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Frequently Asked Questions: Evidence-Based Practices
Please click through the questions below for answers to frequently asked questions. If you have a question that doesn’t appear below, please feel free to share at email@example.com.
You can learn more simply by clicking on each FAQ.
What is an evidence-based practice?
An evidence-based practice (EBP) is a specific treatment technique, model, or program that has been shown, through research, to improve outcomes.
The term, evidence-based practice, also refers to the process of integrating:
- the best available research
- with clinical expertise
- in the context of patient characteristics, culture, and preferences
A free downloadable handout is available providing more information on understanding EBPs.
(Definition from the American Psychological Association, 2006.)
What are the advantages to using EBPs?
There are many advantages to using EBPs. We have highlighted four key examples below.
- Help promote recovery and resilience. A recovery and resilience oriented system of care:
- Supports people in achieving their goals to live, work, learn and participate in their communities.
- Recognizes that services and supports should include multiple pathways to recovery based on an individual’s unique strengths as well as his or her needs, preferences, experiences, and cultural background.
- Has the benefit of, and is grounded in, the best available science.
- Increase the likelihood of a program working by providing structure and a focus on services that achieve meaningful change.
- Support the development of competence and confidence among service providers by equipping them with tools that work.
- Provide hope to families by offering treatments that have been proven to work.
EBPs are tools that should be offered in the context of recovery frameworks and individualized treatment. Learn more about this perspective by checking out the DBHIDS Practice Guidelines.
What is the “evidence”?
The “evidence” that a particular practice is effective is collected through research studies that measure the outcomes of the practice. The most rigorous research studies are called Randomized Control Trials. When there is an accumulation of research evidence from several research studies showing that a specific practice helps people get better, it can be considered an evidence-based practice.
Are there different levels of evidence?
Yes, some practices have not been evaluated through multiple rigorous research studies, but have shown some success in helping people improve through other types of evaluations. As the research evidence for different practices is still being developed, DBHIDS recognizes that there is a continuum of research evidence.
A practice that has been demonstrated to be effective through an accumulated body of well-designed research studies conducted by more than one research team in diverse settings and populations.
A practice that has demonstrated positive outcomes in a limited number of research studies or in studies that use quasi-experimental designs. This could also include a practice that has a strong body of research support but is being delivered to different population or in a different setting.
A practice that has demonstrated some positive outcomes through evaluation or research but those studies are limited in their research methodology and the practice has not yet been evaluated through more rigorous or generalizable methods.
How do providers ensure that EBPs are delivered with quality?
While there are many factors to consider when thinking about the quality delivery of an EBP we have detailed three frequently used terms below.
An important feature of EBPs is that the elements of the practice are clearly articulated so that they can be delivered consistently. This is often done through specific training expectations and the use of a manual or protocol to guide treatment delivery. This is important because it allows a researcher to be sure that the outcomes achieved are due to the specific practice. It also provides a roadmap for how a treatment provider should deliver the practice in order to achieve similar outcomes. In other words, an EBP is delivered with “fidelity” when care is taken to ensure that it is delivered as it was designed in the research studies.
The success and sustainability of an EBP starts with selecting a practice or program that fits with your organization, population, or community. Fit impacts things like how well the innovation is adopted at an agency, and how effective it is for the intended population. Below are a few examples of the kinds of fit questions you may want to think about.
How does this program fit with:
- The population that we serve
- The mission, vision and values of my agency and community
- Our organizational resources and readiness
- Staff skills and structure
- Existing initiatives
To read more about fit you can check out this ASPE Brief on contextual fit, this infographic that highlights fit and offers additional useful resources, or this hexagon tool created by the National Implementation Research Network (NIRN).
Adaptation is the process of making changes to an evidence-based practice or program in order to make it more suitable for a particular population, setting or structure without compromising or removing its core components. Adaptations to EBPs need to be done systematically and thoughtfully to ensure that the treatment isn’t compromised. Fortunately, some minor adaptations can be done without changing core elements.
- Adapting language/examples that are relevant to age or culture when teaching skills (e.g making the words, images, and scenarios inclusive of all participants).
- Considering cultural norms when presenting coping methods or skills (e.g. faith or spiritual approaches, expressivity when communicating, respect for elders).
Are EBPs being developed in diverse communities such as ours?
Yes, in fact in recent decades research funders have begun to expect more culturally diverse samples. They have also begun to require that research be conducted in “real world” communities to ensure that the treatment and trainings developed are relevant and feasible. Here in Philadelphia we’ve seen more researchers interested in doing research in our community settings.
- Here is a great webinar on the topic:
EBT’s for ethnic minority youth: What we know and what we don’t know.
You can also learn more by visiting the general registries section on the EPIC Resources page. Many EBP registries provide descriptive information about where and with whom the practice or intervention has been researched. These categories include things like: age, race/ethnicity, geographic location, settings, gender, and many more.
What is implementation science? How does that relate to EBPs?
The definition of implementation is: “a specified set of activities designed to put into practice an activity or program of known dimensions.” Implementation Science is a field of research that aims to identify concrete strategies for how to implement and sustain a practice; these may include supports such as training, coaching, or infrastructure.
Implementation Science is important when talking about EBPs because evidence-based programs aren’t much help unless we can put them into everyday practice and produce the same positive results that they produced during the research process. Implementation Science helps us understand HOW to make use of the interventions and programs that have been identified as effective. Read more about implementation science, or watch this quick implementation overview for more information.
(Definition from the National Implementation Research Network, 2016.)
How does clinician expertise factor into the delivery of EBPs?
Clinician expertise isn’t just a factor in the delivery of EBPs – it’s an imperative. EBPs sometimes get unfairly judged as “cookbooks” because they provide written structures, but within those structures practitioner success depends on their own experience, judgment, and skills.
A clinician using an EBP is analogous to an architect building a house. The architect needs to follow formulas and plans regarding important structures like the foundation and weight bearing walls, but what the house looks like in the end is determined by the creativity and skill set of the architect.
Practitioner experience, knowledge and skill form the basis for: client engagement, assessment of contributing factors to behaviors of concern, delivery of intervention, and so forth. Clinician expertise is the foundation by which the successful delivery of EBPs is built.
I am seeking services for myself / my family, what do I need to know about seeking evidence-based practices?
You can find lots of useful resources under the family section of our resource section, but here are two resources that we find particularly useful.
- The Parents Guide to Getting Good Care helps walk you through the steps of finding the best professional (or team) and the most appropriate treatment.
- The Hawaii State Child and Mental Health Division’s Help Your Keiki site offers links to information about: choosing the right treatment, what to expect from a good therapist, and questions to ask your child’s therapist.
You can also find a listing of the available Evidence-based Practices in Philadelphia by visiting the EBPs in Philadelphia section of our website.
I’d like to learn more about EBP research, where can I find research articles?
This blog post from the Canadian Centre for Addiction and Mental Health offers some free resources and search tips for finding research articles.
In addition, the American Psychological Association has a nice resource that highlights the kinds of things to look for when reading research articles.
How does my organization take part in a DBHIDS-EBP training initiative?
All EBP training opportunities go through a formal procurement process. You can monitor the CBH website for new contracting opportunities, or sign up for CBH News to get email updates on things like upcoming procurement opportunities.
To learn more about the current department funded initiatives visit the Department Funded Initiatives section of our website.