Evidence-based practices and programs defined

Evidence-based practices are skills, techniques, and strategies that can be used by a practitioner. Such practices describe core intervention components that have been shown to reliably produce desirable effects and can be used individually or in combination to form more complex procedures or programs (Embry, 2004).

Examples of evidence-based practices include cognitive behavior therapy (Linehan, 1991), cognitive mapping (Dansereau & Dees, 2002), good behavior game (Embry, 2002), systematic desensitization (Wolpe & Lazarus, 1966), token economy motivation systems and social skills teaching strategies (Phillips, Phillips, Fixsen, & Wolf, 1974), and a variety of clinical practice guidelines.

Evidence-based programs consist of collections of practices that are done within known parameters (philosophy, values, service delivery structure, and treatment components) and with accountability to the consumers and funders of those practices. Evidence-based programs represent a way to translate the conceptual, goal-oriented needs of program funders and agency directors into the specific methods necessary for effective treatment, management, and quality control.

Examples of evidence-based programs include Assertive Community Treatment (Stein & Test, 1978), Functional Family Therapy (Alexander & Parsons, 1973), Multisystemic Therapy (Henggeler & Borduin, 1990), and Supported Employment (Bond, Drake, Mueser, & Becker, 1997).

The Dissemination Working Group (1999) defined the common elements of evidence-based programs as having:

  1. Clear philosophy, beliefs, and values that: a) provide guidance for all clinical judgments, program decisions, and evaluations; b) are fully integrated with actual operations and treatment delivery; and c) promote consistency, integrity, and sustainable effort across all program components.
  2. Specific treatment components (treatment technologies) that promote consistency across clinical people at the level of actual implementation of treatment procedures.
  3. Treatment decision making (within the program framework) that is invested in each clinical staff person with accountability systems for staff and programs.
  4. Structured service delivery components that include an organizational context to facilitate treatment, a definition of service location and duration, staff development systems, and specification of clinical staff: client ratios and clinical staff: supervision ratios.
  5. Continuous improvement components that encourage innovation with scrutiny over a long enough period of time to see if the innovation is beneficial to children, families, the organization, or community.

Research related to evidence-based programs and evidence-based practices may be more alike than different when it comes to their implementation. For example, evidence-based programs may seek to integrate a number of intervention practices (e.g., social skills training, behavioral parent training, cognitive behavior therapy) within a specific service delivery setting (e.g., office-based, family-based, foster home, group home, classroom) and organizational context (e.g., hospital, school, not-for-profit community agency, business) for a given population (e.g., children with severe emotional disturbances, adults with co-occurring disorders, children at risk of developing severe conduct disorders).