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Evidence-based psychological treatments for mental disorders: Modifiable barriers to access and possible solutions
Open accessAbstract
The prevalence of mental disorders is high and appears to be growing, yet the majority of individuals who meet diagnostic criteria for a mental disorder are not able to access an adequate treatment. While evidence-based psychological treatments (EBPTs) are effective single or adjunctive treatments for mental disorders, there is also evidence that access to these treatments is diminishing. We seek to highlight modifiable barriers to these problems at the patient, therapist, treatment, organization and government-levels of analysis. A range of solutions to each set of contributors is offered and domains for future research are highlighted. In particular, we focus on the need to continue to work toward innovation in treatment development while also solving the difficulties relating to the dissemination of EBPTs. Several relatively new concepts in the field will be discussed (implementation cliff, program drift, voltage drop and deployment treatment development) and we contrast America and England as examples of government-level processes that are in the process of major change with respect to EBPTs. We conclude that there is a need for people in our field to become more knowledgeable about, and get involved in, shaping public policy.
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“Overall, MAST-V helps to address patient-, therapist-, and treatment-level barriers to mental health care access (Harvey & Gumport, 2015).”
From Brief modular anxiety intervention for primary care: Hybrid I pilot randomized controlled trial of feasibility, acceptability, effectiveness, and implementation potential (2024) · cites this paper as Harvey & Gumport, 2015
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“Although effective psychological treatments for depression and anxiety exist, they are difficult to access for many individuals [5,6].”
From Blended care-cognitive behavioral therapy for depression and anxiety in real-world settings: Pragmatic retrospective study (2020) · cites this paper as [5]
In the citing paper
“This is caused both by under-treatment of mental disorders such as depression (Demyttenaere et al., 2004, Harvey and Gumport, 2015) and therapist drift from evidence-based treatment protocols (Waller, 2009).”
From Development and initial evaluation of blended cognitive behavioural treatment for major depression in routine specialized mental health care (2016) · cites this paper as Harvey and Gumport, 2015
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“Research suggests that only a limited amount of patients in routine practise actually receives evidence-based treatment (Gyani et al., 2014, Harvey and Gumport, 2015).”
From Development and initial evaluation of blended cognitive behavioural treatment for major depression in routine specialized mental health care (2016) · cites this paper as Harvey and Gumport, 2015
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Citations
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BackgroundSelbstwertförderung in der universellen Prävention von Essstörungen
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“However, conventional evidence-based psychological treatments have certain limitations associated with them, such as lack of access, stigma, and difficulty in affording the services [22].”
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“그러나 대면으로 진행되는 비약물적 중재의 이점에도 불구하고 진료비 부 담에 대한 증가와 자원의 한계로 인하여 치료의 수용과 가 용성 사이에는 큰 격차가 존재하는 것으로 알려져 있다 [31].”
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“…this science-to-practice gap include variability in disciplinary approaches to evidence-based practice; inconsistency in training experiences, types and amount of ongoing continuing education; and differences in individual provider attitudes toward EBIs (Areán et al., 2021; Harvey & Gumport, 2015).”
Bal, F. (2025) · Archives of Clinical Neuropsychology · doi:10.1093/arclin/acaf069
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“…who need treatment do not receive any services due to various barriers, such as socioeconomic or geographic ones (Borson et al., 2019; López-Lara et al., 2012), and the number of individuals affected by mental disorders is large and growing (Harvey & Gumport, 2015; Kessler et al., 2005).”
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“Future research should seek to include adolescents with mental health conditions through the use of appropriate safe-guards, including trained mental health personnel and standardized tools to assess mental health status (Harvey & Gumport, 2015).”
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“This finding supports prior research indicating that brief, didactic education programs without expert supervision are not enough to build proficiency in advanced CBT-I interventions (Harvey & Gumport, 2015; Jernelov & Blom, 2023; Manber et al., 2012).”
Nkrumah, F., & Zaporozhets, O. (2025) · Continuing Professional Education Theory and Practice · doi:10.28925/2412-0774.2025.3.4
Cha, B. S., Kim, J., Borghouts, J. W., Eikey, E. V., Schneider, M. L., Schueller, S. M., Stadnick, N. A., Zheng, K., Mukamel, D. B., & Sorkin, D. H. (2025) · Psychiatric Quarterly · doi:10.1007/s11126-025-10225-8
Milo, R., Amorese, T., Cuciniello, M., Perna, A., Cordasco, G., & Esposito, A. A. (2025) · International Joint Conference on Neural Networks (IJCNN) · doi:10.1109/ijcnn64981.2025.11228561
“Recommended evidence-based psychological interventions, along with pharmacological treatments, are available and effective, however, access to them is often difficult [3].”
Metadata
- Authors
- Harvey, A. G., & Gumport, N. B.
- Affiliations
- University of California, Berkeley (US)
- Corresponding author
- Harvey, Allison G.
- Venue
- Behaviour Research and Therapy
- Publisher
- Elsevier BV
- Published
- 2015-05
- Volume
- 68
- Pages
- 1-12
- ISSN
- 0005-7967 (ISSN-L)
- PMC
- PMC4395546
- OpenAlex
- W2075286177
- Cited by
- 221
- References
- 149
- Citations by year
- 2026: 21 · 2025: 27 · 2024: 24 · 2023: 31 · 2022: 29 · 2021: 10 · 2020: 24 · 2019: 20 · 2018: 19 · 2017: 9 · 2016: 5 · 2015: 2
- FWCI
- 21.28
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Behaviour Research and Therapy (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- eScholarship (California Digital Library) (submittedVersion)
- Funders
- National Institute of Mental Health (1 R01 MH105513-01)
- Topics
- Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
- Health Sciences › Medicine › Psychiatry and Mental health › Mental Health Treatment and Access
- Social Sciences › Psychology › Clinical Psychology › Psychotherapy Techniques and Applications
- Keywords
- evidence-based psychotherapy, mental illness, access to mental health care, barriers to treatment access, voltage drop, mental health policy, public policy, mental health services
- MeSH terms
- Mental Disorders, England, Humans, Mental Health Services, Evidence-Based Medicine
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