Mood and Anxiety Treatments (CANMAT) and International Society for Bipolar Disorders (ISBD) collaborative update of CANMAT guidelines for the management of patients with bipolar disorder: Update 2013. Bipolar Disorders, 15(1), 1-44. https://doi.org/10.1111/bdi.12025; Youngstrom, E. A., Halverson, T. F., Youngstrom, J. K., Lindhiem, O., & Findling, R. L. (2017). Evidence-based assessment from simple clinical judgments to statistical learning: Evaluating a range of options using pediatric bipolar disorder as a diagnostic challenge. Clinical Psychology: Science and Practice, 24(4), 331-363. https://doi.org/10.1111/cpsp.12214; Kennedy, S. H., Lam, R. W., Parikh, S. V., Patten, S. B., & Ravindran, A. V. (2016). Canadian Network for Mood and Anxiety Treatments (CANMAT) 2016 clinical guidelines for the management of adults with major depressive disorder. Canadian Journal of Psychiatry, 61(9), 540-560. https://doi.org/10.1177/0706743716659418; Guo, T., Xiang, Y. T., Xiao, L., Hu, C. Q., Chiu, H. F., Ungvari, G. S., Correll, C. U., & Lai, K. Y. (2015). Measurement-based care versus standard care for major depression: A randomized controlled trial with blind raters. American Journal of Psychiatry, 172(10), 1004-1013. https://doi.org/10.1176/appi.ajp.2015.14050652
3. ↑ Guo, T., et al. (2015). Measurement-based care versus standard care for major depression: A randomized controlled trial with blind raters. American Journal of Psychiatry, 172(10), 1004-1013. https://doi.org/10.1176/appi.ajp.2015.14050652
4. ↑ Norcross, J. C. (2009). The heart and soul of change: Delivering what works in therapy. American Psychological Association; Wampold, B. E. (2001). The great psychotherapy debate: Models, methods, and findings. Lawrence Erlbaum Associates.