Evidence-Based Therapy Interventions

You may be familiar with the term “evidence-based therapy”, but what does that mean exactly? The word “therapy” is used to describe a teen treatment intended to alleviate or cure any type of sickness or disorder. For example, chemotherapy is a drug treatment used to kill cancer cells that grow and divide rapidly in the human body.

If a treatment is “evidence-based”, it means there is scientific evidence that supports the efficacy of that particular therapy. In other words, the therapy proves to be effective through scientific experiments that are peer reviewed, and not just solely based on theory.

In the world of science, theories are basically like opinions. Everybody is going to have their own. Scientific evidence, however, presents facts obtained through conducting research and experiments, that ultimately tell us if a treatment works or not.

Where exactly does this scientific evidence come from? Here are a few examples: effectiveness studies, process studies, systematic case studies, clinical observation, single-case reports, randomized controlled trials, and meta-analyses.

As a parent, you want the very best for your child. Especially, when it involves their mental health. There are so many external influences that children are faced with today, that can be destructive to a developing mind. Below, is more information on the history of evidence-based therapy, some advantages and disadvantages, and examples of a few common evidence-based therapy interventions.

 

The History of “Evidence-Based”

The idea of evidence-based practice began in the 1970’s, following the passing of the Health Maintenance Organization (HMO) Act. This act was intended to curb medical inflation by establishing managed care plans that incorporated financing and provided health care services to individuals within a certain network.

Prior to that, health care providers used more of a “one size fits all” method. The public began to view the health care system as wasteful and outdated. According to Yates (2013), “In response to the negative public image of health care providers, a trend appeared in the research community to examine the efficacy and cost effectiveness of treatments provided by health professionals” (p. 2). Basically, researchers started investigating whether treatments at that time were working and at what cost.

Once scientific research began integrating with medical practice, the health care system became revolutionized in a way that better suited the needs of individual patients, rather than the masses. This laid the foundation for many new individualized treatments within the medical community, as well as in psychology and counseling professions.

 

Advantages of Evidence-Based Therapy

1. Quality of Life

Evidence-based therapy is beneficial, not only to the patient, but also their quality of life. No one wants to feel like a test subject being used in scientific experiments. Cook, Schwartz, and Kaslow (2017) explain, “By incorporating research into clinical practice, providers use research-driven evidence rather than rely solely on personal opinion” (para. 7). This allows health care providers to diagnose patients quickly and more effectively, while saving the patient stress from becoming an experiment.

2. Cost-Effectiveness

Another benefit of using evidence-based therapy is its cost-effectiveness. Treatments for any type of physical or mental illness often carry a hefty price tag. Especially, if there is a trial-and-error period where various treatments need to be tested. “Ideally, practitioners who actively employ EBPs [evidence-based practices] save time, money, and resources by avoiding treatments with little or questionable effectiveness for their patients” (Cook, Schwartz, & Kaslow, 2017).

3. Patients Have More Options

Evidence-based therapy also provides an increased number of options to patients. “Since the outset of EBP generally and the psychotherapy movement specifically, patients’ preferences are prioritized, which affords them active choices” (Cook, Schwartz, & Kaslow, 2017). Evidence-based therapy can even help providers in the development of complex treatment plans for patients with multiple disorders.

4. Quality of Treatment

Evidence-based therapy encourages providers to use critical thinking and decision-making skills. It also promotes research, so providers are urged to continuously review literature for updated information. Because of this, providers are more knowledgeable in the subject matter and can “think outside the box” when developing treatments based on scientific evidence. This allows patients the ability to have treatments individualized to fit their specific needs.

 

Disadvantages of Evidence-Based Therapy

1. Time

In order to put the best treatment plan to use, providers need timely access to current information. One disadvantage of evidence-based therapy is the amount of time it takes from conduction of research to implementing policy or practice. First, there is a significant time lag between where research first begins and where the findings are published. Then, there is another time lag between the findings being published and the adoption of a new policy or practice.

2. Biases

As with any scientific research, evidence-based therapies are subject to biases. Examples of some of these biases include subjects chosen for the study, methodologies used, and who sponsored the research. Unfortunately, biases such as these can have an impact on the credibility of treatments.

3. Increased Workload for Providers

Providers must focus a substantial amount of their energy towards reviewing literature, so they can stay up to date on the newest research findings. Between the added work and higher demands, it is easy for providers to become overwhelmed.

4. Cost to Providers

Evidence-based-therapy not only comes with an increased workload, but also costs providers significant amounts of money. Yates (2013) describes, “These costs include the intervention materials and the cost of trainings to help counselors become competent” (p. 7).

Although evidence-based therapy has some disadvantages toward providers, it ultimately saves the client time, money, and stress. Let’s face it. If your child needs help, you want a treatment that has been tested with positive results. You deserve the peace of mind, knowing that your child will not be a science experiment.

 

Interventions Used in Evidence-Based Therapy

Here are some common evidence-based therapy interventions for mental health and substance abuse:

1. Acceptance and Commitment Therapy (ACT)

Acceptance and Commitment Therapy has proven to be effective in treating depression, anxiety, OCD, chronic pain, workplace stress, the stress of terminal cancer, PTSD, anorexia, marijuana abuse, heroine abuse, and schizophrenia. ACT is a behavioral therapy that emphasizes change through acceptance of the ‘abnormal’ part of the human psyche. Harris (2011) states, “In ACT, there is no attempt to try to reduce, change, avoid, suppress or control these private experiences. Instead, clients learn to reduce the impact and influence of unwanted thoughts and feelings through the effective use of mindfulness” (para. 26). ACT is intended to create a safe, healthy, and meaningful life, by incorporating mindfulness skills to handle any type of barrier one may encounter, in the form of negative thoughts, influences, sensations, memories, feelings, urges, or images.

2. Cognitive Behavioral Therapy (CBT)

Cognitive Behavioral Therapy has proven to be effective in treating depression, anxiety, marital problems, eating disorders, Body Dysmorphic Disorder, alcohol and drug use problems, and severe mental illness. CBT puts emphasis towards change taking place in one’s life, through changing the way the individual thinks. This involves efforts to change thinking and behavioral patterns. The American Psychological Association (2020) claims, “Through exercises in the session as well as “homework” exercises outside of sessions, patients/clients are helped to develop coping skills, whereby they can learn to change their own thinking, problematic emotions and behavior” (para. 7). Rather than dwelling in the past, CBT therapists put more emphasis on a client’s current circumstances, in order to develop effective ways of coping while focusing on moving forward in life.

3. Exposure Therapy

Exposure Therapy has proven to be effective in treating social anxiety disorder, generalized anxiety disorder, PTSD, OCD, phobias, and panic disorder. Exposure Therapy is used to help people face their fears. When humans fear something, they tend to avoid it. During Exposure Therapy, a psychologist creates a safe environment for a client to be “exposed” to whatever it is they fear. Exposure over a certain length of time in a safe environment helps to decrease avoidance and reduce fear.

4. Dialectical Behavior Therapy (DBT)

Dialectical Behavior Therapy was originally developed to treat people with borderline personality disorder, but has proven to be effective in treating depression, bipolar disorder, binge-eating, bulimia, PTSD, and substance abuse. DBT works to balance opposites and promotes a both-and rather than an either-or perspective. DBT also helps with regulating emotions, being mindful, and effective communication.

5. Functional Family Therapy (FFT)

Functional Family Therapy works as a family intervention program for at-risk children aged 11-18, who engage in criminal behavior and/or have substance abuse problems. This type of behavior often leads to problems that range from minor offenses to serious crimes. FFT aims to strengthen communication and supportiveness between the troubled youth and their family, while also improving individual skills and prosocial behaviors, such as school attendance.

There are many other evidence-based therapy interventions available, depending on the type of treatment needed. There are also pharmacological therapies to help with drug and alcohol addictions. Buprenorphine and Methadone Maintenance Therapy are used for heroin and opiate addictions. Acamprosate, Naltrexone and Disulfiram are used for alcohol addiction. Nicotine Replacement Therapy, Bupropion, and Varenicline are used for nicotine addiction.

Why are Rehabs with Evidence-Based Therapy Interventions Important?

As mentioned earlier, “evidence-based” means there is a substantial amount of scientific evidence behind a particular treatment. It means the treatment has been thoroughly tested through scientific experiments and has proven to be effective. ‘Effective’ is a keyword when searching for the right treatment.

Evidence-based therapy can also save time, money, and stress because there is no guess work. Since the treatment is backed by scientific evidence, the patient does not have to wonder if it will work or not.

 

What Questions Should You Ask?

In order to find a rehab that practices evidence-based therapy interventions, you need to ask the right questions. Below, are a few suggested questions you can ask that should help you in your search.

1. Is your staff trained in evidence-based therapies? If so, which ones?

This is important because in order for an evidence-based therapy to be applied effectively, the clinician must be properly trained in the subject matter.

2. Do you follow a treatment model that is customized to your clients?

This is important because treatments for mental illnesses and addictions need to be customized to fit the specific needs of each patient. Not every treatment method is going to work the same for everyone.

3. What are your research resources?

This is important because you want a treatment center that has strong research support. The therapies that are being used should be well-established and based on multiple well-designed studies with positive results.

4. How do you measure your success rates? Do you measure both short and long-term outcomes?

This is important because it will indicate how reliable the center’s program evaluation procedures are. Centers with strong evaluation procedures will follow-up with clients shortly after the completion of the program, and again after some time has passed. This allows the center to evaluate both short and long-term outcomes and make any necessary changes to the program.

5. Do you provide evidence-based pharmacological interventions?

This is important for anyone suffering from an alcohol or drug addiction because medications are often a crucial part of treatment for substance abuse.

How Treatment Can Help

When it comes to treatment for addiction, earlier is better. If an adolescent abuses drugs and alcohol, it can lay the foundation for an unstable life. It can also lead to the child dropping out of school, due to lack of interest in pursuing education. According to the Substance Abuse and Mental Health Services Administration (SAMHSA), “Students who fail to graduate face a wide array of negative consequences including higher rates of unemployment, earning less when employed, being more likely to receive public assistance, being more likely to suffer poor health, and being more likely to have higher rates of criminal behavior and incarceration” (Tice, Lipari, Van Horn, 2017).

Without treatment, a teen who abuses drugs or alcohol becomes more susceptible to criminal activity. A first time DUI offense can cost an individual up to $10,000 and that is just the fines. Other fees associated could be lawyer fees, probation, driving classes, license suspension, rehab programs, drug and alcohol testing, etc. Seeking treatment early on could potentially save an individual from a very large financial debt or even the possibility of spending time in jail.

Although treatment does cost money, it is nowhere near the amount that can incur from an untreated addiction. In fact, most insurances cover treatment and many rehabs offer financial aid, accept insurance, or have financing options available to fit the needs of the individual.

Every teenager deserves a chance at life, but no one deserves the life that a dark path will lead them to.  Contact Hillcrest Adolescent Treatment Center today to learn more about how our evidence-based therapy interventions may support your teen.

References

American Psychological Association. (2020). What is Cognitive Behavioral Therapy? Retrieved from American Psychological Association: https://www.apa.org/ptsd-guideline/patients-and-families/cognitive-behavioral

Cook, S. C., Schwartz, A. C., & Kaslow, N. J. (July 2017). Evidence-based psychotherapy: Advantages and challenges. Neurotherapeutics, 14(3), pp. 537-545.

Harris, R. (2011). Embracing Your Demons: An Overview of Acceptance and Commitment. Retrieved from Psychotherapy.net: https://www.psychotherapy.net/article/Acceptance-and-Commitment-Therapy-ACT

Tice, P., Lipari, R. N., Van Horn, S. L. (2017, August 15). Substance use among 12th grade aged youths, by dropout status. Retrieved from Substance Abuse and Mental Health Services Administration: https://www.samhsa.gov/data/sites/default/files/report_3196/ShortReport-3196.pdf

Yates, C. (2013). Evidence-based practice: The components, history, and process. Counseling Outcome Research and Evaluation, pp. 1-14.