National Academies EBP guidelines

The US National Academies Press published a a booklet recommending a framework for promoting evidence-based practices in the areas of mental health and substance abuse. The focus is not expressly on children and youths or on education, which are key concerns for EBD Blog, but the emphases on evidence-based practices (EBP) in mental health and substance abuse certainly overlap sufficiently to make this report of potential interest to readers.

Because the guidelines come from the National Academies, they will carry substantial weight. For the purposes of many who work with students who have EBD, there is similar useful guidance about EBP from a work group composed of leaders from the Division for Research—Bryan Cook (chair), Viriginia Buysse, the late Janette Klingner, Tim Landrum, Robin McWilliam, Melody Tankersley, and Dave Test— of the Council for Exceptional Children (CEC). In January of 2014, the CEC group presented guidance to help consumers determine whether a practice should be considered as (a) evidence-based, (b) potentially evidence-based, (c) having mixed evidence, (d) having insufficient evidence, or (e) having negative evidence. Readers can download their own copy of the standards from the CEC Website and read the CEC press release about the standards.

Read the abstract for the NAP guidelines that follows and learn more from the press release of The National Academies of Sciences, Engineering, and Medicine.

This is surely a good step. Let’s hope it helps to move the conversation forward. It’s a recommended read for those who want to take a deep dive or want to maintain currency in this important area.

Abstract

Approximately 20 percent of Americans are affected by mental health and substance use disorders, which are associated with significant morbidity and mortality. While the evidence base for the effectiveness of interventions to treat these disorders is sizable, a considerable gap exists between what is known to be effective and interventions that are actually delivered in clinical care. Addressing this quality chasm in mental health and substance use care is particularly critical given the recent passage of the Patient Protection and Affordable Care Act (ACA) and Mental Health Parity and Addiction Equity Act, which are changing the delivery of care and access to treatments for mental health and substance use disorders. Increasing emphasis on accountability and performance measurement, moreover, will require strategies to promote and measure the quality of psychosocial interventions.
In this report, the study committee develops a framework that can be used to chart a path toward the ultimate goal of improving the outcomes of psychosocial interventions for those with mental health and substance use disorders. This framework identifies the key steps entailed in successfully bringing an evidence-based psychosocial intervention into clinical practice. It highlights the need to (1) support research to strengthen the evidence base on the efficacy and effectiveness of psychosocial interventions; (2) based on this evidence, identify the key elements that drive an intervention’s effect; (3) conduct systematic reviews to inform clinical guidelines that incorporate these key elements; (4) using the findings of these systematic reviews, develop quality measures—measures of the structure, process, and outcomes of interventions; and
(5) establish methods for successfully implementing and sustaining these interventions in regular practice including the training of providers of these interventions. The committee intends for this framework to be an iterative one, with the results of the process being fed back into the evidence base and the cycle beginning anew. Central to the framework is the importance of using the consumer perspective to inform the process.
The recommendations offered in this report are intended to assist policy makers, health care organizations, and payers that are organizing and overseeing the provision of care for mental health and substance use disorders while navigating a new health care landscape. The recommendations also target providers, professional societies, funding agencies, consumers, and researchers, all of whom have a stake in ensuring that evidence-based, high-quality care is provided to individuals receiving mental health and substance use services.

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