The theory-practice gap in cognitive behavioral therapy: reflections and a modest proposal to bridge the gap

This paper examines the issues related to the gap between theory and practice in the area of cognitive-behavioral therapy. The article begins with a review of the evidence for such a gap, and having demonstrated that the gap exists, provides a discussion of some of the factors that are likely important in its genesis and maintenance. The article then focuses on potential strategies to reduce the theory-practice gap that go beyond the common recommendation for both efficacy and effectiveness research. In particular, we provide recommendations for protocol planning and design, training and competency maintenance, dissemination research, and implementation and policy change. We conclude with the proposition that theory and research should not only inform practice, but that practice should have a reciprocal benefit on theory and research.