The Unevaluated Framework of APA's Policy on Evidence-Based Practice in Psychology (EBPP)

摘要

Responding to the recent concerning evidence-based practice (Norcross, Beutler, & Levant, 2005, pp. 3-9), APA president Ronald F. Levant commissioned Presidential Task Force with the mandate to establish consensus that acknowledge[s] the valid points from all sides of the debate (A presidential, 2005, p. 59). As result, the Task Force (APA, 2006) produced statement concerning evidence-based practice in psychology (EBPP) that was approved as APA policy by APA's Council of Representatives in 2005. The policy defines EBPP as the integration of the available with clinical expertise in the context of patient characteristics, culture, and preferences (p. 280). In more extensive report explaining the and rationale for the policy (APA, 2006), the Task Force explains that best available research includes, but is not limited to, randomized clinical (or controlled) trial (RCT) methodology and empirically supported treatments (ESTs) for specific DSM disorders (p. 273). In comparison to narrower systems of evidence-based practice (e.g., an EST monopoly; see Slife, Wiggins, & Graham, 2005), EBPP's inclusion of diversity of methods and practices better reflects the complexity of psychological treatment. As the Task Force has emphasized, real-world practice is too complex to be informed by the robotic institutionalization of single type of research, such as the RCT (APA, 2006). Instead, it a for integrating of evidence-including but not limited to RCTs-into the intervention process (p. 273). This requires that psychologists recognize the strengths and limitations of evidence obtained from different types of research (p. 275). I agree wholeheartedly with the need to handle multiple streams of evidence, but I wish to take more critical look at the decision-making process the Task Force has in mind. Such an ambitious endeavor would require, it seems, an underlying framework to inform how diversity of evidence-based methods and practices might be used and evaluated. In this article I demonstrate that the APA policy and report imply such framework but, curiously, it is neither explicated nor evaluated. This unevaluated framework is committed to narrow epistemology, and this commitment, I argue, is inconsistent with EBPP's values of justification and inclusiveness.