Week 10: Evidence-based interventions

Question 1

What is the scientist-practitioner model?

Answer 1

It proposes that psychologists should be trained in a way that integrates science and practice, so that one may inform the other.

Question 2

What is evidence-based practice?

Answer 2

It is the integration of the best available research with clinical expertise in the context of client characteristics, culture, and preferences.

Question 3

What are the three legs of EBP?

Answer 3

1. The best available research
2. Clinical judgement and experience
3. Client preferences and values

Question 4

What is best available research?

Answer 4

It refers to a hierarchy of evidence with data from meta-analyses, randomised controlled trials (RCTs), and systematic within subject designs at the apex, well conducted quasi-experimental studies in the middle, and correlational and uncontrolled case studies at the bottom.

Question 5

What is clinical judgement and experience?

Answer 5

It refers to practitioners making use of their clinical skills and past experience to identify each client’s unique health state and diagnosis, risks, and benefits of potential interventions.

Question 6

What is client preferences and values?

Answer 6

It suggests that even when research evidence strongly supports the use of an intervention, a client may be unwilling to endure or participate in the process e.g., using flooding for a phobia.

Question 7

What is level 1 of research evidence?

Answer 7

Systematic review of all relevant RCTs.

Question 8

What is level 2 of research evidence?

Answer 8

At least one properly designed RCT.

Question 9

What is level 3-1 of research evidence?

Answer 9

Well-designed pseudo-randomised controlled trials.

Question 10

What is level 3-2 of research evidence?

Answer 10

Comparative studies with concurrent controls and allocation not randomised or interrupted time series with a control group.

Question 11

What is level 3-3 of research evidence?

Answer 11

Comparative studies with historical control. two or more single-arm studies, or interrupted time series without a parallel control group.

Question 12

What is level 4 of research evidence?

Answer 12

Case series, either post-test, or pre-test and post-test.

Question 13

Evidence supporting treatments for depression.

Answer 13

Level 1: CBT
Level 2: Emotion-focused therapy
Level 3: Mindfulness
Level 4: n/a

Question 14

Evidence supporting treatments for GAD.

Answer 14

Level 1: CBT
Level 2: Psychodynamic psychotherapy
Level 3: n/a
Level 4: Mindfulness

Question 15

What are the six main reasons for resistance to EBP?

Answer 15

1. Naive realism
2. Myths and misconceptions regarding human nature
3. The application of group probabilities to individuals
4. The reversal of the onus of proof
5. Mischaracterisations of what EBP is and is not
6. Pragmatic, educational and attitudinal obstacles

Question 16

What is naive realism?

Answer 16

It refers to practitioners’ tendency to assume that they can rely exclusively on their intuition to infer that an intervention was successful e.g., seeing is believing.

Question 17

What are myths and misconceptions regarding human nature?

Answer 17

It is the acceptance of deep-seated myths and misconceptions e.g., believing that repressing painful memories are the root of the client’s condition.

Question 18

What is the application of group probabilities to individuals?

Answer 18

EBP relies heavily on group-based findings, so when practitioners are confronted with unique cases, they are asked to apply group-based findings to the individual.

Question 19

What is the reversal of the onus of proof?

Answer 19

The burden of proof lies with the proponents of the intervention rather that the sceptics.

Question 20

What is mischaracterisation of what EBP is and is not?

Answer 20

Common mischaracterisations include:
1. EBP stifles innovation and the development of new treatments
2. It requires a one-size-fits-all approach to treatment
3. It excludes nonspecific influences on therapy
4. It does not generalise to individual who have not been examined in controlled studies
5. It neglects evidence other than RCTs
6. It is unnecessary because all treatments are equally efficacious
7. It is inherently limited because therapeutic changes cannot be quantified
8. It is erroneous because human behaviour is impossible to predict with certainty

Question 21

What are pragmatic, educational, and attitudinal obstacles?

Answer 21

Time, knowledge of training materials, learning curve, statistical complexity.