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©
2010 Jordan Institute
for Families
Vol.
15, No. 2
May 2010
Understanding Evidence-Based Mental Health Practices
Here are a few key points to help you effectively advocate and coordinate services on behalf of families.
Understand what an “evidence-based” practice is. An approach to prevention or treatment is considered evidence-based when it is shown to be effective through some form of documented scientific evidence. The evidence can include controlled clinical studies, or less rigorous demonstrations of effective outcomes with a specific population. The principle behind evidence-based practice is that clinicians use approaches that have been proven in some way to be effective, rather than relying solely on tradition, personal beliefs, or anecdotal evidence (USDHHS, 2008).
How Using Evidence-Based Practices Benefits Child Welfare Agencies |
| Helps child welfare workers and supervisors empower families in crisis to resolve their own conflicts, using well-tested programs. Enables agencies to refer families to services that have been scientifically researched and proven effective, which in turn may cause the families to make a greater commitment to participation. Provides child welfare workers with a better understanding of the range of programs available so they can make informed choices when referring families to services. (Source: CEBC, 2010) |
One caveat: an intervention may still be effective for an individual child or family even if it’s not recognized as an EBP. Many factors determine whether a therapist is successful with a particular client, and some of them are hard to measure (NAMI, 2007). For example, the quality of the therapeutic relationship between an individual client and therapist has an important influence on outcomes. In fact, one concern is that an over-reliance on EBPs may prohibit clinicians from exercising their own best judgment as to how to provide the best possible care for an individual. As a result, many organizations work to balance the scientific prescriptions of a program with the practical considerations of relationship and experience (USDHHS, 2008).
Sometimes there are barriers to finding an appropriate EBP. Due to cost and training requirements, some interventions are not available in some communities. In addition, not all EBPs have been studied in culturally and racially diverse communities, so their effectiveness with one population can’t necessarily be generalized to being effective with everyone (NAMI, 2007).
Educate yourself about providers in your area and the type and quality of service they provide. Mental health professionals should be able to describe the type of treatment they will use with a child or family, and why the particular treatment was chosen. See the list on this page for questions you might ask to help you and the families you refer understand the interventions that a provider offers.
Don’t be embarrassed to ask additional questions. If you don’t understand exactly what a provider is saying, he or she has not explained it clearly enough. Even for child welfare social workers, sometimes it can be intimidating to ask follow-up questions of other professionals. We assume that we must be missing something. If you’re not able to clearly explain to a family, youth, or supervisor what a provider has told you, keep asking questions until you can!
For parents and youth, listening to you engaged in dialogue with a provider can serve as a model for respectfully seeking information and clarification, and for making informed decisions about care.
Involve families and youth. Exercising choice in treatment is important for everyone. Every family has unique qualities, beliefs, and experiences which may prompt them to rule out or gravitate towards a particular therapy or clinician. Even if there are few treatment options in your community, encourage families to express their views as they select and then participate in treatment. You can coach parents or youth before an appointment to write a list of their own questions, concerns, or observations to discuss with the provider.
Families are more likely to follow through with therapy—and have their needs met—if they are active partners in treatment and are able to be honest with therapists about their concerns. Sometimes they need explicit permission to do so.
Questions to Ask Providers
Child welfare professionals and families may find it helpful to ask the following questions when talking with providers about evidence-based treatment options (NAMI, 2007):
- Why are you recommending this treatment and what are the alternatives?
- What is the goal of the treatment being recommended?
- How will we know if we’re reaching our treatment goals?
- What are the risks and benefits associated with the recommended treatment?
- Is there research or evidence to support use of this treatment?
- Is there research showing that the recommended treatment works for families like ours?
- What training or expertise do you have with the recommended treatment?
- If you are not recommending an evidence or research-supported treatment, why not?