Evidence based practice (EBP), also known as positivism, continues to be held up as the gold standard for good practice and efficacy. But does evidence based practice itself stand up to the scrutiny that it demands all other treatment models and psychological/medical interventions must meet, before they can be trusted and applied in the real world?
There are a number of researchers and social scientists who believe the answer to this question is no – and that in fact there has been an overselling of EBP in a number of areas, which includes CBT. And in fact there has been a manipulating and fudging of the data to influence the direction that psychological therapies are taking. Does this mean that evidence based practice can’t be trusted? This is something you will need to decide for yourself. We believe evidence based practice, does have an important contribution to make but we equally believe that it should not be held up as the ‘God of evidence’.
Practice based evidence (PBE), also referred to as interpretivism, has a critical part to play but given the biases around EBP, it has not been given sufficient credibility. There is a growing voice of concern and increasing evidence that PBE is at the very least equal in its importance, relevance and application to psychological therapies and interventions. This has long been our perspective and is the basis on which Reach and The Reach Approach was formed in 1990.
To be more precise our position is that it’s not a question of PBE or EBP, but that best practice is established with a PBE + EBP formula – furthermore, we believe that this is the correct sequence. PBE, in our view, should drive the learning and research process. But before we can even have a debate about what works best, we have to ensure that evidence based practice, is operating with integrity because otherwise we can’t entirely trust the data. Also, given its current position of primacy, it is diminishing the value of the lesser recognised PBE. This is unfortunate, as practice based evidence is rich with diversity of content and therefore we cannot afford to ignore its contribution.
Farhad Dalal is a psychotherapist and group analyst, working with individuals, groups and organisations. He has been in independent practice for about thirty years, initially in London and latterly in Devon. He has published numerous papers on the subjects of race and racism, groups and ethics, as well as four books, including: Taking the Group Seriously, Race, Colour and the Processes of Racialisation, and Thought Paralysis: The Virtues of Discrimination, which is a constructive critique of the equality movements. He was Associate Fellow at the University of Hertfordshire’s Business School. Currently, he is Visiting Professor at the PhD School, Open University of Holland. He lectures and teaches internationally and in this presentation he, in a thought provoking and step by step manner, takes us through the flaws of EPB as it relates to CBT and the wider world of research…
Well worth watching…
Here is the research paper in the full: Statistical Spin, Linguistic Obfuscation, Overselling CBT, Farhad Dalal