What Are the Strengths and Limitations of the Concept of Evidence-Based Practice? Illustrate with Reference to One Psychological Condition, Problem or Area.

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What are the strengths and limitations of the concept of evidence-based practice? Illustrate with reference to one psychological condition, problem or area. Evidence-based practice has been firmly placed on the agenda as a key factor in improving standards of mental health care through the introduction of government initiatives such as clinical governance (Department of Health, 1998) and guidelines such as the Department of Health’s ‘Treatment Choice in Psychological Therapies and Counselling: Evidence-based Clinical Practice Guidelines’ (Department of Health, 2001). The Practice Guidelines were developed by the British Psychological Society’s Centre for Outcomes Research and Effectiveness. The Practice Guideline was written following a comprehensive review of the literature from 1990 to 1998 (Barkham and Mellor-Clark, 2003) and commissioned by the Department of Health to attempt to ensure that referral decisions were rooted in research evidence (Parry et al., 2003), rather than impromptu or random allocations leading to inappropriate psychological therapy. This emphasis on evidence-based practice can be seen as an attempt to ensure “that patients receive treatments of proven ‘efficacy’” and that service provision is based on evidence about which interventions lead to the best outcomes for clients (Bower, 2003). The Practice Guidelines use Eccles et al.’s (1998) adaptation of the classification of grading the evidence on which its recommendations for practice are based (Shapiro 2002), shown below: • Ia Evidence from meta-analysis of randomised control trials. • Ib Evidence from at least one randomised control trial • IIa Evidence from at least one controlled study without randomisation • IIb Evidence from at least one other type of quasi-experimental study • III Evidence from descriptive studies, such as comparative studies,

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