A GUIDE TO THE EVIDENCE-BASED DEBATE FOR POLICY MAKERS WITHIN MENTAL HEALTH CARE: ANSWERING ARTHUR C. BOHART LEIF EDWARD OTTESEN KENNAIR Nordfjord Psychiatric Centre, Nordfjord Norway ©Copyright Sacks Publications -Scipolicy, 2003 Box 504 Haverford, PA 19041USA Editor@Scipolicy.net Scipolicy and The Journal of Science and Health Policy are trademarks of Sacks Publications, USA http://Scipolicy.net Abstract: In response to our article (Kennair, Aarre, Kennair, Bugge, 2002) Arthur C. Bohart has written a rejoinder. Our answer attempts to put to rest any worries that our position on professional ethics will cause more suffering among patients. Further, it attempts to clarify problems connected to the epistemol- ogy debate between Bohart and others that oppose an evidence-based approach and those of us in fa- vour of the evidence-based approach. Finally, an attempt is made at presenting explicit conclusions based on this discussion for policy makers within mental health care. This is both a defence of, and a call for, a natural science perspective on clinical psychology. Keywords: Epistemology, Mental Health Policy, Evidence-based mental health care, Health policy, Natural science. Introduction In an article-length rejoinder to our article (Ken- nair, Aarre, Kennair & Bugge, 2002) Arthur C. Bohart questions our approach and the prem- ises on which we build our conclusions. He is also sceptical of the consequences of our pro- posal as a basic foundation of ethical profes- sional practice. I welcome this opportunity to ad- dress Bohart’s misgivings with our article. This answer will be divided into three parts. First I wish to show that Bohart’s fear – that the effect our definition of professional ethics may have is increased suffering among patients – is unwar- ranted. Thereafter I will address Bohart’s ap- proach to natural science within psychotherapy research, by confronting the epistemology de- bate inherent in the pro aut contra approach to evidence-based mental health care. Finally, in order to reflect on how this discussion may in- form policy makers, I will attempt to draw con- clusions based on the differences between those that oppose an evidence-based approach, including (but not limited to) Bohart, and those who champion the evidence-based perspective. Central questions are: will lesser standards for testing, documentation and control of treatments for mental disorder discriminate against mental health patients and the consumers of such ser- vices? Is there any reason today not to demand documented effect for a treatment of a mental disorder? Our paper (Kennair et al., 2002) was a call for a natural science approach to psychiatry and clini- cal psychology. This answer to Bohart’s attack on that perspective may thus be read as both a defence of, and a call for, natural science within clinical psychology.