Evidence-Based Practice

There is perhaps no more frequently used term in the child welfare field today than “evidence-based practice.” Let’s take a look at the definition and evolution of evidence-based practice, why it is important, and an example.

In 2005 the National Association of Public Child Welfare Administrators (NAPCWA) published guidelines for evidence-based practice. NAPCWA noted the following issues surrounding evidence-based practice:

  1. The base of solid empirical research on child welfare practice is still developing.
  2. Child welfare practices cannot simply be divided into “evidence-based” and “non-evidence based.” There is a continuum from highly research supported practice at one end to very questionable and concerning practices at the other end.
  3. There is no universally accepted definition or classification of evidence-based practice.

NAPCWA adapted a definition of evidence-based practice from the Institute of Medicine that combines three factors:

  1. Best research evidence
  2. Best clinical experience
  3. Consistent with family/client values

In order to operationalize these factors and provide objective measures, the California Evidence-Based Clearinghouse for Child Welfare (CEBC) was established ( http://www.cebc4cw.org/ ). A practice is rated based on the following criteria:

1 — Well-Supported by Research Evidence
2 — Supported by Research Evidence
3 — Promising Research Evidence
4 — Evidence Fails to Demonstrate Effect
5 — Concerning Practice
NR — Not Able to be Rated

The CEBC relies on published, peer-reviewed research to determine the rating.

Why is using an Evidence-Based Practice important?

A CEBC advisory committee member’s response to that question follows.

Evidence-based practice:

  • Ensures that families are referred to the most effective and efficacious programs that the community provides.
  • Helps child welfare workers and supervisors empower families in crisis to resolve their own conflicts, using well-tested programs.
  • Allows child welfare workers to refer families to services that have been scientifically researched and proven effective, which in turn may cause the families to make a greater commitment to participation.
  • Provides child welfare workers with a better understanding of the range of programs available so they can make informed choices when referring families to services.

Now, let’s look at an example showing how assessment tools are rated by the CEBC. The CEBC provides information on these tools to help child welfare agencies evaluate the research supporting each tool. In order to be included on the CEBC, the tool must meet two requirements:

  1. It must have a manual and/or training available that describes how to administer and score it and
  2. The tool must be likely to be used in the child welfare field or with children and caretakers in the child welfare system.

Assessment tools also have a somewhat different rating system than practices:

A — Reliability and Validity Demonstrated
• Two or more published, peer-reviewed studies have demonstrated that the measure is reliable and valid.

B — Reliability and/or Validity Level Above Face Validity Demonstrated
• One published, peer-reviewed study demonstrates that the measure is reliable and/or valid beyond the level of face validity.

C — Does Not Reach Acceptable Levels of Reliability and/or Validity
• A preponderance of published, peer-reviewed studies have shown that the measure does not reach acceptable levels of reliability and/or validity

NR — Not Able to Be Rated
• Adequate published peer-reviewed studies demonstrating reliability and/or validity are not yet available for this measure.

About two dozen assessment tools have been rated. The NCFAS assessment tool, measuring family functioning, received the highest rating, an A, from the CEBC. For further details on this rating, visit: http://www.cebc4cw.org/assessment-tool/north-carolina-family-assessment-scale/

The CEBC website is a good first stop when you want information and ratings on evidence-based practices and services. For information on how a practice, Intensive Family Preservation Services, was rated by the CEBC and other rating agencies, check out the IFPS Blog this week at: http://ifpscoasttocoast.wordpress.com

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