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Few topics in mental health are as important and controversial as evidence-based practices. EBPs have profound implications for mental health practice, training, and policy. What is designated as "evidence-based" will determine in part what therapies and tests are conducted, what is reimbursed, what is taught, and what is researched.
Unfortunately, this multifaceted topic has been reduced to simplistic and polarized arguments. This book, designed for mental health practitioners, trainers, and graduate students, addresses nine fundamental questions in the debate on evidence-based practices (EBPs). Each chapter centers on one particular question in the ongoing debate and consists of focused position papers on that question. The position papers, contributed by the some of the most respected psychologists writing today, are argued with passion and intelligence. Each chapter concludes with a dialogue among the contributors in which they emphasize their points of agreement and disagreement. This makes the book an ideal tool for teaching and discussion.
This book helps readers understand the central questions in this fiercely contested subject, provides a balance of views, and purges needless confusion and antagonism. In doing so, the book underscores both the robust commonalities and the remaining contentions regarding evidence-based practices in mental health.
- Sales Rank: #1019234 in eBooks
- Published on: 2005-08-15
- Released on: 2013-05-06
- Format: Kindle eBook
Most helpful customer reviews
10 of 10 people found the following review helpful.
A Crucial Book for Psychotherapists....
By David C. Young
"Few topics in mental health are as incendiary, consequential, and timely as evidence-based practices. [Note: "practices", not "treatments"] Yet, this multifaceted and complex topic has been reduced to simplistic and polarized arguments; regrettably, more heat than light has been shed on the topic."
John C. Norcross, Larry E. Beutler, Ronald F. Levant, eds., "Preface",
"Evidence-Based Practices in Mental Health" is THE overview of Psychology's War: the war over what is & isn't effective, and so what should & shouldn't be done in psychotherapy. The three editors, each of whom come from a different major army in what they call the "Culture Wars of EBPs [Evidence-Based Practices]", have enlisted over 40 researchers/clinicians to respond. In areas I know, the editors have certainly picked the best researchers/clinicians. As the editors say,
"Mental health professionals have become polarized on EBPs and separated into rival camps, with differing language systems and conflicting values."
And that's putting it very mildly.
"Evidence-Based Practices" presents quite-diverse positions on nine crucial questions:
What qualifies as evidence of effective practice?
What qualifies as research on which to judge effective practice?
Does manualization improve therapy outcomes?
Are research patients and clinical trials representative of clinical practice?
What should be validated? (Or what aspect of psychotherapy should we be researching, e.g., a technique, a relationship quality, a client characteristic, etc.?)
What else materially influences what is represented and published as evidence?
Do therapies designated as "empirically supported treatments" for specific disorders produce outcomes superior to non-"empirically supported treatment" therapies?
How well do both "evidence-based practices" and "treatment as usual" satisfactorily address the various dimensions of diversity?
Are efficacious laboratory-validated treatments readily transportable to clinical practice?
For each question, experts stake out their differing positions. For example, on "What should be validated?", leading researchers/clinicians take five different positions: treatment method, psychotherapist, therapy relationship, active client & principles of change. On "What qualifies as research on which to judge effective practice?, researchers/clinicians explain & defend six positions: case studies, single-participant design research, qualitative research, change process research, effectiveness research and randomized clinical trials.
After all the different answers to a question, each researcher/clinician is asked a series of questions about that topic: "Dialogue: Convergence and Contention". For example, in the 5-positioned response to "What should be validated?", three "misconceptions" about Empirically-Supported Treatments (ESTs) were presented for five different responses: "EST advocates ignore contributions of the psychotherapist", "EST advocates hold that the therapeutic relationship is not important" and "EST advocates hold that clients are passive recipients of treatments".
Reading all the answers to each question gives a clear, vivid summary of this war's key aspects. More than urgent, at times, these conflicts, these different positions can be painful & fear-provoking. But always, I find, they're important, even vital to know.
The three editors are self-proclaimed believers in both science & clinical practice, and they say they're all biased toward "informed pluralism". So their shared goal is to find peaceful & productive coexistences & interactions between these different, highly conflicted understandings & approaches:
"Mental health professionals comprise a nation of differences. Those differences do not necessarily make us weak; differences can serve as sources of creativity, strength, and progress if constructively harnessed. In the view of Feyerabend, a philosopher of science, the interplay between tenacity and proliferation is an essential feature in the development of science. It is not the puzzle-solving activity that is responsible for the growth in the development of science, but the active interplay of various tenaciously held views. In the words of Dante (Paradisio, Canto VI), "Of diverse voices is sweet music made." But diverse voices can also sound like nails on a blackboard if they are dissynchronous and out of harmony."
As a clinician working with difficult & complex, multi-problemed clients & families, I absolutely agree. Yet in reading this book, while it was extremely valuable & informative, I found that the editors goal of co-existence and pluralism, sadly, often seemed "a custom more honour'd in the breach than the observance."
(Yes, I know I'm misusing that Hamlet quotation.)
Still, for my fellow clinicians, I strongly recommend this book. You'll be a much wiser consumer of research & practices, and you'll be much more aware of the full range of needed possibilities.
Disclosure: I was first trained by several students -psychotherapists & researchers - who studied and worked with Carl Rogers. Rogers more-or-less began systematic research into the effectiveness of psychotherapy. Obviously, his focus was investigating the client/therapist relationship. Since that time, a quarter century ago, I've become a family therapist, and I also use many cognitive-behavioral therapies & DSM diagnoses. Yet I've always thought of myself as, foundationally, a client-centered family therapist - less in what I do than in how I do it.
Evidence-supported treatments (ESTs) currently dominate high-powered academic psychology, which gets most of the research funding. More, ESTs have also won the public-relations war hands-down. Yes, I was trained on client-centered research & the primacy of the client/therapist relationship. But after years of reading little else but EST research & practice, I discovered that I'd slipped, clinically, in the non-EST's which, research strongly suggests, are at least if not more important & effective than specific treatments for specific diagnoses. (See,especially, the 2nd edition (2010), The Heart and Soul of Change: Delivering What Works in Therapy and the earlier, Psychotherapy Relationships that Work: Therapist Contributions and Responsiveness to Patients.) I'd become steadily more skillful in diagnosis & treatment procedures. But in turning away from non-EST research and its clinical implications, I had not kept up with important research advances in areas such as eliciting & incorporating client skills, getting feedback on the quality of my client/therapist relationship, qualities to develop as the therapist, and more.
Is "Evidence-Based Practices" heavy into statistics? No, at least not for me. And my statistics training - never my strongest suit - is several decades past. These summaries are clearly written with the general mental health audience in mind, though for psychologists in particular. This means that some understanding of basic research terms is helpful. But even if you've forgotten everything from your graduate research class, a dictionary should suffice to refresh your memory, at least enough to read these summaries.
As clinicians, all this research-focus may seem far from our central concern: becoming better at helping clients heal. But in my experience, "Evidence-Based Practices in Mental Health" turned out to be highly relevant in pointing out what I and, more importantly, what my clients most needed. I believe you'll find "Evidence-Based Practices" an important corrective, and a guide back to a more balanced, more truly scientific and effective approach to psychotherapy.
1 of 1 people found the following review helpful.
Evidence-Based Practices in Mental Health: Debate and Dialogue On The Fundamental Questions
By Amazon Customer
Although this is not written for someone who is not able to read counseling verbiage, it is very well laid out and sensible for anyone who has been reading in the field, thus i was able to get a very thorough overview of what Evidence-Based Theory entails, methodologies used with it and reasoning why it is favored by some.
1 of 1 people found the following review helpful.
Great for training in Critical Thinking in EBP
By Trevor M. Dobbs
Gives a classic pro and con dialogue between authors, often 3-4 per chapter.
Probably graduate level, but well written and can be used at undergrad psych level as well.
Very useful as the competing schools in EBP debate typically write religiously, as if it is a foregone conclusion that their approach is the true one. Good at facilitating critical thinking.
Very reasonably priced for texts these days.
Dr. D
See all 8 customer reviews...
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