Understanding the common elements of evidence-based practice: Misconceptions and clinical examples
Understanding the common elements of evidence-based practice: Misconceptions and clinical examples
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DOI：
10.1097/chi.0b013e318033ff71
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发表时间：
2007-05-01
影响因子：
13.3
通讯作者：
Daleiden, Eric L.
中科院分区：
文献类型：
--
作者：
Chorpita, Bruce F.;Becker, Kimberly D.;Daleiden, Eric L.
在过去的十年里，通过研究支持的治疗发展的进步，科学在心理健康实践中重新树立了乐观主义（Kazdin和Weisz，2003;心理程序促进和传播工作队，1995; Wilson，1995）。心理学和精神病学的科学和应用领域继续面临的挑战是普遍推广和实施经验支持的治疗，特别是在儿童的心理健康方面（Barlow，2000年; Chorpita等人，2002; Schoenwald和Hoagwood，2001; Weisz等人，1995年）。有超过500种记录在案的儿童和青少年治疗方法（Kazdin，2000），执业临床医生如何开始为他们的客户确定适当的循证干预措施？一方面，从业人员似乎可以查阅文献，更多地了解特定问题领域的有效干预措施。另一方面，随之而来的指南、列表和定义的日益增加是相当复杂的（例如，Chorpita等人，2002; Lonigan等人，1998; Schinke等人，二○ ○二年; Weisz，2003），并在某些方面矛盾地增加了确定治疗儿童疾病的最佳候选干预措施的复杂性。导致确定循证干预措施的复杂性的是围绕术语Bevidence-based的含义的模糊性。[传统上，尽管是最近的传统，该术语表示具有特定程度和类型的经验支持的特定治疗方案（例如，Chambless和Hollon，1998）。因此，干预的手册化（例如，应对猫，肯德尔，1990年;违抗儿童，巴克利，1997年）有助于定义基于证据的治疗方法。在这种手动分析水平上，医生可以从各种特定的治疗方案中选择，这些方案在研究试验中已经证明了它们的疗效。然而，基于证据的手动治疗通常具有重叠的策略，并且从业者难以确定一种给定治疗手册相对于另一种治疗手册对于特定客户和情况的相对适当性（Kazdin等人，1990年）。
Science has fostered renewed optimism in mental health practice over the last decade through advances in the development of treatment supported by research (Kazdin and Weisz, 2003; Task Force on Promotion and Dissemination of Psychological Procedures, 1995; Wilson, 1995). The challenge that continues to confront both the scientific and applied domains of psychology and psychiatry is the widespread promotion and implementation of empirically supported treatments in general, and in children_s mental health in particular (Barlow, 2000; Chorpita et al., 2002; Schoenwald and Hoagwood, 2001; Weisz et al., 1995). With more than 500 documented treatments available for children and adolescents (Kazdin, 2000), how do practicing clinicians begin to identify the appropriate evidence-based interventions for their clients? On the one hand, it would appear that practitioners could consult the literature to learn more about efficacious interventions for particular problem areas. On the other hand, the increasing proliferation of guidelines, lists, and definitions that has followed has been rather complex (eg, Chorpita et al., 2002; Lonigan et al., 1998; Schinke et al., 2002; Weisz, 2003), and in some ways has paradoxically increased the complexity of identifying Bbest candidate [interventions for treating children_s disorders. Contributing to the complexity of identifying evidence-based interventions is ambiguity surrounding the meaning of the term Bevidence-based.[Traditionally, albeit a recent tradition, the term has denoted specific treatment protocols with a particular degree and type of empirical support (eg, Chambless and Hollon, 1998). Thus, the Bmanualization [of interventions (eg, Coping Cat, Kendall, 1990; Defiant Children, Barkley, 1997) has lent itself to a method of defining evidence-based treatments. At this manual level of analysis, practitioners may choose from a variety of specific treatment programs that have demonstrated their efficacy in research trials. However, evidencebased, manualized treatments often have overlapping strategies, and it is difficult for practitioners to determine the relative appropriateness of one given treatment manual over another for particular clients and situations (Kazdin et al., 1990).