Evidence-Based Practices

Steps to Implementing Evidence-Based Practices
The implementation of Evidence-Based Practices may seem like a daunting task for some youth serving agencies. However, Gambrill’s Transparency as the route to evidence-informed professional education offers these key steps on implementing evidence-based practices:

  1. Convert information needs related to practice decisions into well-structured answerable questions;

  2. Track down with maximum efficiency, the best evidence with which to answer them;

  3. Critically appraise evidence for its validity (level of effectiveness), impact (size of effect) and applicability (usefulness in practice);

  4. Apply the results of this appraisal to practice-policy decisions. This involves deciding whether evidence found (if any) applies to the decision at hand (e.g., is a client similar to those studied? Is there access to services described?) and considering client values and preferences in making decisions as well as other application concerns;

  5. Evaluate effectiveness and efficiency in carrying out steps 1 – 4 and seek ways to improve them in the future.1

There are several tools available to evaluate the wide body of Evidence-Based Practices available. One such tool is the National Registry of Evidence-Based Programs and Practices (NREPP). This tool developed by the Substance Abuse and Mental Health Services Administration (SAMHSA) is a searchable database (http://nrepp.samhsa.gov) of interventions that have been reviewed and rated by independent reviewers. The NREPP provides general information, ratings and a list of studies and materials reviewed about each intervention. The information contained in a NREPP report can help you begin to determine whether a particular intervention may meet your programmatic needs.

1Gambrill, E. (2006, October) Transparency as the route to evidence-informed professional education. Paper presented at the Improving the Teaching of Evidence-Based Practice conference, Austin, Texas; 24 p. 7

Evidence-Based Practice Registry Resource
RHYTTAC created a brief directory of some of the most common registries of evidence based, evidence informed, promising and emerging practices. This resource was created for grantees to reference when searching for a model, program, or practice to implement. Each registry contains various resources to assist grantees at all stages (from decision making to implementation) when considering certain model or practice into their existing program/agency. Please review the document, save it to your desktop, and explore the registries at your convenience. It is RHYTTAC's hope that it will be a useful tool to you and your program to strengthen what you already do well for youth.

What are Some Evidence-Based Practices that RHY Providers are Using?
RHYTTAC requested input from grantees on the Evidence-Based Practices they use in their programs. A portion of the NREPP description and link to the NREPP report for Evidence-Based Practices that grantees have indicated they use is provided. This is not an exhaustive list of Evidence-Based Practices; to view the 207 Evidence-Based Practices that are highlighted on the NREPP site go to http://nrepp.samhsa.gov/AdvancedSearch.aspx.

  • Cognitive Behavioral Therapy for Adolescent Depression (http://nrepp.samhsa.gov/Legacy/ViewIntervention.aspx?id=106)
    Cognitive Behavioral Therapy (CBT) for Adolescent Depression is a modified version of the classic cognitive therapy model developed by Aaron Beck and colleagues which emphasizes the way client’s think and feel.

  • Motivational Interviewing (http://nrepp.samhsa.gov/Legacy/ViewIntervention.aspx?id=346)
    Motivational Interviewing (MI) is a goal-directed, client-centered counseling style whose goal is to seek behavioral change by helping clients to explore and resolve ambivalence.

  • Seven Challenges Substance Abuse Interventions (http://nrepp.samhsa.gov/Legacy/ViewIntervention.aspx?id=159)
    The Seven Challenges is designed to treat adolescents with drug and other behavioral problems. Rather than using pre-structured sessions, counselors and clients identify the most important issues at the moment and discuss these issues while the counselor integrates the seven challenges into the conversation.

  • Trauma Focused Cognitive Behavioral Therapy (http://nrepp.samhsa.gov/Legacy/ViewIntervention.aspx?id=135)
    Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) is a psychosocial treatment model designed to treat posttraumatic stress and related emotional and behavioral problems in children and adolescents. The treatment model is designed to be delivered by trained therapists who initially provide parallel individual sessions with children and their parents (or guardians), with parent-youth sessions increasingly incorporated over the course of treatment.

Evaluation Tools and Resources
RHY grantees are encouraged to have an evaluation plan to determine whether their program is producing the desired outcomes. From the process of evaluation, unplanned for benefits or areas for growth are more easily seen allowing for programs to make necessary adjustments as well as acknowledge what is working and going well. Information on various aspects of evaluation as well as user friendly resources and articles have been compiled to help guide you in developing or refining your evaluation plan.

How are Evidence-Based Practices Best Used?
Grantees found Evidence-Based Practices were most effective when used to determine and achieve outcomes. In order to measure outcomes and continually evaluate the effectiveness of their program, agencies are using existing screening and assessment instruments that are already available, tested and were determined to be reliable. Since many funding entities require agencies to document and report service outcomes, agencies should become familiar with screening and assessment tools available.

Resources on Evidence-Based Practices
Grantees found evidence based practices were most effective in order to determine and achieve outcomes. In order to measure outcomes and continually evaluate the effectiveness of their program, agencies are using existing screening and assessment devices. Other evidence-based practices can also be found on SAMHSA's National Registry of Evidence-Based Programs and Practices (NREPP) at http://www.nrepp.samhsa.gov/, and additional resources are available at http://rhyttac.net/evidence-based-practices.