Invitation to a Dialogue Between Researchers and Clinicians About Evidence-Based Behavioral Medicine Bonnie Spring, Ph.D. University of Illinois Chicago and Edward Hines, Jr. VA Hospital Sherry Pagoto, Ph.D. University of Illinois Chicago Peter G. Kaufmann, Ph.D. National Heart, Lung, and Blood Institute Evelyn P. Whitlock, M.D. Kaiser Permanente Center for Health Research Russell E. Glasgow, Ph.D. Kaiser Permanente Colorado Timothy W. Smith, Ph.D. University of Utah Kimberlee J. Trudeau, M.A. City University of New York Graduate Center Karina W. Davidson, Ph.D. Columbia College of Physicians and Surgeons ABSTRACT Background: Evidence-based behavioral medicine (EBBM) aims to improve the process through which best scientific re- search evidence can be obtained and translated into best clini- cal decisions regarding behavioral treatments to improve health. Purpose: The objective was to examine some legitimate con- cerns raised by both clinicians and researchers about the evidence-based movement. Methods: This article begins with a discussion of clinicians’ fears that EBBM devalues clinical judgment and the therapist–patient relationship, will be used to restrict practice, is unnecessary, and is based on research that is irrelevant to clinical decision making. Next we consider researchers’ worries that EBBM neglects evidence not based on randomized controlled trials and ignores causal mecha- nisms. Results: We find that these fears, although understand- able, largely reflect misinterpretations of the evidence-based movement. Further, it is suggested that behavioral medicine is in a unique position to enhance the evidence-based movement by encouraging increased attention to treatment mechanisms and to knowledge translation. Conclusions: Clinicians, re- searchers, and, importantly, the public will benefit from the evi- dence-based movement by having a health care system that is built on solid grounds of evidence in determining which treat- ments should constitute the standard of care. A full partnership between clinicians and researchers is called for to generate the practical, rigorous evidence base needed to take behavioral health treatments to the next level of scientific support and implementation. (Ann Behav Med 2005, 30(2):125–137) INTRODUCTION Tensions have always existed between researchers and cli- nicians. Researchers pursue programmatic lines of research aimed at understanding theoretical relationships by applying scientific principles and experimental control. Clinicians pursue the betterment of their individual clients’ health and well-being by applying the training and clinical judgment they possess. Re- searchers view clinicians as the persons who should apply the knowledge handed to them. Clinicians view researchers as aca- demics whose pursuits usually are irrelevant to patient care. This article is the start of a dialogue between these two groups about each of their needs and likely misconceptions about the evidence-based movement. After a brief introduction to evi- dence-based behavioral medicine (EBBM), we describe first clinicians’ and then researchers’ fears about embracing the evi- dence-based movement. Next we demonstrate to researchers how they cannot successfully pursue the evidence-based move- ment without a full partnership with clinicians. We highlight unique contributions that behavioral medicine is positioned to make to the evidence-based movement by extending the tradi- tional medical research continuum to incorporate studies of treatment mechanisms and knowledge translation. Although public health, consumer, educator, and policy audiences also are interested in and concerned about the implications of the evi- dence-based movement to their respective fields, here we focus 125 This article was supported by the National Institutes of Health Office of Behavioral and Social Science Research contract NLM 00–158/LTN. Reprint Address: B. Spring, Ph.D., Department of Psychology, Univer- sity of Illinois Chicago (M/C 285), 1007 W. Harrison Street, Chicago, IL 60607. E-mail: bspring@uic.edu