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What Is Evidence-Based Practice?
What Is Evidence-Based Practice?
Evidence-based practices are treatments that work based on the best available research. Evidence-based practices take into account three different pieces of information (Sackett, 2000)
- The latest research
- Your own values and preferences as a patient
- Your therapists’ clinical experience
When your clinician is using evidence-based practices, they are synthesizing these pieces of information to get you the best outcomes.
To help give you all the information you need to best advocate for yourself, let’s break down the components of evidence-based practices:
Treatment Based on Research
There are so many factors that go into choosing a therapist (location, fees, availability, among others). When you’re looking for therapy, be aware that not all therapies are the same. While some methods have years of research supporting and proving that they work, others lack this rigorous testing. Research support is so important because studies show that therapists are actually not very good at figuring out which treatments will work based on their own subjective opinion. Instead, we know that when treatment is based on research, it’s more likely to lead to successful outcomes. In other words, you’re more likely to feel better and meet your treatment goals if your therapy is proven to work in research studies.
For a treatment to be considered “empirically supported” or “evidence based,” it needs to have numerous large, well-designed studies demonstrating that it leads to positive outcomes for treating a specific problem. Treatments in this category have typically been studied in several large-scale research trials, involving thousands of patients and careful comparison to other types of psychological treatments. Although there are a number of empirically supported treatments for various issues, the majority are variations of Cognitive Behavioral Therapy (CBT). The effectiveness of CBT has been demonstrated for a wide range of problems in adults, adolescents, and children. Click here to learn more about CBT. It is important to note that different problems call for different treatments – therapy is not a “one size fits all” thing. To find more information about the research supported treatments for various problems and conditions, click here.
Your Values and Preferences
The second important component in evidence-based treatment is your own values and preferences. Psychological treatment should be a collaboration that respects your own experiences, needs, and values. You should be open with your therapist about any concerns you have so you can address them collaborativel, and expect your therapist to take your values and preferences into consideration when making treatment recommendations.
You might have specific personal preferences for your ideal therapist. It isn’t always possible to find a therapist who meets these preferences and also provides research-supported treatment. Know that research shows that evidence-based treatments often lead to positive outcomes even when therapists and patients come from very different backgrounds.
The final piece of evidence-based practice is your therapist’s clinical expertise. It is your therapist’s job to interpret the best evidence from research in light of your preferences, values and culture. Therapists rely on their own clinical judgment to figure out how to integrate these different pieces of information into your individual treatment plan. They also rely on clinical expertise whenever the existing research base does not provide enough information to address your situation. A therapist who is serious about engaging evidence-based practice should give the scientific evidence extra weight in designing your care so that you have the best chance to improve. However, sometimes the scientific evidence is lacking or incomplete. For instance, if you present with two mental health problems for which there are two different treatments, the existing research may not clearly spell out whether you would be better off starting with Treatment A or Treatment B. In this situation, your therapist will use their clinical experience to create an individualized treatment plan for you. In this case, you should expect your therapist to clearly explain to you how the scientific evidence applies to your situation/problem, where the gap in information lies, and what your options are. Then you can collaboratively pick the best path forward.
In thinking about clinical expertise, you will want to consider the degree of experience that a therapist may have with a specific problem or particular group of people. Many therapists who engage in evidence-based practice have particular specialties (e.g., anxiety, eating disorders, depression etc.), and just because someone has expertise in one area doesn’t mean they do in another! Ultimately, the best recommendation would be to find a therapist who has substantial experience treating the specific problem you are looking for help with and does so based on the most up-to-date scientific evidence. That said, even relatively inexperienced therapists, such as those who recently received their doctoral degrees, can be extremely helpful if they are well trained, caring, and empathic, and rely on scientific evidence to guide their interventions.