Resistance to evidence-based practice
Practitioners from various domains have mixed responses to evidence-based practice (Rousseau & Gunia. 2016). Psychologists indicate favourable attitudes at an abstract level, but they are reluctant to endorse scientific evidence above other sources of information, particularly clinical experience, when helping clients (Lilienfeld. Ritschel. Lynn, Cautin. & Latzman. 2013). Practitioners’ ambivalence does not necessarily reveal antipathy toward scientific evidence. Instead, psychologists' mixed attitudes may reflect that they are unable to digest, interpret, and apply research findings because of the way investigators communicate the results of their studies (Lilienfeld et al.. 2013).
One practitioner misperception is that only randomized controlled trials count as best evidence (Satterfield et al.. 2009). Randomized controlled trials, when conducted well, provide high-quality answers to some questions that have relevance for practice, such as the inference of causality. Nevertheless, experimental research does not provide answers to all questions practitioners have about sen ice delivery. As presented earlier, there are many types of research design and sources of knowledge, and they each provide some insight that can guide applied sport, exercise, and performance psychology. Evidence-based practice is not restricted to only using results from randomized controlled trials (American Psychological Association. 2006).
Individuals may also believe that evidence-based practice minimizes the practitioner’s expertise (Cook et al., 2017: Moore, 2007). There is the misperception that evidence-based practice leads to an overly structured, cookbook, one-type-fits-all approach to sen ice delivery. and it devalues the psychologist’s expertise. Such perceptions are at odds with the definition of evidence-based practice. As detailed earlier, the American Psychological Association (2006. p. 273). for example, defined evidence-based practice as the "integration of the best available research with clinical expertise in the context of patient characteristics, culture and preferences.” Practitioner expertise is acknowledged as one of the flagstones underpinning effective psychological help (Satterfield et al.. 2009). The practitioner s roles, for example, include knowing what research is relevant to guide decision-making and how to tailor psychological interventions to clients’ circumstances. These roles take on increasing significance when the research base is less than ideal (American Psychological Association. 2006).
Related to the belief that evidence-based practice downgrades the practitioners’ role is the misperception that it also ignores client, contextual, and cultural variables (Satterfield et al., 2009). People with these misperceptions fear evidence-based practice forces clients to accept unsuitable interventions (similar to driving square pegs into round holes). In contrast, however, one of the assumptions on which evidence-based practice is built is that sen ices and inters entions are tailored to clients and their needs, preferences, circumstances, and cultures (Cook et al.. 2017).
A common theme among these misperceptions is that evidence-based practice is inflexible: it has a dogmatic view of what is acceptable science and attempts to impose a rigid set of procedures onto practitioner-client relationsliips. The authors of empirically supported inters entions, however, do not normally advocate such a strict viewpoint but instead argue for flexibility to ensure clients receive optimal help (Cooket al., 2017). The balance between fidelity and flexibility may be achieved through differentiating core components and specific techniques. Core components refer to the defining characteristics of a senice deliven model or intervention programme and can be gleaned from the underlying theoretical orientation (Substance Abuse and Mental Health Senices Administration. 2002). Core components in mental skills training, for example, might be the identification of mental skills needing improvement and the employment of psychological methods to address deficiencies. Practitioners can tailor specific techniques, such as goal setting, imagery, and self-talk, to clients’ needs and circumstances.
Conclusion
Photographers use tripods to establish a stable base for their cameras because doing so improves the quality of their work. Similarly, evidence-based practice is a conceptual tripod that provides a stable base from which consultants can enhance the quality of their client interactions. The three legs in the evidence-based tripod include the best available research, consideration for clients’ needs, preferences, and circumstances: and recognition of resources and practitioner expertise. Removal of any leg leads to an unstable base that may jeopardize sen ice delivery. Overemphasis of any leg also threatens the balance and stability of applied work. The current chapter has examined various aspects of the evidence-based tripod, such as what it looks like, the materials out of which it is made, and instructions for its use. Effective use of the tripod will help practitioners attain the primary of goal of sen ice delivery, which is to provide high-quality help to clients, allowing them to manage their problem situations and take advantage of unused opportunities.
