Practicing psychologists’ reflections on evidence-based practice in psychology.

An American Psychological Association (APA) policy definition of evidence-based practice in psychology (EBPP) states that practice based on evidence must consider the best available research, use clinical expertise, and consider client contextual variables (APA Presidential Task Force, 2006). The researchers qualitatively examined clinical and counseling psychologists’ attitudes toward EBPP using grounded theory. The study explored the extent to which the official view of EBPP reflects current psychological practice as well as whether EBPP is an idealistic definition to work toward. An examination of themes from this research yielded evidence that the framework for EBPP is in place, although many participants initially confused EBPP with research. Psychologists will benefit from an open-minded review of the official APA policy definition and from considering how the policy may affect their practice and interactions with managed care providers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Clarification and elaboration on evidence-based practice in psychology.

Responds to comments by D. C. Wendt and B. D. Slife (see record 2007-13085-019), P. H. Hunsberger (see record 2007-13085-020), and R. B. Stuart and S. O. Lilienfeld (see record 2007-13085-021) regarding the report by the APA Presidential Task Force on Evidence-Based Practice (see record 2006-05893-001) entitled Evidence-based practice in psychology. The goal of the task force was to create a scheme that would suggest how evidence should be used to design and offer services that will benefit patients and to assure the public and the health care system that psychologists are providing evidence-based services. There were and will continue to be many scientific and philosophical issues inherent in any such enterprise, and agreement by all psychologists with every aspect of EBPP may not be possible. Nevertheless, the APA's EBPP policy and the report that accompanied it are remarkably inclusive of various perspectives while remaining unambiguous about the need to use evidence in a way that leads to effective services. What is needed at this point are clinically relevant evidence and investigations of how such evidence can be used to best benefit those served by psychological interventions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Is evidence-based practice diverse enough? Philosophy of science considerations.

In its policy rationale for evidence-based practice in psychology (EBPP), the APA Presidential Task Force on Evidence-Based Practice (see record 2006-05893-001) claims to have constituted itself with "scientists and practitioners from a wide range of perspectives and traditions, reflecting the diverse perspectives within the field" (p. 273). We applaud this attention to diversity but contend that an entire perspective of the debate was omitted in the Task Force's newly approved policy and its underlying report. The failure to consider a philosophy of science perspective led the Task Force to make a number of epistemological assumptions that are not based on evidence or rationale and that thus violate the very spirit of evidence-based decision making. In this comment, we reveal a few of these assumptions and discuss their detrimental consequences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Changing paradigms from empirically supported treatment to evidence-based practice: A cultural perspective.

Psychotherapy research guidelines have a profound impact on research, training, and practice, and they also influence reimbursement decisions that can have ethical and legal consequences. Furthermore, research guidelines have implications for the treatment of culturally diverse groups. Unfortunately, these implications have often been overlooked. Therefore, this article contrasts the impact of two prominent research guidelines on the development of culturally sensitive psychotherapies: (a) empirically supported treatments (ESTs) developed in 1995 by the American Psychological Association’s (APA) Division 12 (Society of Clinical Psychology; Task Force on Promotion and Dissemination of Psychological Procedures, 1995), and (b) evidence-based practice in psychology (EBPP) developed by the APA (Task Force on Promotion and Dissemination of Psychological Procedures,2006) Presidential Task Force on Evidence-Based Practice. Although overall we believe that EBPP is more responsive to the needs and characteristics of culturally diverse groups, ESTs also have many strengths. As the cultural implications of research guidelines are better understood, researchers and clinicians will be able to more effectively advance the development of culturally sensitive evidenced-based psychological treatments. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Empirically supported treatments in psychology: Implications for Canadian professional psychology.

Examines several interconnected efforts to develop evidence-based practice in professional psychology. We first review the American Psychological Association (APA) Division 12 (Clinical Psychology) Task Force on the Promotion and Dissemination of Psychological Procedures' development of criteria and listings for empirically supported psychological treatments. Next, we present related efforts to develop procedures to identify treatments that have established efficacy and to develop practice guidelines. The possible impact of these initiatives on Canadian professional psychology in the domains of training, credentialing, practice, and research are then examined. Finally, we present recommendations for steps that should be taken by Canadian psychology organizations to respond to these initiatives in order to ensure that psychological practice in Canada is optimally supported by scientific evidence. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Evidence-Based Practice: Promoting Evidence-Based Interventions in School Psychology.

We present an overview of issues related to evidence-based practice and the role that the school psychology profession can play in developing and disseminating evidence-based interventions (EBIs). Historical problems relating to and the recurring debate about the integration of research into practice are presented as a context for the current challenges faced by those engaged in the EBI movement in psychology and education. Potential solutions to the problems posed by the adoption of EBIs in practice are presented within the context of the directions to be taken by the Task Force on Evidence-Based Interventions in School Psychology (Task Force). Five assumptions are presented that can guide the Task Force in addressing the integration of EBIs in practice. These assumptions are followed by five recommendations that can be translated into action plans to be adopted by the Task Force for the promotion of EBIs in practice. The action plans are conceptualized as a shared responsibility of school psychology researchers, trainers, and practitioners. Future directions and implications for policy among groups with a common agenda for promoting EBIs are also presented. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Reestablishing clinical psychology's subjective core.

Comments on the report by the APA Presidential Task Force on Evidence-Based Practice (see record 2006-05893-001) entitled Evidence-based practice in psychology. The Task Force is to be commended for their report valuing evidence from "clinical expertise" on a par with "research data" (p. 272) in guiding psychological practices. The current author suggests that the APA not only should make a place at psychology's policymaking table for "clinical expertise" but should prioritize clinical and subjective sources of data--the essence of the psychological--and set policies to ensure that objective data, such as behaviors and DSM diagnoses, are considered in their subjective context. The APA should also encourage researchers to devise ways to preserve as much as possible the personal "feel" of the clinical encounter in their data analysis and published conclusions. The APA also needs to assign priority to subjective emotional and relational skills on a par with academic and analytic skills in the selection and training of clinical psychology students. Reconnecting clinical psychology with its subjective evidentiary roots in ways such as these should help to bring us out from under the dominance of medicine, to the benefit of our profession and our clients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Annual report of the Policy and Planning Board: 1986.

This year the Policy and Planning (P&P) Board's agenda was dominated by the issue of reorganization. The P&P Board endorsed and recommended to the February 1987 Council of Representatives that APA be reorganized in accord with the 22 elements presented in the Final Report of its Task Force on the Structure of APA and that final proposed bylaws language changes be brought before the August 1987 Council for forwarding to the APA membership for approval. The proposal was defeated by a roll call vote (56 yea, 63 nay, 1 abstention). Jack I. Bardon, Chair, and David A. Rodgers, Member, presented the Task Force's proposal to Council. This report presents a summary of their remarks to Council and the Final Report of the Task Force on the Structure of APA. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The science and practice of empirically supported treatments.

The impact on Canadian professional psychological treatment practices of the American Psychological Association""s Division 12 (Clinical Psychology) Task Force""s development of criteria and listings for empirically supported psychological treatments, along with other industrial efforts to standardize the identification of treatments with established efficacy is described in the article by J. Hunsley et al (see record 1999-01869-001). Here Hunsley et al extend their previous discussion and reply to other commentaries (see records 1999-01869-002, 1999-01869-003, 1999-01869-004, 1999-01869-005, 1999-01869-006) by viewing the current emphases in the Canadian health care system on accountability and empirically supported treatment (ESTs) as an unparalleled opportunity for professional psychology to deliver on its birthright. The generalizability of US experiences to Canadian contexts is discussed. Clinical practice guidelines should and will become the norm for providing evidence-based services in psychology, yet it would be impossible to develop such a guideline without empirical evidence proving that there are "best" interventions for a given problem. Canadian research issues in this light are discussed along with future challenges to professional psychology in Canada. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Integrated health delivery systems: Psychology's potential role.

Describes the ways in which psychologists are defining their role within integrated health delivery systems (IHDSs). The integration of psychological services with primary medical care is discussed. Examples of medical crisis counselling services as part of a medical practice and PhD student preparation for professional work in IHDSs are provided. Recent collaboration between the military and the APA Committee for the Advancement of Professional Practice's Task Force on Primary Care is mentioned. For psychology, the key will be legislatively broadening psychologists' defined role within the generic health delivery system to match their existing everyday clinical role in health care. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Addressing key challenges in evidence-based practice in psychology.

With its promise of enhancing the effectiveness of services, evidence-based practice in psychology (EBPP) appears to offer much to psychologists, patients, and policymakers. The purpose of this article is to examine some of the key challenges facing psychologists who wish to provide evidence-based treatment services, including how research evidence is used in EBPP, whether the results of the treatment research literature can be generalized to typical clinical practice, and how effective evidence-based treatments are in clinical practice. On the basis of recent evidence-based initiatives and treatment research, there is a solid scientific basis for EBPP, although much more research is necessary on the treatment of relatively mild, but common, clinical conditions and on the transporting of evidence-based treatments into clinical practice. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The evidence missing from evidence-based practice.

Comments on the report by the APA Presidential Task Force on Evidence-Based Practice (see record 2006-05893-001) entitled Evidence-based practice in psychology. Regrettably, the task force report was largely silent on three critical issues. As a consequence, it omitted much of the evidence necessary for a complete picture of evidence-based practice. First, the task force report did not operationalize "evidence." Second, the task force report did not address the crucial problem of iatrogenic treatments. Third, the task force report said little about the necessity for ongoing objective evaluation of clinical cases, which is critical to ethically responsible services. Current debate centers on how research findings should be factored into interventions, not on whether it is necessary to do so. Rather than waiting for the resolution of competing views on the matter, psychologists bear an ethical obligation to offer evidence-informed services. Three critical steps that were largely neglected by the task force report can go far toward helping psychologists honor that commitment: (a) providing a clearer operationalization of scientific evidence, (b) using current research to rule out the use of potentially harmful methods, and (c) using objective criteria to evaluate all of their cases on an ongoing basis. These steps, in turn, clarify the menu of options available to therapists, help protect clients from harm, and offer the advantage of allowing clinicians to contribute to the growing body of knowledge about what does and does not work in psychotherapy. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emory L. Cowen.

Presents an overview of the career contributions of Emory L. Cowen. For his remarkable contributions to conceptual, empirical and human service advances in the fields of community and clinical psychology, community mental health and education. He has been instrumental in the creation of a field for an entire generation of psychologists. His work has changed public schools throughout the United States. His ideas, research, model programs, program evaluations, and workshops have inspired others to generate new programs that provide affordable human services to thousands of children who are otherwise unlikely to receive help. He pioneered early detection and secondary prevention research. His clear thinking and conceptual challenges have fostered the study of primary prevention and wellness in mental health, both as a field for research and as a social policy. His tireless efforts as President of APA's Division of Community Psychology, a member of the Prevention Task Panel of the President's Commission on Mental Health, and the APA Task Force on Promotion, Prevention and Intervention Alternatives in Psychology are examples of his energetic contributions to psychology in the public interest. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Let us move ahead together: Commentary on "Empirically supported treatments in psychology: Implications for Canadian professional psychology."

The impact on Canadian professional psychological treatment practices of the American Psychological Association (APA) Division 12 (Clinical Psychology) Task Force on the Promotion and Dissemination of Psychological Procedures' development of criteria and listings for empirically supported psychological treatments, along with other industrial efforts to standardize the identification of treatments with established efficacy is described in the article by J. Hunsley et al (see record 1999-01869-001). P. A. Pilkonis comments here on these efforts with an eye towards both producing additional information in support of the new practice criteria and establishing grounds for future progress and collaboration, especially in the research arena. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Training for the future of psychology practice.

This article responds to the Eby et al. (this issue, pp. 57–68) paper on issues and dilemmas for the future of training for psychology practice. The author addresses these issues and discusses them in regards to our identity as psychologists and changes in training needed in light of the recent passage of federal health care reform legislation. The changes in health care include the importance of training to work in integrated health care systems, primary care, using electronic health records, and dealing with health disparities. Training recommendations from the 2009 APA Presidential Task Force on the Future of Psychology Practice are presented. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Cultural competence and evidence-based practice in mental health services: A complementary perspective.

The need for cultural competence and the need for evidence-based practice in mental health services are major issues in contemporary discourse, especially in the psychological treatment of people of color. Although these 2 paradigms are complementary in nature, there is little cross-fertilization in the psychological literature. The present article illustrates the complementary nature of these 2 paradigms. A main point of convergence is related to the development of culturally adapted interventions in the move from efficacy research to effectiveness studies. The implications of cultural adaptations of empirically supported treatments for mental health services in terms of research and practice with ethnic/racial minority populations are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The future of health care reform: Implications of 1994 elections.

The Republicans took control of both houses of Congress in November of 1994 for the 1st time in 42 yrs. Although the magnitude of the Clinton Administration's proposed Health Security Act may well have triggered fears of overcontrol, it is clear that the delivery of psychological care will be changed dramatically by the combined forces of federal and state health reform. R. J. Resnick, President of the American Psychological Association, has appointed the Task Force on Education and Training for Work in Organized Delivery Systems to look at how psychological health care is provided in the new and evolving systems, and to examine how current training programs prepare new psychologists to practice in and around organized health care systems. Dr. Resnick is similarly concerned about standardization of training, training in nontraditional areas of competence, and increased federal recognition and funding of training in psychology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapy in long-term care: II. Evidence-based psychological treatments and other outcome research.

This article is the 2nd of 2 that together examine 3 domains important to providing high-quality, evidence-based services to long-term care (LTC) facility residents: policy and advocacy, practical considerations, and outcome research. Older adults who reside in LTC facilities have a very high rate of mental health difficulties. Psychologists have been able to provide services to this population through Medicare since the late 1980s, and empirical findings on treatment approaches are important in guiding psychotherapists to more helpful intervention. The focus of this article is outcome research in LTC settings. This article emphasizes evidence-based psychological treatments (EBTs) but also examines other scientifically supported approaches and discusses the strengths and limitations of focusing on EBTs, as well as general issues in the relation between science and practice in the provision of psychotherapy in LTC settings. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Benefits of comprehensive health care for improving health outcomes in women.

The American Psychological Association Health Care for the Whole Person Task Force was formulated to provide a rationale for integrating behavioral health services in primary care. Collectively, the task force called for a transformation of the biomedical system into one based on the biopsychosocial model. This article is a summary of the Women's Health Committee position paper that reviewed contextual factors in women's health, provided recommendations for clinical service action, and recommended an integrated primary health care system to address women's health needs. This article provides a vision of integrated care and a practical guide for psychology practitioners as they collaborate with other health care providers and health policy groups to improve health outcomes for women over the life course. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

CMA-sponsored Task Force on the Allocation of Health Care Resources.

Hurray for the Canadian Medical Association! They have just released Health: A Need for Redirection, the report of a Task Force on the Allocation of Health Care Resources. The task force, headed by Joan Watson, the former hostess of CBC's "Marketplace," included the Honourable Pauline McGibbon, former lieutenant-governor of Ontario, Roy Romanow, former NDP attorney general of Saskatchewan, and two physicians, John O'Brien-Bell and Leon Richard. The purpose of the task force was to examine the allocation of health care resources in the face of an increasing elderly population and the explosion of new technology. The report could help shape the future of the health care system. The report makes it clear that the health system is in crisis and the reform of the health system needs us all, as both active professionals and critical consumers. (PsycINFO Database Record (c) 2010 APA, all rights reserved)