Fw: [Adta] evidence based practice

[Sharon Chaiklin]

----- Original Message ----- 
From: Sharon Chaiklin 
To: ADTA Listserve 
Sent: Monday, February 19, 2007 8:01 AM
Subject: Fw: [Adta] evidence based practice


Below are some remarks made by a dean of Social Work when we presented him the question re evidence based practice as taught in social work.

Also,  I would like to remind all that the Chace Foundation collects and puts out all student thesis abstracts with the newest collection due out this fall...if not before.  The purpose of collecting these and publishing them over the years is for the very reason people have been discussing:.  What have students done and what can be built upon.

It is very exciting to see the enthusiasm and the ACTION that is being taken to make this happen.   Thank you all.
Sharon


----- Original Message ----- 
From: Barth, Rick 
To: Harris Chaiklin 
Sent: Sunday, February 18, 2007 1:23 PM
Subject: RE: [Adta] evidence based practice


Harry: The way that we are now talking about this in the School is that evidence based practice (EBP) is a process that includes understanding the problem, understanding client preferences, and understanding the evidence on what interventions might help (and possible side effects) so that you can work with clients to choose the intervention that the client (or guardian) selects that maximizes their goals (it might not always be the one that has the best likelihood of impact).  Evidence supported interventions (ESIs) are those specific interventions that have gotten the seal of approval for consistently doing significantly more good than harm or nothing.  So, I’m not sure about the first part of her post.

 

NONETHELESS, this is a very important area for us, because we have lots of curriculum components that are similar to dance therapy—they have a long history of development with strong underpinnings that would argue for the logic of their success, but probably do not enough rigorous study to get into systematic reviews like those requested by AHRQ or get on the SAMHSA or NIJ or BLUEPRINT ESI lists.  (Without going to look for a systematic review on dance therapy, which is what I should do,  I’m going to proceed with this argument.) So, in the case of dance therapy, we know from basic scientific evidence that movement and exercise is related to changes in serotonin levels and in immune responses that are beneficial.  We know from basic scientific evidence that relaxation and concentration training—part of what is learned through dancing--help reduce impulsivity.  I am sure that there are many more pieces that you and Sharon know about that also create a body of evidence that can help sustain a logic model that would serve to justify the use of dance therapy for at least some conditions.  Should we teach it, then? Should insurers pay for it, then?  Perhaps so.  Still, if the logic model is tight enough, and the basic science is good enough, then what prevents the accumulation of evidence to the point at which Dance Therapy can be added to the AHRQ list, for at least one of the conditions listed?

 

If we excluded all practices that are not approved by AHRQ or on one of the other governmental ESI lists, we would have a very short MSW program and do a lot of standing around in the field. So we only exclude interventions like Holding Therapy (based on attachment theory), that has killed children?  Or, do we have a higher standard and being to exclude interventions with minimal or no evidence and a weak logic model?  We haven’t begun this work, here, but it is a judgement we have to make every day in the MSW program and CPE—what should we continue to promulgate as important to know.

 

I’d welcome your thoughts on this.  I’d also like you to consider moving some of this discussion to our BLOG so that we can begin to engage the SSW in the curricular implications of EBP.

 

Thanks as always for staying in touch,

 

Rick


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From: Harris Chaiklin [mailto:hchaikli at comcast.net] 
Sent: Sunday, February 18, 2007 11:55 AM
To: Barth, Rick
Subject: Fw: [Adta] evidence based practice

 

The dance therapist list serve has gotten into a lot of discussion about the nature of research. I thought this was a particularly good message.

 

From: Joan S. Ingalls [mailto:joan.ingalls at verizon.net] 
Sent: Saturday, February 17, 2007 6:09 PM
To: skdmt2
Subject: Re: [Adta] evidence based practice

 

Susan,

 Thanks for asking.

  My thoughts are that we need to be clear about what we mean by evidenced-base practice, and in addition, not mix up evidence-based practice with evidience-based research (which seems redundant)

   Evidence-based practice from what I understeood a few years ago meant merely a class of programs like job programs where the evidence was there easy to see whether or not a person got a job (or a home or a degree or quit smoking or quit drinking or merely attended over a period of time - reached the goal of the program whatever it was).

  The term did not refer at all to the method or theory that was used in the program. 

  I think that recently "evidence-based" has been misunderstood. There has always been a pull to "prove our method works." So that is not new. What has caused all the recent "buzz" is that there is funding or special recognition for "evidence-based" programs, ie the attachment I sent. My thinking is that dance therapy could never qualify because it is not a "program" with a concrete goal. It is a methodology or theory or therapy. It is a means by which evidence based progams may or may not succeed. 

  I think the attachment is asking for people to suggest criteria, or programs that could be considered evidence-based. This effort is a service to agencies that want to send clients to programs that are in this catagory. I guess they get a special kind of funding or recognition when they do that.

  I am in the field of sport psychology and the people interested in promoting bio-feedback are thowing this term around trying to intimidate others and win disciples. I don't think too many of us are taken in. Those people want to prove "what we do works" will continue to do  research as they always have - basing it on data (a form of evidence, but a different flavor than that in "evidence-based practice") that they collect. Joan

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