Evidence-based practice Flashcards
Definition of Intervention
Intervention: refers to all direct services rendered by health care psychologists, including assessment, diagnosis, prevention, treatment, psychotherapy, and consultation.
Definition of Evidence-Based Practice (EBP): 3 definition
Evidence-Based Practice (EBP) in Psychology is the integration of best available research with clinical expertise in the context of patient characteristics, culture, and preferences
That means…
Individual therapy is based (or should be) on empirical evidence of what works (from empirical studies)
Adherence to psychological approaches and techniques that are based on scientific evidence is referred to as “Evidence-based Practice” (EBP).
What factor people consider when looking for mental health treatment?
Common factors people consider when looking for mental health treatment for themselves or a loved one:
Availability of therapist and his/her their schedule, desired fees, or is it covered by a specific insurance plan.
* Essential factors to consider are the type of treatment that a mental health care provider will offer.
• Not all mental health treatments are equally efficacious
• Consumers must be educated when searching for a therapist
• Some therapies may work better than others
• Therapists may subscribe to different ‘schools of thought,’ or philosophies on how to effectively reduce psychological symptoms
• Some of these philosophies are based directly on scientific evidence that indicates the best routes to symptom relief
• However, other mental health care providers may offer treatment that is not based on strong scientific evidence, or for which no evidence is available to date.
What are Criteria for evaluating treatment guidelines?
Evidence base for any psychological intervention should be evaluated in terms of two sperate diminutions:
• Efficacy:
- the strength of evidence pertaining to establishing causal relationships between interventions and disorders under treatment.
- Treatment Efficacy: the systematic and scientist evaluation of whether a treatment works?
• Clinical Utility:
- a consideration of available research evidence and clinical consensus regarding the generalizability, feasibility (including patient acceptance), and cost and benefits of interventions.
Is the applicability and usefulness of the intervention in the local or specific setting where it is to be offered.
Why promote EBP in psychology?
- Clients are in distress, make a major personal commitment to therapy, and have a right to effective treatment, and a right to know that the therapy offered is safe and effective.
- Need to protect the public from practitioners of “pseudoscience”.
- Psychologists have a responsibility to continuously improve the treatment they offer.
- Psychological therapy represents a substantial economic investment and it could be seen as unethical to waste this money on ineffective treatments.
- Ineffective therapy harms patients and gives a bad image of psychological treatment.
- Although psychological therapies do benefit patients, there is also evidence that patients’ mental health can get worse if therapies are inappropriate and/or carried out incompetently.
- Healthcare money should not be wasted on ineffective treatments.
What is evidence based practice first debate, and what does it mean?
research-practice divide
Research tends to be viewed as only constituted by large scale trials, while practice of individual therapy is viewed as a much smaller process. (Research in Individual Therapy, p.578)
Practice-Based Evidence
• Does this make therapy and research incompatible/isolated from each other? No
• Is the gap between researcher and practitioner that big? No
evidence is generated from within the therapy, generated by the collaboration between therapist and client, and between different therapists that could work collaboratively to gather data within a defined research question with a clear methodological base
Randomized controlled trial (RCT)
study in which participants are randomly assigned to different treatment conditions (2 or more), to control and compare their effectiveness. Procedures are controlled to make sure that all participants in the study are treated the same, except for the intervention/treatment under research.
So, there is the experimental group (the one that receives the treatment) and the control group (the one that doesn’t have the treatment) – participants don’t know who has the treatment!
Meta-analysis
study in which statistical methods are used to contrast and combine the results from different studies
What is evidence based practice second debate, and what does it mean?
Debate 2: ebp in psychology
“Is therapy helpful?” To judge the efficacy of therapy outcomes research is necessary. However, therapy is influenced by many factors that research cannot take into account.
factors influence therapy outcomes?
o Patient Characteristics including the problems, personality, culture, and preferences, gender, sociocultural context, religious beliefs, age…..etc.
o Clinical expertise including clinical decision making, interpersonal expertise (including interpersonal skills and ability to form a relationship with clients), cultural competence, knowledge of research, assessment, treatment planning…etc.
o Type of treatment
What are the limitations and criticisms of EBP?
- Shortage of evidence (not enough high-quality large studies available in Psychology).
- Applying the results to individuals (results of RCTs are analyzed by comparing the mean score of the experimental group to the mean score of the control group; this masks any individual differences – it is de-individualising, de-contextualising).
- Discrepancies between carefully controlled research environment and clinical reality.
- Training, time and resources needed
- Many family-systems, existentialist, humanist, feminist, psychodynamic, and psychoanalytic therapists find their own ways of thinking about human experience incompatible with the model of empirical support used by EBP advocates.
