Evidence-Informed Practice and Policy: Choices and Barriers

The history of the helping profession shows that clients are often harmed in the name of helping. Evidence-based practice is designed to help us to avoid ineffective and harmful methods and to offer clients services likely to help them achieve outcomes they value. It is an alternative to authority-based decision making in which decisions are based on what is popular or what is usually offered (tradition). The process of evidence-based practice can help us to identify information needs related to important decisions. It calls on us to be honest about our ignorance (what is not known") as well as our knowledge and to share this with clients in the context of a supportive dialogue. This paper provides an overview of the process and philosophy of evidence-informed practice as designed by its originators and as it is evolving. It contrasts this with narrow views such as using practice guidelines, and with cosmetic views (changes in name only). It is argued that only the process and philosophy of EBP which entails a systemic view attending to behaviors and products in all related venues, including professional education, practice and policy, administration, and the conduct and reporting of research, is likely to help us to improve the quality of services. This systemic view, as well as the related philosophy and process clearly described in original sources, is often ignored in secondary sources.