Approved by Council October, 2006
To be reviewed October, 2011
Evidence-Based Practice (EBP) comprises empirically-validated processes that facilitate the conscientious, explicit and judicious integration of individual clinical expertise with the best available external clinical evidence from systematic research in making decisions about the care of individual patients. The ultimate goal of EBP is to base clinical decision making in the areas of causation, diagnosis, prognosis, treatment and guidelines on empirical evidence. However, evidence is a continuum and the best available evidence may not (and often does not) include the kind of empirical validation that would support an unequivocal standard of care. For example, many interventions currently used in the psychiatric treatment of children and adolescents need more rigorous controlled studies. Furthermore, it is common for children to present with multiple diagnoses that affect their psychological, social and academic functioning, and current available evidence rarely encompasses all the factors relevant to a particular patient care decision in a single study. Thus, it is a central principle of EBP that a treating clinician must use all available information in developing an appropriate treatment plan for an individual child or adolescent.
The policy of the Academy is as follows:
- The American Academy of Child and Adolescent Psychiatry supports expanded research on the safety and efficacy of all reasonable diagnostic methods and interventions used in the psychiatric care of children and adolescents.
- The American Academy of Child and Adolescent Psychiatry encourages practitioners to evaluate the strength of evidence for diagnostic methods and interventions that they recommend or provide to their patients, and to discuss the range of appropriate therapeutic options with patients and families.
- When substantial empirical support is available, the American Academy of Child and Adolescent Psychiatry encourages practitioners to give greater weight when making patient care decisions to empirically supported diagnostic methods and interventions.
- In its publications and presentations, the Academy will continue to support a range of clinical interventions, including those which have not yet met the most rigorous standards of efficacy research but are supported by current clinical consensus.
- The Academy opposes the use or misuse of the concept of evidence based practice as a sole justification for the denial of insurance coverage or reimbursement for psychiatric treatment.