On the surface, the idea of evidence-based practice is solid. We don’t want to be acting on assumption, impulse or “I reckon it’s a good idea”. Decades of research have clearly shown that what one person thinks will be helpful for another person isn’t always the case.
However we also need to take a considered approach to the evidence base we are drawing from. The techniques we choose only account for a modest prediction of positive outcome. They’re important but far from enough.
This broader body of research highlights that the quality of the therapeutic relationship and the qualities of the helper have a greater impact. Who delivers the treatment, and how, matters.
It is easier to recommend a specific intervention, write manuals and roll out training. It is harder to create systems that prioritise workers feeling well-rested, supported and resourced to be their best self for the people they work with.
We can take the lens even wider. There is a solid body of research that emphasises the importance of more systemic factors, such as feeling connected to a community, to nature, to meaningful work. Or the relief of secure accommodation or employment.
And it is much easier to fund six sessions of a clearly prescribed intervention than to address social and financial inequality, ensure fair and safe workplaces, tackle the threat of climate change or the need for affordable housing.
But if we only focus on the evidence for specific techniques, we risk being evidence-biased by selecting narrow fields of research at the expense of other just as valid ones.
Helen Mentha 