The Broad Response to Evidence Based Treatmentby Mark Warren, M.D.
Re-posted from Cleveland Center for Eating Disorders (CCED) blog archives. CCED and The Emily Program partnered in 2014.
By Dr. Mark Warren
Harriet Brown, well known to readers of this blog and to the eating disorder community for her book Brave Girl Eating, recently published an article in the New York Times on why evidence based care is so rarely used in the field of mental health and psychology. Her article is the latest in what has become a very important conversation about the translation of evidence based research into the treatment of mental illness. This topic was also discussed at great length at the recent eating disorder conference in London, organized by Drs Bryan Lask and Rachel Bryant-Waugh. The keynote of this conference, which echos Harriet's article, shows that the number of practitioners in the community using evidence based care is shockingly low.
Unsurprisingly the response to this article, the presentation in London, and other articles of this nature has been twofold. Many people and clinicians are excited and hopeful that there is effective treatment for historically difficult to treat illnesses. On the other hand, some practitioners are responding by challenging the notion that evidence based care should be the standard of care. The reasons for this vary from the notion that the evidence is weak (possibly, but it is the best we have), to the assumption that the evidence doesn't apply to every practice (unclear why not), to the criticism that the evidence doesn't acknowledge cultural and clinical realities (it does). Many criticisms are based on the anecdotal experience of the provider. One provider referred to the evidence as "weak tea."
It is very difficult when scientific evidence challenges our own personal experiences and beliefs. However, if you happen to have an eating disorder, or a loved one has an eating disorder, and if you're aware of the last 20 years of eating disorder treatment, you would want to know that since the advent of evidence based care we have started to get better outcomes. If I, or a loved one, had an eating disorder, I would far prefer a glass of weak tea to no tea at all.
For more information: Looking for Evidence That Therapy Works
Contributions by Sarah Emerman