Information for Providers

Division of Mental Health/Division of Behavioral Health

Evidence Based Practices

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The Division of Mental Health is encouraging the use of Evidence Based Practices in the treatment of mental illness. Research has shown that Evidence Based Practices consistently produce positive outcomes. In 2006 and 2007, the 17 Community Mental Health Centers in Colorado will be implementing Evidence Based Practices programs.  Please click here for information about the specific programs being implemented at each Community Mental Health Center. Many of the Centers currently have other Evidence Based Practices in place as well.

In the year ahead, the Division of Mental Health will track the progress the Centers make in implementing Evidence Based Practices and will report the highlights on this page.
Additional information on these and other Evidence Based Practices can be found at the following web addresses:

The Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services (CMHS)
http://www.mentalhealth.samhsa.gov/cmhs/communitysupport/toolkits/default.asp

The Substance Abuse and Mental Health Services Administration (SAMHSA), Center for Mental Health Services (CMHS) – Steering Committee, Implementing Evidence Based Practices Project
http://www.mentalhealthpractices.org/

Overview of Evidence Based and Promising Practices

Simply put, an Evidence Based Practice is the "use of treatment methodologies for which there is scientifically collected evidence that the treatment works." (Hayes, 2005). It has its roots in the area of outcomes management. Additionally, the Institute of Medicine (2001) defines EBP as "the integration of best research evidence with clinical expertise and patient values." The Colorado Psychological Association (APA Presidential Task Force, 2005) further adds in its Draft statement that "Evidence Based Practice in Psychology is the integration of the best available research and clinical expertise within the context of patient/client characteristics, culture, values and preferences." Promising Practices are those which are judged to be clinically sound, designed to meet high priority needs of consumers, and are associated with positive outcomes, but lack sufficient scientifically based evidence of their effectiveness through research. They are often the subject of on-going research to prove their efficacy.

Examples of Evidence Based Practices include Supported Employment, Assertive Community Treatment, Family Psychoeducation, Medication Management Approaches in Psychiatry, Illness Management and Recovery, and Co-Occurring Disorders: Integrated Dual Diagnosis Treatment. Despite rational support for the use of these EBPs there has been some resistance in implementing such practices. Stout (2001) investigated the issue and suggested four factors may be at play: (1) lack of clinician support; (2) difficulties in converting clinical guidelines into actionable performance measures; (3) poor use of available technologies (tools) to gauge gaps in performance; and (4) inadequate integration of findings into daily operations. Cost factors have also been identified as additional concerns by program administrators in Colorado and other states. Another concern heard in our community is that some consumers and/or researchers believe that the EBP movement may not always be consistent with the Recovery movement.

  
EBPs and Promising Practices conceptually are in their formative stages and will continue in the future to be refined as clinicians, researchers, consumers, and academicians continue their efforts to expand the knowledge base and evaluate its effectiveness.

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REFERENCES

Hayes, R.A., (2005). Introduction of evidence-based practices. In C. Stout and R. Hayes (Eds.), The evidence-based practice - methods, models and tools for mental health professionals (pp. 1-9). Hoboken, New Jersey; John Wiley & Sons.

Institute of Medicine (2001). Crossing the quality chasm: A new health system for the 21st century. Washington, DC: National Academy Press.

Stout, C.E. (2001, February). Evidence-based guidelines have a role if addressed realistically. Behavioral Health Accreditation and Accountability, 8.