Figure 1. A general counseling setting.

The Setbacks of Evidence Based Counseling

By: Ramanjot Singh ’19

Figure 1. A general counseling setting.
Figure 1. A general counseling setting.

In the recent years, there has been a strong wave of focus on evidence-based psychology. The push is towards achieving an evidence-based assessment for psychological conditions. More specifically, being able to have a physical test that will determine if you have a certain ailment or not. Counseling psychologist, Dr. Angie Cucchi, hypothesized that the evidence-based treatment would not be sufficient to treat someone on its own.

In order to determine the extent to which evidence-based treatment is beneficial, Dr. Cucchi conduced a case study on a patient suffering from depression. The patient was in his forties, who in addition to suffering from severe depression experienced several physical health ailments. Dr. Cucchi treated the patient according to the National Institute for Health and Clinical Excellence’s (NICE) guidelines. When she saw evidence of his progress through positive health outcomes, she decided that they could skip a session to slowly let him be on his own. This resulted in the patient negatively reacting and destroyed the progress they had made. Ultimately, the patient was discharged without having made any significant progress.

This case study is an important example of when evidence based treatment does not work in counseling psychology. The psychologist’s intuition cannot always be replaced by medical evidence. Dr. Cucchi concludes that ideally, counseling psychology should integrate evidence-based practice, but not solely rely on it. The limitation of this study is that it is a case study and extremely difficult to generalize, however, it still provides substantial reason to abstain from solely evidence-based therapy.



  1. Cucchi, Angie, A journey through the ‘Rational Mind’ and the ‘Paradoxical Logic of the Unconscious’: implications for treatment guidelines. Counselling Psychology Review 32, 47-56 (2017).
  2. Image retrieved from:

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