When the National Family Preservation Network (NFPN) was founded 25 years ago, there were no standards for Evidence-Based Practice. However, since its inception NFPN has supported evidence-based practice including one of the first child welfare programs demonstrating effectiveness through research: Intensive Family Preservation Services.
What is the definition of Evidence-Based Practice? The gold standard comes from the field of medicine with the Institute of Medicine defining it as:
- Best Research Evidence
- Best Clinical Experience
- Consistent with Family/Client Values
Today all fields, including social work, have adopted standards for Evidence-Based Practice (EBP). More narrowly, the field of child welfare has a searchable registry of EBP available through the California Evidence-Based Clearinghouse for Child Welfare. The Clearinghouse uses a scientific rating scale of 1-5 to determine the level of research evidence and the following is a description of each level:
- Well-supported by research evidence: Two rigorous randomized controlled trials (RCT), with sustained effect for at least one year post-treatment, and published in peer-reviewed literature
- Supported by research evidence: One RCT, with sustained effect for at least six months post-treatment, and published in peer-reviewed literature
- Promising research evidence: One study using a control group and published in peer-reviewed literature
- Evidence fails to demonstrate effect: Two RCT studies have found the practice has not resulted in improved outcomes and published in peer-reviewed literature
- Concerning practice: Multiple outcome studies suggest the intervention has a negative effect and/or risk of harm
- Not able to be rated: Does not meet criteria for any other level and is generally accepted in clinical practice as appropriate and there is no known risk of harm
All ratings also require a written description of the components of the practice protocol and how to administer it, and the program must be replicable. The list of descriptions have been abbreviated; to view the complete descriptions visit http://www.cebc4cw.org/ratings/scientific-rating-scale/
The CEBC was launched in 2006 and has over 40 topic areas with over 300 programs plus a special section for measurement tools. The complete list of topics is available here: http://www.cebc4cw.org/search/by-topic-area/. Suppose that you wish to find evidence-based programs for Trauma Treatment for Children and Adolescents. Programs, beginning with the top level rating, are listed on one web page to allow a quick review: http://www.cebc4cw.org/topic/trauma-treatment-client-level-interventions-child-adolescent/. You can then select a specific program to obtain a detailed report.
For a webinar overview of the CEBC, visit: http://www.cebc4cw.org/cebc-webinars/cebc-sponsored-webinars/looking-beyond-the-numbers/.The CEBC is not an exhaustive resource and it is not recommended for use as the sole source of evidence-based practice.
There are other evidence-based clearinghouses such as the National Registry of Evidence-Based Programs and Practices with more than 350 mental health and substance use interventions. Programs listed must have a random control trial or control/comparison group study published in peer-reviewed literature. Programs are not rated effective or ineffective but are rated on the quality of research. Evidence ratings are based on outcomes. An outcome rating instrument is used to review each program with four levels of outcome ratings: effective, promising, ineffective, and inconclusive. For example, entering “trauma” into “Find an Intervention” lists all of the reviewed programs and a color-coded rating for each outcome that was tested.
For more information on this registry visit http://www.nrepp.samhsa.gov/landing.aspx.
NFPN recommends checking EBP registries when EBPs are required by government contracts or when considering design and implementation of a new program. If there is a program listed that could meet the need, it will save you a tremendous amount of time and resources.
Posted by Priscilla Martens
NFPN Executive Director