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Evidence-Based, Empirically Supported, Best Practice Ronnie Detrich, Trina Spencer, Tim Slocum
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Definition of Evidence-Based Practice Evidence-Based Practice is a process of making decisions being informed by three sources of influence: a)best available research evidence b)professional judgment c)client values Cf. Clinical Psychology: APA Task Force (2006) Cf. Medicine: Sackett et al (2000) Cf. Education: Whitehurst (2002) Cf. Communication Disorders: Schlosser & Sigafoos (2008)
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Definition of Evidence-Based Practice One tool that is useful in this process is a list of interventions that are well supported by research. These interventions are often called ‘evidence-based practices’. This usage invites confusion between: the process of making decisions and a list of some of the possible intervention choices This confusion could trivialize a complex decision making process by treating it as a simple menu choice.
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Definition of Evidence-Based Practice Interventions that are well supported by research Terms are not at all consistent. Virtually all combinations have been used: Do not use “evidence-based practice” to refer to an intervention As a speaker and listener, remember: The verbal community is NOT consistent in usage. We cannot assume anything from the term alone. We must attend to the procedures, not the label. EvidenceBasedPractice(s) ResearchValidatedTreatment ScientificallyProgram EmpiricallySupportedIntervention
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Definition of Evidence-based Practice Primary question of the symposium: How do we most effectively use the research base to guide professional practice? Requires generalization from a set of specific studies to a range of practical situations How broadly/narrowly shall we define The intervention? The client characteristics? The outcomes? The contexts of practice?
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What is to be validated? Interventions can be defined a various levels of specificity. Specificity general specific less more Research This issue also applies to outcomes, clients, and contexts.
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Definition of Evidence-based Practice The research base will never match our specific questions regarding practice; therefore, we must address the difficulties of generalizing beyond specific research studies. By reviewers of research on a particular topic Different styles of research reviews allow different ranges of generalization By practitioners This is part of ‘professional judgment’ that is included in the definition of evidence-based practice.
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What is “Professional Judgment”? Professional judgment Fills the gap between an imperfect research base and the specifics of a clinical situation. Includes rule-governed elements Knowledge of the research base Knowledge of broader principles of behavior Includes contingency-shaped elements Subtle discriminations of when and how to apply principles Repertoire of shaped interactive behavior
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Methods of Deriving Practice Recommendations 1. Empirically Supported Interventions (Slocum) Using objective and operationalized procedures for identifying the level of research support for particular interventions. 2. Best Practices (Detrich) Employing experts to review research and make critical judgments and reasonable generalizations as a basis for recommendations. 3. Research-Based Principles (Spencer) Drawing from basic principles to construct or adapt interventions for individual settings or clients. The nexus between ‘research base’ and ‘professional judgment’
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Methods of Deriving Practice Recommendations We will argue: 1. Each of these methods can be employed with a range of quality and rigor. 2. Each has distinct strengths and limitations. 3. The three methods can work together to inform practice.
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