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Limits of Evidence Based Medicine and Its Application to Mental Health Evidence-Based Practice. (Part One)

Title: The Limits of Evidence Based Medicine and Its Application to Mental Health Evidence-Based Practice. (Part One).
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Name(s): Gomory, Tomi, author
Type of Resource: text
Genre: Text
Issuance: serial
Date Issued: 2013
Physical Form: computer
online resource
Extent: 1 online resource
Language(s): English
Abstract/Description: The present article outlines the major limitations of Evidence Based Medicine (EBM) and through a close review demonstrates that the three component EBM process model is a pseudo-scientific tool. Its "objective" component is the collection, systematic analysis, and listing of "effective" treatments applying a research hierarchy from most rigorous (systematic reviews of randomized control trials) to least rigorous (expert opinion). Its two subjective components are the clinical judgment of helping professionals about which "evidence-based" treatment to select and the specific and unique relevant personal preferences of the potential recipients regarding treatment. This procedural mishmash provides no more rigor in choosing "best practice" than has been provided by good clinical practitioners in the past since both turn out to be subjective and authority based. The article also discusses EBM's further methodological dilution in the National Institute of Mental Health (NIMH) endorsed Evidence Based Mental Health Practice (EBP) movement. In EBP the allegedly rigorous EBM protocol is altered. Instead of systematic expert protocol driven EBM reviews of randomized controlled trials, NIMH sanctioned expert consensus panels decide "evidence-based practices." This further problematizes the development of best practices in mental health by converting it to a political process. The article concludes with some observations on these issues. In a second article (part two) forthcoming, Assertive Community Treatment (ACT) is examined as an example of an EBP that fails as a scientifically effective treatment despite its EBP certification and general popularity among practitioners.
Identifier: FSU_migr_csw_faculty_publications-0031 (IID)
Keywords: clinical practice; evidence-based medicine; evidence-based practice; mental health; social work
Subject(s): Mental health
Social psychiatry
Mental health
Psychiatry
Psychology
Social sciences
Social service
Persistent Link to This Record: http://purl.flvc.org/fsu/fd/FSU_migr_csw_faculty_publications-0031
Owner Institution: FSU
Is Part of Series: College of Social Work Faculty Publications.
Is Part Of: Ethical Human Psychology and Psychiatry.
Issue: 1, 15

Choose the citation style.
Gomory, T. (2013). The Limits of Evidence Based Medicine and Its Application to Mental Health Evidence-Based Practice. (Part One). Ethical Human Psychology And Psychiatry. Retrieved from http://purl.flvc.org/fsu/fd/FSU_migr_csw_faculty_publications-0031