Why implementing evidence-based practices is a good choice
Let’s start by being honest—it’s hard to implement Evidence-based Practices (EBPs). However, keep in mind, it’s even harder to start an unscripted practice even with the most well-intentioned service providers, rely on the limited scope of implementation expertise in many jurisdictions or shoot in the dark hoping for outcomes that may not even target the needs in your local community.
Just for argument’s sake, consider several alternatives. Without implementing an evidence-based practice, most jurisdictions or agencies will be doing business as usual. In other words, doing the same thing over and over and expecting different results. This is a common definition of insanity. Agencies and jurisdictions might have great ideas about helping youth that never get to implementation because there is no real plan. (Most evidence-based practices come with a plan.) They may have a few stellar “go-to” clinicians, but what happens when they go? Individual clinician’s practices often can’t be replicated. (EBPs give you options for sustaining good practices with many different practitioners over time.)
Jurisdictions probably won’t know the longer-term outcomes of the youth in their care at the individual case level and certainly not at the aggregate system-impact level. (Most evidence-based practices come with data-collection tools and useful ways to monitor outcomes for practitioners and systems.)
Service areas will miss opportunities to catch youth and families making progress as many wait and hope for a big long-term goal like reduced recidivism, fewer out-of-home placements, graduation, etc. This doesn’t mesh with the best behavior-shaping practices or what we know about how teens’ brains work. (Most EBPs attend to progress and symptom reduction, and in doing so, expedite behavior change.)
Without an evidence-based practice, many, if not most, jurisdictions will do what systems have been doing for decades—they will chase crisis behavior after crisis behavior without ever getting to their causes. (Most EBPs focus on the causes of crisis without losing focus in the whirlwind of the crisis of the day.)
Last, but certainly not least, who has money to spend on unknown or unestablished results? EBPs aren’t always going to work, but studies suggest that in general, evidence-based practices will demonstrate higher retention rates and better outcomes for as many as 80 percent of the youth and families served. Ten percent will likely have no change, and 10 percent are likely to continue to get worse. These remain much better outcomes than what systems have traditionally relied on or hoped for.
So yes, EBPs can be hard to put into place. Fixing systems is hard. Working with high-risk and high-need families is hard. We also know these youth and families don’t have a lot of time to waste on hoping an intervention will work. Their lives and futures are at stake. That should make choosing a treatment with more likelihood of success relatively easy.
Stephen Phillippi, Ph.D. is the Director, Institute for Public Health & Justice, LSU School of Public Health
