Abstract
The recent movement toward evidence-based practice in mental health services has highlighted the importance of research evidence in treatment decisions. However, the fact that many treatments with strong research support are not widely used in clinical settings suggests that practitioners’ decisions are not based on research alone but rather are influenced by other considerations. This study examines the relative importance of various considerations on practitioner treatment selection using a national survey of mental health practitioners including doctoral-level psychologists, master’s-level psychologists, and master’s-level clinical social workers (N = 206). Results indicate that practitioners are influenced by a range of considerations including empirical evidence from applied field studies, the perceived flexibility of a treatment, and the appeal of a treatment to colleagues and clients. These findings are discussed within the context of efforts to design, evaluate, and disseminate treatments with research support into clinical settings.
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References
American Psychological Association Task Force on Evidence-Based Practice. Evidence-based practice in psychology. American Psychologist. 2006;61(4):271–285.
Institute of Medicine. Crossing the Quality Chasm: A New Health System for the 21st Century. Washington, DC: National Academy Press; 2001.
Chambless DL, Hollon SD. Defining empirically supported therapies. Journal of Consulting and Clinical Psychology. 1998;66(1):7–18.
McFall RM. Manifesto for a science of clinical psychology. The Clinical Psychologist. 1991;44(6):75–88.
Herbert JD. The science and practice of empirically-supported treatments. Behavior Modification. 2003;27(3):412–430.
Hoagwood K, Olin S. The NIMH blueprint for change report: Research priorities in child and adolescent mental health. Journal of the American Academy of Child and Adolescent Psychiatry. 2002;41(7):760–767.
Kazdin AE, Siegel TC, Bass D. Drawing upon clinical practice to inform research on child and adolescent psychotherapy: A survey of practitioners. Professional Psychology: Research and Practice. 1990;21(3):189–198.
National Institute of Mental Health. Bridging science and service: A report by the National Advisory Mental Health Council’s Clinical Treatment and Services Research Workgroup. Bethesda, MD: National Institutes of Health; 1998.
New Freedom Commission on Mental Health: Achieving the Promise: Transforming Mental Health Care in America. Final Report. DHHS Pub. No. SMA-03-3832. Rockville, MD; 2003.
Kazdin AE. Psychotherapy for Children and Adolescents: Directions for Research and Practice. New York: Oxford University Press; 2000.
Weisz JR, Kazdin AE. Present and future of evidence-based psychotherapies for children and adolescents. In: Kazdin AE, Weisz JR, eds. Evidence-Based Psychotherapies for Children and Adolescents. New York: Guilford Press; 2003:439–451.
Nelson TD, Steele RG. Beyond efficacy and effectiveness: A multifaceted approach to treatment evaluation. Professional Psychology: Research and Practice. 2006;37(4):389–397.
Addis ME, Krasnow AD. A national survey of practicing psychologists’ attitudes toward psychotherapy treatment manuals. Journal of Consulting and Clinical Psychology. 2000;68(2):331–339.
Nelson TD, Steele RG, Mize JA. Practitioner attitudes toward evidence-based practice: Themes and challenges. Administrative Policy in Mental Health and Mental Health Services Research. 2006;33(3):398–409.
Norcross JC (ed.). Psychotherapy Relationships that Work: Therapist Contributions and Responsiveness to Patient Needs. New York: Oxford University Press; 2002.
Persons JB, Silberschatz G. Are results of randomized controlled trials useful to psychotherapists? Journal of Consulting and Clinical Psychology. 1998;66(1):126–135.
Yates BT. Toward the incorporation of costs, cost-effectiveness analysis, and cost-benefit analysis into clinical research. Journal of Consulting and Clinical Psychology. 1994;62(4):729–736.
Kendall PC, Beidas R. Smoothing the trail for dissemination of evidence-based practices for youth: Flexibility within fidelity. Professional Psychology: Research and Practice. 2007;38(1):13–20.
Stirman SW, Crits-Christoph P, DeRubeis RJ. Achieving successful dissemination of empirically supported psychotherapies: A synthesis of dissemination theory. Clinical Psychology: Science and Practice. 2004;11(4):343–359.
Substance Abuse and Mental Health Services Administration. Mental health services locator. n.d. Available at http://www.mentalhealth.samhsa.gov/databases. Accessed December 10, 2005.
Beutler LE, Williams RE, Wakefield PJ, et al. Bridging scientist and practitioner perspectives in clinical psychology. American Psychologist. 1995;50(12):984–994.
Henin A, Otto MW, Reilly Harrington NA. Introducing flexibility in manualized treatments: Application of recommended strategies to the cognitive-behavioral treatment of bipolar disorder. Cognitive and Behavioral Practice. 2001;8(4):317–327.
Kendall PC. Flexibility within fidelity. Clinical Child and Adolescent Psychology Newsletter. 2001;16:1–5.
Atkins MS, Graczyk PA, Frazier SL, Abdul-Adil J. Toward a new model for promoting urban children’s mental health: Accessible, effective, and sustainable school-based mental health services. School Psychology Review. 2003;32(4):503–514.
Chorpita BF, Donkervoet C. Implementation of the Felix consent decree in Hawaii. In: Steele RG, Roberts MC, eds. Handbook of Mental Health Services for Children, Adolescents, and Families. New York: Kluwer; 2005:317–332.
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Nelson, T.D., Steele, R.G. Influences on Practitioner Treatment Selection: Best Research Evidence and Other Considerations. J Behav Health Serv Res 35, 170–178 (2008). https://doi.org/10.1007/s11414-007-9089-8
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DOI: https://doi.org/10.1007/s11414-007-9089-8