Evidence-Based, Empirically Supported, Best Practice. Ronni

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Evidence-Based, Empirically Supported, Best
Practice

• Ronnie Detrich, Trina Spencer, Tim Slocum

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Definition of Evidence-Based Practice

• Evidence-Based Practice is a process of making
  decisions being informed by three sources of
  influence
• best available research evidence
• professional judgment
• client values
• Cf. Clinical Psychology APA Task Force (2006)
• Cf. Medicine Sackett et al (2000)
• Cf. Education Whitehurst (2002)
• Cf. Communication Disorders Schlosser
  Sigafoos (2008)

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Definition of Evidence-Based Practice

• One tool that is useful in this process is a list
  of interventions that are well supported by
  research.
• These interventions are often called
  evidence-based practices.
• This usage invites confusion between
• the process of making decisions and
• a list of some of the possible intervention
  choices
• This confusion could trivialize a complex
  decision making process by treating it as a
  simple menu choice.

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Definition of Evidence-Based Practice

• Interventions that are well supported by research
• Terms are not at all consistent.
• Virtually all combinations have been used
• Do not use evidence-based practice to refer to
  an intervention
• As a speaker and listener, remember The verbal
  community is NOT consistent in usage.
• We cannot assume anything from the term alone.
  We must attend to the procedures, not the label.

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Definition of Evidence-based Practice

• Primary question of the symposium
• How do we most effectively use the research base
  to guide professional practice?
• Requires generalization
• from a set of specific studies
• to a range of practical situations
• How broadly/narrowly shall we define
• The intervention?
• The client characteristics?
• The outcomes?
• The contexts of practice?

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What is to be validated?

• Interventions can be defined a various levels of
  specificity.

This issue also applies to outcomes, clients, and
contexts.
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Definition of Evidence-based Practice

• The research base will never match our specific
  questions regarding practice therefore, we must
  address the difficulties of generalizing beyond
  specific research studies.
• By reviewers of research on a particular topic
• Different styles of research reviews allow
  different ranges of generalization
• By practitioners
• This is part of professional judgment that is
  included in the definition of evidence-based
  practice.

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What is Professional Judgment?

• Professional judgment
• Fills the gap between an imperfect research base
  and the specifics of a clinical situation.
• Includes rule-governed elements
• Knowledge of the research base
• Knowledge of broader principles of behavior
• Includes contingency-shaped elements
• Subtle discriminations of when and how to apply
  principles
• Repertoire of shaped interactive behavior

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Methods of Deriving Practice Recommendations

• Empirically Supported Interventions (Slocum)
• Using objective and operationalized procedures
  for identifying the level of research support for
  particular interventions.
• Best Practices (Detrich)
• Employing experts to review research and make
  critical judgments and reasonable generalizations
  as a basis for recommendations.
• Research-Based Principles (Spencer)
• Drawing from basic principles to construct or
  adapt interventions for individual settings or
  clients.
• The nexus between research base and
  professional judgment

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Methods of Deriving Practice Recommendations

• We will argue
• Each of these methods can be employed with a
  range of quality and rigor.
• Each has distinct strengths and limitations.
• The three methods can work together to inform
  practice.