What Does Evidence-based Treatment Mean?

Evidence-based treatment (EBT) has long been the dominant approach in most areas of healthcare. However, it did not gain as much traction in drug and alcohol treatment until fairly recently.^1,2

The highly-influential book Evidence-Based Addiction Treatment, released in 2009, defines EBT as “a treatment that has been scientifically tested and subjected to clinical judgment and determined to be appropriate for the treatment of a given individual, population, or problem area.¹

Over the years, EBT in the context of substance use disorder (SUD) has come to be defined in many other ways, often based on specific agendas or treatment ideologies. However, most academics and mental health experts who treat SUD will tend to more or less define it as treatment that is based on current scientific understanding.^1,2,3,4

Here, we’ll look into a few key features of evidence-based treatment and rehab that distinguish it from so-called “faith-based” practices. If you are interested in either EBT or faith-based programs in North Texas, contact Dallas Drug Treatment Centers to learn more.

Key Concepts of Evidence-based Treatment (EBT)

EBT practices in SUD rehabilitation mirror those of other healthcare fields. Evidence-based treatment for SUD tends to be premised around these key ideas:^1,2,3,4

1.) Iterative

This means that if a treatment is ineffective, an adjustment in the approach or a complete rethinking of treatment is done. Approaches and specific types of treatment are selected based on the best evidence available at a given time. This is in contrast with non-EBT approaches which may stick with one specific set of treatments for all cases, regardless of how the patient responds.^1,2,3,4

According to the University of Washington Health Sciences Library, the iterative process to evidence-based treatment has five steps:²

1. 1. Develop a relevant, answerable clinical question
   2. Plan, search, and find the best available evidence
   3. Critically appraise articles (e.g. white papers, research, etc.) for validity and applicability
   4. Integrate the evidence into practice
   5. Evaluate the clinical decision

In practical terms, this means that the common practices in EBT for SUD will change from generation to generation as more knowledge about SUD and the effectiveness of different practices become more disseminated among clinicians. Faith-based programs as well as those that are not specifically evidence-based tend to have similar if not the same approaches year after year.^1,3,4

2.) Considers The Patient’s Specific Situation

Clinicians employing EBT will try to consider as many factors as possible that may be affecting the patient’s condition. In the case of substance use disorders, the existence of co-occurring mental health conditions is fairly common and may be a cause or effect of the SUD. Also, the existence of withdrawal symptoms or physical illnesses can greatly influence how the patient may respond to different treatments. These will ultimately affect the choices a clinician following EBT principles will need to make.^1,3,4

Additionally, clinicians may also need to consider less obvious things that influence how the patient may respond. In many cases, the patient’s financial security, culture, religion, values system, politics, and the healthcare system where they are treated can serve to further complicate the treatment available.^4,5,6

Clinicians may have to balance these all with what they may believe is best for the patient. In contrast, non-EBT programs will tend to use a one-size-fits-all approach that tends to be more consistent from patient to patient.^1,4,5,6

3.) Uses Informed Judgement Calls By Clinicians

The skills, knowledge, and experience of therapists, counselors, psychiatrists, and other clinicians are a critical part of evidence-based SUD rehab. However, these things are not acquired in a vacuum.^1,2

Even though healthcare practices generally are consistent, the quality and type of training, as well as the prevailing ideologies clinicians are exposed to during their education is highly influential in the types of decisions they make.^4,5,6

SUD clinicians that use EBT methods tend to be cognizant of these different contexts and are more likely to continuously inform themselves of new developments. At the same time, they are more likely to take things on a case-by-case basis, weighing what they know of the risks and potential benefits of each treatment, given a specific context. Clinicians at non-EBT programs are more likely to lean on methods that are considered “tried and true” for specific situations.^1,2,3,4

Find Evidence-based SUD Treatment in Dallas, TX

If you’re interested in evidence-based drug or alcohol treatment for yourself or a loved one, help is just a phone call away. Call Dallas Drug Treatment Centers at +1(214) 453-5663 to find SUD treatment programs in North Texas that follow the latest EBT practices.

Resources:

1. Miller, P. M. (Ed.). (2009). Evidence-based addiction treatment. Academic Press.

2. University of Washington Health Sciences Library. (2021). Evidence-Based Practice in Rehabilitation.

3. Glasner-Edwards, S., & Rawson, R. (2010). Evidence-based practices in addiction treatment: Review and recommendations for public policy. Health policy, 97(2-3), 93-104.

4. Beetham, T., Saloner, B., Gaye, M., Wakeman, S. E., Frank, R. G., & Barnett, M. L. (2020). Therapies offered at residential addiction treatment programs in the United States. JAMA, 324(8), 804-806.

5. McKinlay, J., Link, C., Marceau, L., O’Donnell, A., Arber, S., Adams, A., & Lutfey, K. (2006). How do doctors in different countries manage the same patient? Results of a factorial experiment. Health services research, 41(6), 2182–2200. https://doi.org/10.1111/j.1475-6773.2006.00595.x

6. Nelson, A. (2002). Unequal treatment: confronting racial and ethnic disparities in health care. Journal of the national medical association, 94(8), 666.