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Explain what evidence-based practices are. Describe the controversy that surrounds them and summarize the main arguments agai
Explain what evidence-based practices are. Describe the controversy that surrounds them and summarize the main arguments against their use.
According to Tanenbaum (2005) evidence based practice is defined as the application of scientific-research findings to the treatment of individual patients. Different treatments have been put forth in the treatment of similar mental conditions making it a very controversial matter (Psychological Treatments, 2005).
The first controversy according to Tanenbaum (2005) is the definition of evidence. The question is; does the definition of evidence inappropriately favour some treatments over others? Some evidence hierarchies have been set as the golden standard not giving room to upcoming clinical trials that uses diverse population and collection of data from a wide range of health outcomes. The traditional measures are more interested in efficacy as opposed to effectiveness.
The second controversy is whether research evidence should be put in practice. If put into practice, all medical practitioners are required to take the findings of the research into consideration when treating various medical conditions. This becomes almost impossible considering that researches based on the same condition are being carried out all over the world.
The third controversy is the effectiveness of the evidence based practice. Effectiveness is relative and the question is; which measures are used as the standard measures so as to term the EBP as effective? Who decides whether it is effective or not? Many argue that it is a matter of morality because the use of the word effective to refer to treatment of a mental disorder is contentious.
In conclusion, evidence based practices should be eliminated because although they are meant for advances in medicine, they are not entirely effective. Research by certain people is termed as better compared to others in regards to the set golden standards. Many of the medical practitioners concentrate on research as opposed to offering judgement and care to their patients (Hayes & Stout, 2005).
Describe what is meant by a clinical interview, identifying the topics typically covered during an interview, and contrasting structured with unstructured interview.
A clinical interview is carried out by a counsellor and mainly comprises of questions directed to the patient in order to gather important information. The counsellor tries to make the patient feel as comfortable as possible so that they can reveal important information. The clinical interview is carried throughout the process of counselling, but is a major step carried out during the initial stages.
As discussed in the article Clinical Interview as an Assessment Technique the initial interview involves gathering of information about the patient. Information gathered include; demographic (marital status, employment, race or ethnicity), current problems (frequency of the problem, previous attempts to solve the problem, degree problem affects functioning). Other questions asked are about medical history, social support and current medication. Additionally, therapists may question about substance use and abuse, suicide and violence issues. Honesty is very significant in initial clinical interviews because it provides information for assessment of the condition and at the same time provides a basis for the treatment plan to be used.
As explored by Jones (2010) a clinical interview can either be structured or unstructured. A structured interview is carried out in such a way that all patients are asked the same questions in the same manner while unstructured interviews allow the therapist to formulate different questions for different clients depending on their personalities and conditions (The Unstructured Clinical Interview, 2010). The questions asked in a structured interview are more reliable and tend to give desired results as compared to unstructured questions where the therapists is required to have excellent interviewing skills in order to obtain reliable information. However, structured interviews are not fit for patients with rare mental conditions.
References
Clinical Interview as an Assessment Technique (2010). Retrieved from HYPERLINK “http://pagerankstudio.com/Blog/2010/05/clinical-interview-as-an-assessment-technique/” http://pagerankstudio.com/Blog/2010/05/clinical-interview-as-an-assessment-technique/
Hayes, R. & Stout, C. (2005). The Evidence Practice: Methods, Models and Tools for Mental Health. New Jersey: John Wiley and Sons. Print.
Jones, K. (2010). The Unstructured Clinical Interview. Journal of Counselling and Development. March 22, 2010.
Tanenbaum, S. (2005). Evidence-Based Practice as Mental Health Policy: Three Controversies and a Caveat. Health Affairs. 24, no. 1 (2005): 163-173
The Unstructured Clinical Interview. (2010). The Journal of Counselling and Development. Retrieved from HYPERLINK “http://goliath.ecnext.com/coms2/gi_0199-12468553/The-unstructured-clinical-interview.html” http://goliath.ecnext.com/coms2/gi_0199-12468553/The-unstructured-clinical-interview.html
Psychological Treatments: Evidence Based Practice and Practice Based Evidence. (2005). The Australian Psychological Society. Retrieved from HYPERLINK “http://www.psychology.org.au/publications/inpsych/treatments/” http://www.psychology.org.au/publications/inpsych/treatments/
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