Psychology Training Directors' Reflections on Evidence-Based Practice in South Africa

Abstract

Despite its importance in the international arena, the evidence-based movement appears to have had little impact among South African clinical and counseling psychologists. We interviewed 13 of the 18 directors of psychology training programmes to understand the extent to which these programmes were rooted in an evidence-based approach to psychological practice; how important directors thought it was to emphasise an evidence-based approach in psychology training; and how students were taught to use research to inform their ongoing practice as clinical or counselling psychologists. Directors expressed a range of positions including opposition to evidence-based practice (EBP), support for EBP, and equivocality about EBP. Those who were opposed to EBP based their opposition on a “critical” approach to evidence, epistemological and ontological differences with the notion of EBP, and the conflation of theoretical orientation with EBP. Concerns were also raised in relation to areas of psychological need that lacked a research base, cultural factors that did not fit well with EBP, and different viewpoints on what constituted evidence. However, among several training directors, EBP was considered essential, particularly in light of the need to offer cost-effective services in an under-resourced setting like South Africa. These results are discussed in the context of the international evidence-based movement in mental health. Three recommendations flow from our research, namely, that the Health Professions Council of South Africa engage formally and vigorously with EBP for psychological interventions; that the Psychological Society of South Africa (PSYSSA) place the matter of EBP squarely on the organisational agenda; and that a standardised accreditation of clinical and counselling psychology training programmes be developed according to locally developed criteria for assessing EBP.