Evidence-Based Child and Adolescent Mental Health Services: Oxymoron or Brave New Dawn?

Abstract

Professionals working in child and adolescent mental health services are increasingly encouraged to examine the evidence underlying their clinical practice. Embracing evidence-based practice can present difficulties, as barriers to changing practice exist. These difficulties are examined, along with the meaning of evidence-based practice in a multidisciplinary speciality, and the potential benefits that develop from it.

An Evidence-Based Practice Model for Residential Treatment Programs

“…An example of such controversy has been the development of empirically-supported, manualized lists of treatments that some state mental health systems and insurance companies have prepared for the purpose of determining reimbursement policies and rates (Reed & Eisman, 2006). Critics voice concern that exclusive reliance on such lists, along with the strict evidentiary criteria of the empirical position, effectively excludes most of what is done in therapy (Messer, 200, Norcross, 200;Ramchandani, Joughin, & Zwi, 200;Reed & Eisman, 2006). They note most interventions in clinical practice are not manual-based.…”

Corporate Communications

“…Unfortunately, many have taken evidence-based practice to mean that practice should be based upon experimental research evidence alone, and that all other practice is either not evidence-based or of a lower quality. Such a narrow approach was not envisaged by the original proponents of evidencebased medicine (Sackett et al 1996), and is a common misunderstanding of the paradigm (Ramchandani, Joughin & Zwi 2001). Evidence based practice actually:…”

“…Workers will also need to be educated on how to access and use the information resources of specialist research agencies (e.g. National Child Protection Clearinghouse) and academic libraries to supplement their knowledge (Ramchandani et al 2001).…”

Practice-based evidence – overcoming insecure attachments

“…Early articles referred to the "skills gap" with the difficulties of professionals accessing the evidence and interpreting it (Ramchandani, Joughlin, & Zwi, 2001). This moved to an argument that the evidence was contradictory, or that there was really not enough evidence, in terms of RCTs, to justify decisions about interventions.…”