ABSTRACT
Efficacy refers to how well a treatment works under ideal conditions, usually in a research setting. Effectiveness, by contrast, refers to how well a treatment works under “real-world” conditions, usually outside academic centers. If this sounds a bit theoretical and you are therefore tempted to skip this chapter, hold on a moment. Another way of thinking about these ideas is in terms of advantages and disadvantages faced by clients seen in different settings. Thus, we will discuss here all the reasons why your CBT clients may be at a relative disadvantage compared to those seen in academic centers, even if you are just as skilled as the therapists there are. Only by understanding these disadvantages can you hope to improve the chances of success for your clients.
