In defense of clinical judgment, credentialed clinicians, and reflective practice

Although clinical psychology is rightly characterized by its commitment to science, the author argues that clinical practice cannot rely entirely or primarily on scientific evidence and empirically supported treatments. Too many of the problems that clinicians encounter will invariably fall outside the purview of scientific evidence. Whether grounded in questions of value or the particularities of human experience, clinicians inevitably deal with uncertainty and cannot avoid clinical judgment. An overly narrow and hyperskeptical approach to clinical practice would impoverish clinical training and would both disenfranchise and impose excessive restrictions on conscientious clinicians. A more inclusive definition of evidence-based practice is necessary, one that values scientific and clinical evidence and reasoning equally. (PsycINFO Database Record (c) 2010 APA, all rights reserved).