Ch 9: Incorporating evidence-based practices in the treatment of mental disorders

Question 1

evidence based practice (EBP)

Answer 1

refers to the intentional selection of therapeutic approaches or modalities that have been rigorously examined using various research methodologies to document their effectiveness with diverse clients and a range of presenting issues and concerns
the integration of the best available research with clinical expertise in the context of patient characteristics, culture, and preferences

Question 2

three perspectives of APA task force definition of EBP (the three legs of the EBP stool)

Answer 2

1. counselors should evaluate available interventions, and discern what the research indicates about efficacy
2. counselors should consider their own clinical experience and expertise, realizing that intuition educated by years of experience is beneficial in understanding a clients presenting problem
3. clinicians should account for the unique experience of their clients is impacted by their culture, values, beliefs, and preferences

Question 3

longitudinal studies

Answer 3

where the observational data are gathered repeatedly over time

Question 4

randomized control trials

Answer 4

studies where separate groups created by chance are used to compare treatments or interventions

Question 5

client characteristics to consider when making treatment decisions

Answer 5

presenting concerns
comorbidity
age
state of life
developmental history
gender
gender identity
ethnicity
social class
race
religion
employment status
capability
sexual orientation
worldview

Question 6

empirically supported treatment (EST)

Answer 6

refers to a SPECIFIC technique, intervention, or treatment shown to be efficacious in precious research (EBP is more broad to overall process)
when used, it is an example of counselor applying EBP

Question 7

practice based evidence (PBE)

Answer 7

counselors firsthand clinical experiences with their clients are used to inform research
used ti gather their own data from clients through observation, assessment, and monitoring progress made toward established treatment goals; then compared to an existing model or standard of care

Question 8

importance of EBP

Answer 8

represents current best practice in the field
has ethical and legal implications (helps them adhere to ethic codes, and avoid legal issues)
EX: its main competent accounts for counselor expertise/competence and making sure they don’t use un-researched techniques that may cause harm

Question 9

for an intervention to be considered EST (therefore, a part of EBP), it must be…..

Answer 9

included in the national registry of evidence-based programs and practices (NREPP)

Question 10

NREPP

Answer 10

a SAMHSA maintained searchable online registry of mental health and substance abuse interventions thoroughly reviewed and rated by independent reviewers

Question 11

the 4 criteria for NREPP eligibility

Answer 11

1. the intervention has produced one or more positive behavioral outcomes among individuals/communities with significant differences between groups over time being demonstrated for each outcome
2. evidence of the positive behavioral outcomes has been demonstrated in at least one study Ising an experimental or quasi-experimental design
3. the results of these studies have been published in a peer-reviewed journal or other professional publication
4. implementation materials, training and support resources, and quality assurance procedures have been developed and are ready for use by the public

Question 12

quasi-experimental

Answer 12

used to validate treatment methods or to establish potential associations between variables
include a control or comparison group and a pre and post test assessments but do not use random assignment

Question 13

comprehensive evaluation reposts must include the following..

Answer 13

a review of the literature
theoretical framework
purpose
methodology
findings/results
discussion
conclusions

Question 14

peer review

Answer 14

a process through which professionals review each others work, assessing its merit based on the identified need for the study, its rationale, execution, results, and contributions to the profession

Question 15

Criteria to interpret and evaluate evidence

Answer 15

quality
robustness
relevance of the evidence

Question 16

evidence

Answer 16

the available facts and information supporting the truth and validity of a belief or proposition

Question 17

EST evidence hierarchy

Answer 17

top to bottom:
Level A: meta-analysis and systematic reviews
Level B: randomized control trials
Level C: cohort studies, case-control studies, cross sectional studies, qualitative studies, descriptive and correlational studies

Question 18

meta-analysis

Answer 18

aggregate data collected across multiple randomized and controlled studies

Question 19

meta-syntheses

Answer 19

combines qualitative data collected across studies to form a new interpretation of the phenomena being examined

Question 20

robustness

Answer 20

a method for evaluating incongruent evidence
you look at the research results, the population amount, the magnitude of the observed effect (effect size), observe the number of sources used to collect data

Question 21

relevance

Answer 21

relates to its purpose and use of practices
consider questions being asked in the research they review, what treatments are found to be effective for a presenting issue or disorder, and for whom these treatments are most likely to work
gauge the simulation value

Question 22

impact factor

Answer 22

a calculation of the number of citations received by a journal from other journals catalogued in the Web of Science database
the higher the better

Question 23

six steps of the EBP decision making process

Answer 23

1. drawing on client needs, and circumstance learned in a thorough assessment, identify answerable practice questions and related research information needs
2. efficiently locate relevant research knowledge
3. critically appraise the quality and applicability of this knowledge to the clients needs and situation
4. discuss the research results with the client to determine how likely effective options fit with the clients values and goals
5. synthesize the clients clinical needs and circumstances with the relevant research and develop a shared plan of intervention collaboratively with the client
6. implement the intervention

Question 24

barriers to implementing EBP

Answer 24

intervention-level barriers: proprietary nature of ESTs, less convenient and more difficult, confusing
client-level barriers: lack of buy in and support, resistance, cultural
counselor-level barriers: lac of consistency and prior education/training, lack of time, lack of incentive to use
organization-level barriers: inadequate infrastructure and administrative support, lack of qualified supervision, limited resources
system-level barriers: differing values and priorities across treatment settings, paperwork, nonrecovery-based model of care

Question 25

where to find ESTs

Answer 25

library databases
American Counseling Association
Substance Abuse and Mental Health Service Administration (SAMHSA)