Treatment plans for troubled youth were found to be better when social workers and clinicians engaged clients at their homes instead of treating them in the traditional office setting.
The article “Evidence-Based ‘Gold Standard’: Coveted, Yet Controversial,” written by Gary Gately, mentions the advantages of being able to sit in the living rooms of the clients. Scott W. Henggeler, Ph.D., said, “When you understand better, and there’s really nothing better than sitting in someone’s living room for this, when you understand the real-life context of folks – who’s living at the house, what people are like, what their life is like – it helps you develop better and more accurate treatment plans.” Henggeler was an intern at the University of Virginia’s medical school in the mid-1970s, and learned of this style of treatment from his supervisor, who was a social worker on staff.
Understanding the causative factors ultimately assists the health workers in developing a viable treatment tailored to the individual client. Visiting the client allows the clinicians and social workers to see first-hand what is happening in the home, in real time, rather than have the client come to an office and report what is going on.
Evidence-based practices (EBP) have garnered praise and acceptance as well as controversy. Gately reports that there are purists who support the notion that only the programs under the toughest scrutiny fall within the paradigm of the gold standard in medical practice. EBPs have been considered to be effective by many. However, due to limited funding, upstarts and homegrown programs find it difficult to compete with larger brand name programs.
In the juvenile justice system, EBPs have been used to some degree since the mid-1990s. These evidence-based practices were modeled after the Food and Drug Administration’s format for reviewing applications for new drugs. As organizations seek funding, states, counties, federal and private foundations specify that a reform effort must be qualified as an EBP to receive funding.
Requiring programs to be EBPs can lead to such disparities, according to James Bell, executive director of the Oakland-based W. Haywood Burns Institute, a movement geared toward eliminating racial and ethnic disparities in juvenile justice.
Bell also expressed his moral objection to the use of control groups of children who only receive a placebo treatment. There is no benefit to the children exposed to the placebo treatment, which calls into question the ethics of its use. But there has to be some paradigm for compromise. Bell believes in order to move forward evidence-based programs and generic programs must somehow find common ground. Secondly, developers of evidence-based programs and community members have to stop being pitted against one another.
In such situations where communities and EBP organizations are at odds, a collaboration between the two should be formed to discover what are the best practices and treatments for young people, believes Bell.
It appears that EBPs are here to stay. However, it is evident that there is still room for relationship building between the organizations and the conscious communities affected.
