Implementing evidence-based treatments in routine mental health services: strategies, obstacles, new developments to better target care provided

This chapter focuses on the discrepancies between evidence and clinical practice in mental health. It first addresses the efficacy-effectiveness gap (i.e. the difficulty of implementing therapeutic advances proven effective in large well-conducted trials into the daily practice) and the evidence-practice gap (i.e. the distance between therapeutic interventions that are scientifically proven and applicable, as formulated in clinical guidelines, and the actual content of everyday clinical encounters) that occur in routine mental health care. The chapter then makes the case, as a prototypic example, of research-practice gaps in the treatment of early phases of psychosis, with specific reference to discrepancies between clinical guideline recommendations and interventions provided in routine practice. Challenges and obstacles in implementing evidence-based treatment for first-episode psychosis (FEP) are therefore discussed. New developments to provide effective care for FEP are finally outlined. © 2013 by John Wiley & Sons, Ltd. All rights reserved.