Empirical support for efficient clinical practice is difficult to establish largely due to the fact that there are numerous models of interventions used by clinical practitioners in their local settings. Efficacy studies of psychotherapeutic interventions have shown consistently that treatment is better than no treatment, but that various models of intervention differ little in terms of the amount of outcome variance explained (Wampold, Mondin, Moody et al., 1997). Thus, the question that each practitioner may need to address is: Is the model of therapy [that I use] beneficial for the client-consumer and is the outcome significantly better than that resulting from any other model of treatment? To validly answer this question, a practitioner would need to engage in a series of controlled treatment comparison studies to demonstrate the efficacy of his/her model of treatment for a specific client population. Because efficacy studies require experimental rigor, such as inclusion of theoretically-based and clinically-tested comparison treatments, fidelity to predefined treatment protocols, randomized assignment to the treatment comparison groups, reliable and valid outcome measures, and, at minimum, a six-month post-treatment period for follow-up assessments, there is low probability that any clinician would be able to

pursue this line of inquiry to establish evidence for his/her own models of practice.