The Evidence-Based Status of Psychotherapy Training Programs in Italy

Introduction: There are approximately 380 private institutes in Italy offering paid psychotherapy training programs that qualify students for registration with the psychotherapists' registry. These institutes have been approved by relevant authorities and committees over the span of forty years, during various historical periods. The Italian Code of Ethics for Psychologists states: "Psychologists employ methodologies for which they can indicate scientific sources and references." The purpose of this study is to assess if and how the methodologies taught in the statutes of Italian psychotherapy training programs meet evidence-based indicators grounded on currently available scientific references. Methods: Websites of 382 Italian training institutes were screened, and the theoretical models and methodologies offered were extracted. Utilizing a Delphi consensus method, evidence-based indicators were developed to evaluate whether the efficacy of the taught methodologies are supported, for at least one clinical population, by: 0) no evidence, no peer-reviewed scientific articles with any experimental design; 1) very low evidence, at least five case reports; 2) low evidence, at least one randomized controlled trial (RCT) or cohort study; 3) moderate evidence, at least one meta-analysis or network meta-analysis of RCTs; 4) high evidence, at least one umbrella review or at least one international guideline for the administration of psychosocial treatments. Major bibliometric search engines of peer-reviewed journals and key international guidelines were consulted to apply the designed evidence-based indicators. Results: 72% of psychotherapy training institutes in Italy meet the criteria from high to moderate evidence, 12% low evidence, 10% very low evidence, and 6% no evidence. Institutes teaching methodologies rated as "low evidence" or below were contacted to provide additional information to correct any potential errors in our data extraction or in the application of the indicators – this consultation is ongoing, and the reported results may be subject to minor changes. Discussion: Over a third of psychotherapy training institutes in Italy teach psychotherapeutic intervention methodologies not supported by scientific evidence according to very broad evidence-based indicators (i.e., evidence referred to at least one clinical population, no evidence grading was considered).