Integrating psychoeducation in clinical practice

One of the greatest problems of evidence-based medicine is the distance that often separates tested approaches and suitable approaches. Most clinical trials of a drug can be criticized because they suffer from a certain sample bias (only cooperating patients are included, the frequency of visits is increased, etc.), a bias that is used as an argument against the possibility of generalizing the results of studies. However, although the legitimacy of such criticisms must be recognized, randomized clinical trials are certainly the only method of demonstrating the efficacy of a specific treatment. In real world practice, open series and naturalistic studies can be very useful in determining the applicability and efficiency of a treatment, but not its efficacy, since by definition its methodology is less rigorous. In spite of that, a hierarchically arranged combination of these two strategies is the only way to provide an overall evaluation of the clinical usefulness of any treatment: first the randomized-controlled study is performed, and then, if the results are positive, the open series.