The Broad Response to Evidence-Based Treatment
Re-posted from the Cleveland Center for Eating Disorders (CCED) blog archives and updated with additional Emily Program client thoughts. CCED and The Emily Program partnered in 2014. Contributions by Sarah Emerman.
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 echoes 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.
ABOUT THE AUTHOR
Mark Warren, MD
Dr. Mark Warren is the Chief Medical Officer for The Emily Program and Veritas Collaborative. He is also one of the original founders of the Cleveland Center for Eating Disorders, which became The Emily Program – Cleveland in 2014. A Cleveland native, he is a graduate of the Johns Hopkins University Medical School and completed his residency at Harvard Medical School. He served as Chairman of the Department of Psychiatry at Mt. Sinai Hospital and Medical Director of University Hospital Health System’s Laurelwood Hospital. A past vice-chair for clinical affairs at the Case School of Medicine Department of Psychiatry, he continues on the Clinical Faculty of the Medical School, teaching in both the Departments of Psychiatry and Pediatrics. He is currently a faculty member and former chair of the Board of Governors at the Gestalt Institute of Cleveland. Dr. Warren is a Distinguished Fellow of the American Psychiatric Association, a two-time recipient of the Exemplary Psychiatrist Award of the National Alliance for the Mentally Ill, and a winner of the Woodruff Award. He leads the Males and Eating Disorders special interest group for the Academy of Eating Disorders.