Evidence-Based Programs and Practices
Part 1: Define and Refine

Evidence-Based Theories

Evidence-based programs are defined as a prevention or treatment practice, that is based on consistent scientific evidence providing proof that the practice improves client/patient outcomes. The practice should be supported by sufficient documentation and peer-reviewed research that shows its effectiveness (Operational Definition for Evidence-Based Practices Addictions and Mental Health Division, 2017).

Programs draw from theory in that the theoretical framework developed by researchers and professionals serve as a set of parameters or guidelines for how to interpret evidence and how to implement the recommendations based on the evidence into one’s practice. Theories serve as the lens through which to look at the evidence. Just as a microscope has a lens and a focus so that one can see all the details of the subject, the theory allows the data to be put into perspective, and that perspective is defined by the theory or theories that are used in the research.

In the field of addiction, there are numerous evidence based theories: behavioral theories, pharmacological theories, psychotherapeutic theories, and so on. Each theory has been tested in research and examined from multiple dimensions. There is not always agreement on theories, as many studies can be contested based on the findings, the way the studies were conducted, how the sample was selected, and what methods of analysis were used. However, the important point when it comes to evidence-based theories is that the findings are consistent and the case can be made over time that the theoretical approach has benefits.

Questions Researchers Asked

One of the big questions researchers ask is how to integrate or implement evidence-based programs into their practices (Evidence-Based Practice in Psychology, 2006). Guidance for practice is typically developed based on evidence from studies that support the findings. Studies can be exploratory or experimental, but when the researcher is seeking to obtain evidence using a test that can be duplicated to verify the results that researcher is focused on contributing to the field’s understanding of the subject so that practice can be influenced and shaped by the evidence.

In the field of addiction, researchers ask, “What strategies or approaches are beneficial for clients or patients suffering from addiction?” For example, one approach that is currently being studied by researchers is animal therapy, wherein a person suffering from substance abuse or addiction is paired with an animal so as to learn what it means to care for another living creature outside oneself. The evidence has shown that animal-assisted therapy can help addicts develop greater self-esteem and learn self-management skills so that they can overcome their addictions (Muela, Balluerka, Amiano,Caldentey &Aliri, 2017). It can be a dog that one takes care of or a horse that one rides at a ranch. The important thing is that there is another living creature that the individual is to some degree responsible for. Without researchers analyzing the effects of the therapy on a representative sample, there would be no evidence to support the practice. But doing the research is the point: it gives the foundation for why the practice should be initiated, what good it can do, and what other therapies it can be coupled with. In the case of animal therapy, researchers recommend that it be used in a facilitative or supporting role, with cognitive behavioral therapy being the main therapeutic approach and pharmacological therapy...…maladjustment…[is the result of a person] denying awareness of significant sensory and visceral experiences” and that “the best vantage point for understanding behavior is from the internal frame of reference of the individual” (p. 495). To fully understand a person, one has to take a person-centered approach. One has to see their self-worth, self-image and self-ideal, and this self was what emerged in the findings with the participants.

The theoretical framework of mentalization also helped the researcher to interpret the findings and shed light on what they could mean. For example, the findings showed that horse assisted therapy helped to complement the work of the counseling that the person was receiving through the program and that the therapy helped the person to stay committed to the program. The therapy produced a mental change in the person and empowered the person to see things from a new perspective.

This shows that theory does play an important role in developing an evidence-based approach to practice. The theory behind animal-assisted therapy could be anything, depending on how the researcher or practitioner wants to look at the data or implement the program. For this study the researchers chose to adopt the framework of Rogers and the theory of mentalization—but they could have selected different theoretical perspectives as well. Maslow’s theory of human motivation could have been adopted or Hofstede’s model of cultural dimensions might have introduced new concepts to the issue of animal therapy.

The importance of theory in terms of interpreting the evidence or of justifying a practice thus cannot be understated and should always be examined from the point of view of the participants. They are the ones who are bringing the results to be…