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About Evidence-Based Practices

By Steve Gallon, Ph.D., Northwest Frontier Addiction Technology Transfer Center

The availability of empirically supported clinical practices and interventions for the treatment of substance use disorders has increased as research moves from tightly controlled studies in the laboratory to community treatment settings. The volume of community-based research projects has grown significantly in recent years. As empirically validated manual-based approaches grow in number it becomes more and more difficult for addiction professionals and policy makers to maintain awareness of the variety of practices available. To make informed decisions about which science-based practices are most appropriate in which circumstances for which individuals, treatment designers need an up-to-date resource that is easy to use and can answer questions about the nature of the practices. That is the purpose of the EBP Substance Abuse database.

Programs included must either have published research citing them as evidence-based, or be recognized by reputable organizations as evidence-based. In keeping with the educational function of this database, preference is given to programs which have developed a manual or other documentation that can be used by others to replicate the program in their community. This database is intended to serve laypeople and professionals, consumers of substance abuse services, family members, providers of substance abuse services, administrators, and anyone else interested in researching evidence-based practices. A list of the sources used to select EBPs for addition to the database can be found here.

Currently, evidence-based practices are not in common use in addiction treatment settings. The reasons are many. The research literature often does not include the information necessary to implement a practice with a proven ability to produce positive outcomes. Sometimes the practice requires considerable preparation in form of policy adjustment, resource acquisition, procedural documentation, staff training and ongoing supervision to assure accurate implementation. At other times the new practice might challenge existing philosophical values within the agency about such things as the use of medication or rewarding patients for desirable behavior. This database presents a broad variety of scientifically supported practices. It does not represent practices that appeal or are consistent with only one approach to treatment. It is hoped that a range of treatment and recovery programs will find tools and methods within this database that have the potential to improve the quality and outcomes of their services.

The database can be searched with a variety of identifiers. Author, population, therapy type, and drug problem are just a few of the ways an inquirer can seek to find specific interventions or treatment methods. Once located, the database includes a description of the intervention, its intended impact, a summary of the evidence that supports its efficacy, the availability of instructional manuals and fidelity measures, literature citations, author/developer notes, implementation issues and other useful information.

Clinical practices and their relation to research can be placed on an evidence continuum ranging from multiple studies using randomized assignment of patients in clinical settings to no evidence that supports the efficacy or efficiency of the practice. The practices in this database have met the following minimum criteria:

  • Research: The practice has been subjected to scientific study that included randomized controlled trials, quasi-experimental studies, or in some cases a less rigorously controlled research design. For the most part the research has been published in a peer-reviewed journal.
  • Meaningful Outcomes: The practice has resulted in benefits to the individuals receiving the service. It has helped consumers achieve desired outcomes related to treatment goals and objectives.
  • Standardization: The practice or intervention has been standardized so that it can be replicated. Standardization typically involves a published description that clearly defines the nature of the practice, the audience for whom it is intended and the desired impact of the practice on the individuals receiving it. Thorough instructions are available, as well as copies of printed materials and other tools needed to implement the practice.
  • Replication: The interventions and practices included in the database have been studied in more than one setting and findings have yielded consistent results.
  • Fidelity Measure: A fidelity measure either exists or could be developed from available information. Such measures allow practitioners to verify that an intervention is being implemented in a manner consistent with the protocol evaluated in the research.

Finally, the database is intended to be an expanding resource. As the efficacy and effectiveness of practices are documented and meet the minimum criteria established above, they will be added to the database. We invite nominations of practices from the treatment and research communities to help keep the database as current as possible. In addition, if needed information about a practice is not included in the database, please let us know. Our goal is to provide a resource that makes the work of building and researching effective treatment services easier and more efficient.

 

EBP Substance Abuse was developed as a joint project of the University of the Washington Alcohol & Drug Abuse Institute and the
Northwest Frontier Addiction Technology Transfer Center, with funding from the Washington State Division of Alcohol and Substance Abuse.
It is currently maintained by ADAI. For comments or suggestions, email adai@uw.edu.


Some rights reserved. This work is licensed under a Creative Commons License.
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