What is Evidence-Based Practice (EBP)?

The most common definition of Evidence-Based Practice (EBP)is “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of the individual patient. It means integrating individual clinical expertise with the best available external clinical evidence from systematic research.” (Sackett D, 1996)

EBP is the integration of clinical expertise, patient values, and the best research evidence into the decision making process for patient care. Clinical expertise refers to the clinician’s cumulated experience, education and clinical skills. The patient brings to the encounter his or her own personal preferences and unique concerns, expectations, and values. The best research evidence is usually found in clinically relevant research that has been conducted using sound methodology. (Sackett D, 2002)

The Diagram

The evidence, by itself, does not make the decision, but it can help support the patient care process. The full integration of these three components into clinical decisions enhances the opportunity for optimal clinical outcomes and quality of life. The practice of EBP is usually triggered by patient encounters which generate questions about the effects of therapy, the utility of diagnostic tests, the prognosis of diseases, and/or the etiology of disorders.

Evidence-Based Practice requires new skills of the clinician, including efficient literature searching, and the application of formal rules of evidence in evaluating the clinical literature.

Just because we can do something doesn’t mean we should. We need to ask, ‘How is this going to change the patient’s overall prognosis and outcome and quality of life?’ If it’s not going to change any of these things, then we shouldn’t be doing it. We need to look at the evidence in the context of the patient and make sure we are doing things that will make a difference.

Kathryn Stewart, MD

Some Evidence-Based Practices

• Assertive Community Treatment (ACT) Evidence-Based Practices
• Integrated Treatment for Co-Occurring Disorders Evidence-Based Practices
• Supported Employment Evidence-Based Practices
• Supported Education Evidence-Based Practices
• Illness Management and Recovery Evidence-Based Practices
• Family Psychoeducation Evidence-Based
• Practices
• MedTEAM (Medication Treatment, Evaluation, and Management) Evidence-Based Practices

EBP Presently employed at TRH

Illness Management and Recovery

IMR is an evidence-based practice program that helps people: Set meaningful goals for themselves. Obtain information and learn skills to have power over psychiatric illness. Maintain focus and make progress toward personal goals.

Recovery occurs when people with mental illness discover, or re-discover, their strengths and abilities for pursuing personal goals and develop a sense of identity that allows them to grow—Illness Management and Recovery: A Review of the Research, Psychiatric beyond their mental illness.

Services, October 2002, Vol. 53, No. 10.

Family Psychoeducation

Family Psychoeducation (FPE) is an approach for partnering with clients and families to treat serious mental illnesses. FPE practitioners develop a working alliance with clients and families & includes :-

• Education about serious mental illnesses;
• Information resources, especially during periods of crises;
• Skills training and ongoing guidance about managing mental illnesses;
• Problem solving; and
• Social and emotional support.

MedTEAM (Medication Treatment, Evaluation, and Management)

MedTEAM is a systematic, evidence-based approach for offering medication management to people with mental illnesses It helps those who prescribe medications to integrate the best current research evidence, clinical expertise, and consumer experience . (Samhsa )

Supported Employment

Supported Employment is an evidence-based practice that helps people with mental illness and other disabilities identify and acquire part-time or full-time jobs of their choice in the community with rapid job-search and placement services. It emphasizes that work is not the result of treatment and recovery but integral to both. It also emphasizes client choice as well as time-unlimited and individualized follow-along services, among other components. (Samhsa)

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