Using the new criteria for empirically supported treatments, cognitive-behavioral therapy and contingency management were both given strong recommendations for substance use disorders. Credible components of treatment include skills training, motivational enhancement, and access to nondrug alternative reinforcement. A sidebar discusses mutual support organizations such as Alcoholics Anonymous. Another sidebar describes harm reduction strategies.

Insomnia disorder involves trouble falling asleep, trouble staying asleep, or both. A review using the new criteria for empirically supported treatments gave a strong recommendation for cognitive-behavioral therapy for insomnia. Credible components of treatment include stimulus control, sleep restriction, and relaxation therapies. A sidebar discusses components requiring further research.

This opening chapter defines the concept of science-based therapy. The original framework for characterizing an approach as an empirically supported treatment is presented, for both well-established treatments and probably efficacious treatments. Also presented, a newer framework – sometimes called “the Tolin criteria” – provides greater emphasis to meaningful functional outcome improvement, meaningful effects in nonresearch settings, and lasting improvements. Other concepts in this chapter include evidence-based practice and pseudoscience in therapy.

Based on a review using the new criteria for empirically supported treatments, this chapter emphasizes exposure with response prevention for obsessive-compulsive disorder, a treatment that has strong research support. Cognitive therapy is also discussed. Credible components of treatment include exposure, behavioral experiments, and cognitive reappraisal. A sidebar also reviews treatments for body dysmorphic disorder, hoarding disorder, trichotillomania, and excoriation.

The postscript opens by reviewing the original Chambless criteria for identifying empirically supported treatments. A table lists well-established treatments for all of the disorders discussed in the book. Next, the postscript reviews the newer, more stringent criteria – sometimes called the “Tolin criteria” – for identifying empirically supported treatments, and a second table summarizes the reviews of disorders using these newer criteria.