Beyond a single standard: levels of evidence approach for evaluating marriage and family therapy research and practice

Randomized clinical trial (RCT) research has come to dominate the research landscape of marriage and family therapy (MFT). Despite becoming the ‘gold standard’ for evaluating clinical research and clinical practices, there is a growing debate regarding the reliance on RCTs as the primary basis for evaluating clinical intervention in MFT. Given the natural diversity of clients, settings and clinical problems faced by practitioners and the relational and recursive interactional process of MFT, one of the major challenges for the field of MFT will be to come to grips with the research–practice gap by moving beyond a single methodological standard through adopting a ‘levels of evidence’ approach as a framework that promotes diverse research methods, different methodological criteria (depending on the method), and evaluation based on the accumulated type of evidence needed to answer a specific policy, clinical practice choice, or within a model clinical decision.