It implies only that such practice must be attuned to so-called “comorbidities.” Evidence-based practice that cavalierly ignores this problem is poor evidence-based practice. Why many clinical psychologists are resistant to evidence-based practice: Root causes and constructive remedies. I understand your argument saying that practitioners should use research based interventions instead of just relying on intuition, but I was confused by your statement "we should side with research evidence unless there a clear-cut reason to do otherwise".
If studies show that a treatment protocol works well for Problem X but not for “comorbid” Problem Y, this can and should be built into practice guidelines. I was wondering if you could clarify what you believe these clear-cut reasons are, and how do we go about identifying them.
Still, not all objections to evidence-based practice are unreasonable or based on dubious logic.Crucially, by sorting the wheat from the chaff, evidence-based practice can also tell us which treatments are extremely unlikely to be effective – and thereby decreases the odds that clients will be harmed directly (by iatrogenic interventions) or indirectly (by opportunity costs incurred by the loss of time, energy, effort, and resources that could have otherwise been invested in effective interventions).Klein continues: “Practitioners shouldn’t believe a published study just because it meets the criteria of randomized controlled design.Yet, there has been a good deal of resistance to evidence-based practice.As social work scholar Eileen Gambrill and her colleagues have noted (e.g., Gibbs & Gambrill, 2002), much of this resistance stems from misunderstandings and misconceptions.
Too many of these studies cannot be replicated.”” Of course. I have to challenge your statement of "optimal treatment" being "evidenced based treatment." given the fact that a significant amount of studies cannot be replicated, that the typical person often seen in sessions are excluded from studies, that studies average around a 30% drop out rate, and that study after study has consistently shown the therapeutic relationship is more powerful in predicting positive outcome than any technique, I believe we should hold back on declaring what's optimal or scientific or not.But nothing in evidence-based practice implies that treatment decisions should be based exclusively on the results of single studies; quite the contrary. Thanks very much..below for instructions for citing blog posts in APA style. Scott Once again Dr Lilenfeld has presented a reasonable statement of a scientific position.Perhaps the most persuasive argument against evidence-based practice in its present form comes from physician Kimball Atwood (2008) and his colleagues at their superb blog, Science-Based Medicine.As they observe, evidence-based medicine relies too heavily on the results of controlled trials, and not sufficiently on theoretical plausibility.I had assumed that the universe of possible misconceptions surrounding evidence-based practice had been exhausted until last week, when I read an essay by well-known psychologist and consultant Gary Klein on the website, “The Edge.” Along with 175 other eminent invited contributors, Klein responded to the provocative question, posed by prominent book agent and science advocate John Brockman, “What Scientific Idea is Ready for Retirement?
” See: To my surprise, Klein responded “Evidence-Based Medicine.” My surprise only grew, however, as I read on: “…we should only trust EBM [evidence-based medicine] if the science behind best practices is infallible (italicized) and comprehensive (italicized), and that’s certainly not the case.” This statement reflects a jaw-dropping misunderstanding of evidence-based practice.In an influential report, a task force of the American Psychological Association (2005) regrettably declined to explicitly address the question of whether these stool legs should be weighted equally.Nevertheless, many researchers, myself included, believe that the research leg of the stool should be accorded the highest priority in the decision-making hierarchy.Indeed, one of the major advantages of evidence-based practice is that like all good science, it is in principle self-correcting.As better treatments become available, they will eventually displace less effective ones.