Identifying evidence-based interventions in school psychology: Building a bridge or jousting with windmills?

The outcomes of current efforts at identifying evidence-based interventions (EBIs) within school psychology remain uncertain. The political and professional contexts, diversity of settings in which school psychologists function, wide variety of intervention objectives, and multiple constituencies served by school psychologists present unique challenges to this endeavor. As the EBI process evolves, it is predicted that vigorous debate will continue over basic epistemological questions, methodological rigor, and professional use of EBI reviews. It is argued that such discussion is critical if the EBI project is to be relevant to both researchers and practitioners. Although a complex task, the effort to identify EBIs can facilitate a more data-based, problem-solving approach to school psychological services. (PsycINFO Database Record (c) 2011 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)     

Preparing psychologists for evidence-based school practice: Lessons learned and challenges ahead.

The evidence-based practice (EBP) movement has the potential to significantly advance the quality of psychological and educational services provided by psychologists working in schools. Training psychologists in EBP has challenged the profession and caused faculty in graduate programs to reevaluate and retool professional training curricula and instructional practices. Four domains of challenges in graduate training are identified: (a) integrating the EBP knowledge base into the curriculum, (b) expanding models of research training, (c) expanding training in prevention science, and (d) expanding training in problem-solving consultation and school contextual issues. For each of these, the author discusses the range and scope of the challenge and possible solutions for advancing graduate training in psychology relevant to school practice. (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)     

Ethics and the Advertising of Professional Services: Blame Canada.

Shead and Dobson (see record 2004-14467-001) provide an excellent historical review of policies concerning self-advertising by psychologists in the United States and Canada. They conclude that psychologists can become considerably more aggressive in their professional advertising practices, while still adhering to appropriate ethical constraints. Whether such practices will truly benefit either consumers or psychologists remains an open question. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

History, Politics, and Transformational Change in Canadian Health Care: A Rejoinder.

Our rejoinder addresses two common themes raised in the responses by Arnett et al (see record 2004-17185-005), by Hunsley and Crabb (see record 2004-17185-006) and by Mikail and Tasca (see record 2004-17185-007) to our article (see record 2003-09748-001) concerning the potential role of psychological services in the future of public health care in Canada. The first concerns the current system's capacity to evolve beyond the medical-hospital illness model of the 1960s to incorporate psychological treatments aimed at illness prevention and health promotion. This would be more likely if psychologists were to participate directly in primary-care and home-based mental health-care reform. The second theme is the presumed negative role of "politics" rather than scientific evidence in decisions concerning public coverage or subsidy. We argue that democratic decision-making is the proper basis upon which decisions concerning public coverage are made, but it need not be in opposition to evidence-based decision-making. As recommended in the final report of the Commission on the Future of Health Care in Canada, the Health Council of Canada along with applied research institutes can make politicians and policy-makers more aware of the growing body of evidence supporting the efficacy of psychological treatments relative to the alternatives. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

At home in a strange land!

The narrative describes one psychologist's journey from university classroom to state senate chamber. Also included are observations on applying psychological principles and practices to a campaign. The author argues that psychologists are uniquely qualified to participate in the political process and that more psychologists should apply their special abilities to politics--and professional organizations should encourage them to do so. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Undergraduate ratings of the acceptability of single and combined treatments for depression: A comparative analysis.

Consumers' perceptions regarding the acceptability of treatments for mental disorders can have a direct effect on the clinical practices of professional psychologists. This exploratory study compared the acceptability of single and combined treatments commonly offered to adults with depression (cognitive-behavioral therapy or interpersonal therapy—each by itself and in combination with medication—and support group with medication). All treatments were seen as acceptable, but psychotherapy alone was more desirable than when combined with medication. Support group with medication was least acceptable. Implications for professional practice are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

From clinical trials to professional training: A graduate course in evidence-based interventions for children, youth, and families.

In preparing students to become competent professional psychologists, graduate coursework must lay the foundation for the development of competence in the ethical delivery of evidence-based interventions. This paper describes a graduate course designed to introduce students to evidence-based treatments with children and youth. The course is designed to enhance critical thinking in translating research into practice as well as to develop core competencies in intervention planning, implementation, and evaluation. Activities to enhance interaction and to promote problem-based learning include student presentations of a workshop on an effective practice element, as well as a case assignment requiring treatment planning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cultural adaptation of treatments: A resource for considering culture in evidence-based practice.

There is a growing interest in whether and how to adapt psychotherapies to take into account the cultural, linguistic, and socioeconomic context of diverse ethnocultural groups. At the root of the debate is the issue of whether evidence-based treatments (EBTs) developed within a particular linguistic and cultural context are appropriate for ethnocultural groups that do not share the same language, cultural values, or both. There is considerable evidence that culture and context influence almost every aspect of the diagnostic and treatment process. Yet, there are concerns about fidelity of interventions, and some have questioned whether tinkering with well-established EBTs is warranted. We present arguments in favor of the cultural compatibility and universalistic hypotheses. Next, we review the available published frameworks for cultural adaptations of EBTs and offer examples from the literature on the process and outcome of different approaches used. Conceptual models for adapting existing interventions and emerging evidence that adapted intervention leads to positive outcomes suggest that there are tools for engaging in evidence-based psychological practices with ethnocultural youth. Recommendations for future directions are provided. (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)     

Opinions about industrial psychology by different groups of psychologists.

"In general, the findings provide a partial sketch of how industrial psychology is perceived and evaluated by different groups of psychologists. The most common criticism is that industrial psychology is not sufficiently concerned with its ties to basic psychology… . In addition, serious questions are raised concerning the areas of research that are emphasized or slighted, the professional qualifications of many practitioners, tendencies to offer psychological judgments that reach beyond scientific results, frequent overselling of industrial applications, and an excessive accent on the practical in training industrial psychologists. Many psychologists also charge that industrial psychology is too management oriented, that it operates too much within a management frame of reference… . Finally, it should be noted that our results reveal wide differences of opinion among the psychologists questioned, not only between the industrial psychologists and the other professional groups but strikingly also within the ranks of each group." (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attending to the Omissions: A Historical Examination of Evidence-Based Practice Movements.

Evidence-based practice and empirically supported treatment movements are potent forces that affect the practice of psychology today and have the potential to mandate the types of treatments psychologists conduct. The histories of these movements reveal that certain aspects of therapy valued by psychologists have been ignored. It is shown that the evidence-based movements (a) overemphasize treatments and treatment differences and (b) ignore aspects of psychotherapy that have been shown to be related to outcome, such as variation among psychologists, the relationship, and other common factors. It is important that psychologists understand the development of these movements so that they can be critical consumers of research and can effectively influence the future course of events. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Malpractice claims experiences of psychologists: Policy issues, cost comparisons with psychiatrists, and prescription privilege implications.

Psychiatrists often argue that psychologists are not competent to diagnose mental disorders or formulate treatment plans and that patients will be harmed if psychologists provide psychotherapy without supervision by psychiatrists. However, a review of 13 years of psychology's nationally available professional liability (malpractice) insurance has shown that there has never been a court award about any insured psychologist practitioner for failure to refer to a physician when needed, failure to identify a medical problem, or failure to provide appropriate psychological care for a patient with medical complications. Psychiatric malpractice insurance costs are 3-24 times more than psychological malpractice coverage, depending on the state. The implications for public policy are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Commentary on evidence-based psychological treatments for older adults.

This article comments on the articles in the Special Section on Evidence-Based Psychological Treatments for Older Adults (see records 2007-03358-002, 2007-03358-003, 2007-03358-004, 2007-03358-005, and 2007-03358-006). The articles apply criteria developed by the Society of Clinical Psychology to evaluate treatments for late-life anxiety, insomnia, behavior disturbances in dementia, and caregiver distress. The articles document that there are evidence-based psychological treatments that can help older adults. However, there are 2 substantial hurdles: evidence and access. Gaps in the evidence, as mentioned by the authors of the articles in the special section, result from disproportionate research attention to some psychotherapies and some mental disorders, with corresponding lack of research about other treatments and disorders. The challenge for access is to ensure that older adults with treatable mental disorders will get connected to psychologists trained in these evidence-based therapies. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Canadian professional psychology and empirically supported treatments": Commentary.

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). D. L. Chambless comments on the importance of having empirically supported treatments (ESTs) because many clients will not have the specific problems for which ESTs have been developed. In such cases, clinicians need to decide whether they are warranted in generalizing from the samples on which an EST is based, or whether they need to devise a novel approach. Also of importance is the therapeutic relationship or working alliance: a focus on ESTs should not be taken to mean that foundational issues such as the alliance can be forgotten. Training therapists should first learn basic therapeutic skills before learning more specialized ESTs. Other comments concern traditional training in Canada and a US trend of rejecting ESTs until more efficacy studies are completed of research-to-treatment generalizability. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Review of Psychology as a profession: Foundations of practice.

Reviews the book, Psychology as a profession: Foundations of practice by W. B. Pryzwansky and R. N. Wendt (see record 1987-98014-000). Pryzwansky and Wendt provide a guidebook on professional issues addressed to both applied psychologists and those in training. The book begins with a general introduction to the topic of psychology as a profession, which is followed by a chapter on each of the following issues: credentialing in psychology, ethics and standards, legal impact in practice, professional development and accountability (including internships), and professional organizations. Many important professional issues are presented by the authors. It is clear that this book is directed to an audience of applied psychologists in general, but school psychologists will find a number of relevant areas not well covered. Psychology as a profession is a handy, small book to supplement a professional practices course. However, its size and purpose limit the depth with which specific topics can be elaborated, resulting in a number of gaps in coverage. In addition, given the vulnerability of several of the topics in this book to ongoing change, the reader needs to be reminded of the possibility that some information will become outdated. However, the book does provide a useful introduction to topics that seem to impact increasingly on the lives of professional psychologists. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology and health care.

Recent advances in health care psychology are noted, especially those involving the conceptualization and treatment of lifestyle and chronic health problems. The contributions to health care psychology of community psychology, brief psychological treatments, behavioral medicine, and health psychology are outlined. The central task of both organized psychology and individual psychologists is to create an underlying structure of clear boundaries and standards for clinical practice and training in health care psychology. Initially, this task should involve an inventory of Canadian psychologists currently providing health care services and the nature and amount of those services. Subsequently, a need exists for the profession to examine and create guidelines in psychological service delivery, professional role models, training, and scientific methods pertaining to general health care. (French abstract) (27 ref) (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Behaviour alteration and the criminal law.

Working Paper 43 of the Law Reform Commission of Canada addresses a number of issues that are of concern to psychologists. The paper describes in lay terms a variety of psychological and medical treatments and discusses the ethical and legal issues involved in each. It begins by setting out to answer the following questions: (1) Do present laws provide sufficient protection against involuntary or nonconsensual administration of behaviour alteration treatments? (2) Should criminal law protect psychological integrity in the same way it already protects physical integrity? (3) Should the law make legitimate the use of these techniques as punishment or as a method of social control? Without entirely answering these questions, it ends by making a series of recommendations. The most important of these recommendations are: (a) that the criminal law affirm the right of psychiatric patients not to be treated against their will except under certain specified circumstances, (b) that uniformity of practice over the provinces be established, and (c) that a code of ethics on the medical and psychological treatment of prisoners be established as an administrative directive covering consent to treatment and related issues. Although it is unlikely that many psychologists would disagree with the advocation of procedural uniformity, the undesirability of coercive treatment, or the importance of obtaining informed consent, psychologists are very unlikely to be happy with this paper. The authors of this paper do not have the foggiest understanding of behaviourism, and what they do know appears to have been learned from A Clockwork Orange. There are important terminological problems, logical and philosophical difficulties, and an avoidance of some of the more important and intractable ethical dilemmas that confront treatment efforts within both health and correctional institutions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)