Evidence-Based Practice: Separating Science from Pseudoscience

Abstract

Evidence-based practice (EBP) requires that clinicians be guided by the best available evidence. In this article, we address the impact of science and pseudoscience on psychotherapy in psychiatric practice. We describe the key principles of evidence-based intervention. We describe pseudoscience and provide illustrative examples of popular intervention practices that have not been abandoned, despite evidence that they are not efficacious and may be harmful. We distinguish efficacy from effectiveness, and describe modular approaches to treatment. Reasons for the persistence of practices that are not evidence based are examined at both the individual and the professional system level. Finally, we offer suggestions for the promotion of EBP through clinical practice guidelines, modelling of scientific decision making, and training in core skills. W W WPratique fondée sur des données probantes : séparer la science de la pseudoscience La pratique fondée sur des données probantes (PFDP) exige que les cliniciens soient guidés par les meilleures données probantes. Dans cet article, nous abordons l'effet de la science et de la pseudoscience sur la psychothérapie dans la pratique psychiatrique. Nous décrivons les principaux principes d'une intervention fondée sur des données probantes. Nous décrivons la pseudoscience et offrons des exemples illustrant les pratiques d'intervention populaires qui n'ont pas été abandonnées, malgré qu'il soit prouvé qu'elles ne sont pas efficaces et peuvent être nuisibles. Nous distinguons entre efficience et efficacité, et décrivons les approches modulaires du traitement. Les raisons de la persistance des pratiques qui ne sont pas fondées sur des données probantes sont examinées au niveau individuel et professionnel du système. Enfin, nous offrons des suggestions pour la promotion de la PFDP par des guides de pratique clinique, la modélisation de la prise de décisions scientifiques, et la formation en compétences de base.

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Marginalizing Humanism, a Preference for the Objectifiable, and Moving On

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