The term evidence-based practice EBP was used initially in relation to medicine, but has since been adopted by many fields including education, child welfare, mental heath, and criminal justice. The Institute of Medicine defines evidence-based medicine as the integration of best researched evidence and clinical expertise with patient values p. In social work, most agree that EBP is a process involving creating an answerable question based on a client or organizational need, locating the best available evidence to answer the question, evaluating the quality of the evidence as well as its applicability, applying the evidence, and evaluating the effectiveness and efficiency of the solution.
EBP is a process in which the practitioner combines well-researched interventions with clinical experience, ethics, client preferences, and culture to guide and inform the delivery of treatments and services. Here, for consistency, we will use the term evidence-based treatments EBT.
Differentiating from the evidence-based practice process described above, one definition of an evidence-based treatment is any practice that has been established as effective through scientific research according to a set of explicit criteria Drake et al. These are interventions that, when consistently applied, consistently produce improved client outcomes. Some states, government agencies, and payers have endorsed certain specific evidence-based treatments such as cognitive behavioral therapy for anxiety disorders and community assertive treatment for individuals with severe mental illness and thus expect that practitioners are prepared to provide these services.
Evaluation of Research on Practice Interventions. Randomized controlled trials RCT are frequently viewed as the gold standard for the evaluation of interventions. However, it is not always possible or ethical to conduct RCT in social, health, and human services, and thus there is a lack of that type of research evidence for some interventions provided by social workers. Qualitative research can enhance quantitative research and help us better understand cultural issues and contexts related to interventions.
Some view research as falling into a hierarchy with the highest level of the strength of research being systematic reviews and meta-analyses. A number of organizations have attempted to develop objective evidence grading systems to rate the strength of evidence for interventions.
The Institute of Medicine IOM has convened a multidisciplinary roundtable on evidence-based medicine that is exploring multiple issues including examination of the lack of consistency in assessing the strength of evidence regarding what works. The Campbell Collaboration conducts systematic reviews of research and promotes systematic reviews because such rigorous analysis of research endeavors to minimize bias in the identification, assessment and synthesis of research results Littell, , p.
In these systematic reviews, the review process and decision-making criteria are transparent and established in advance. While there is no consistent agreement on the hierarchy of best available research, a common perspective on a hierarchy of evidence might be:. For practitioners trying to identify EBT for the clients they serve, there are a growing number of Web sites and guidebooks available to provide some useful information to help guide practice. In identifying EBT, the practitioner must assess the extent to which the particular EBT is adoptable and adaptable for their client and specific situation.
In particular, practitioners may have concerns that many interventions are tested on very homogenous samples and therefore may not represent the complex co-occurring conditions or cultural and community contexts of many of the clients with whom social workers work. The University of Minnesota School of Social Work convened a group of researchers, practitioners, educators, consumers, legislators, and judges to address this issue at a symposium on Evidence-Based Practice and Cultural Competence in the Context of Child Welfare.
Read the symposium report. California Evidence-Based Clearinghouse for Child Welfare provides up-to-date information on evidence-based child welfare practices. It also facilitates the utilization of evidence-based practices as a method of achieving improved outcomes of safety, permanency, and well-being for children and families involved in the California public child welfare system.
Cancer Control PLANET provides access to data and resources that can help planners, program staff, and researchers design, implement, and evaluate evidence-based cancer control programs. Still need help? Feel free to contact us. With our dedicated customer support team, day no-questions-asked return policy, and our price match guarantee, you can rest easy knowing that we're doing everything we can to save you time, money, and stress. The spine may show signs of wear.
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