Читать книгу Practitioner's Guide to Using Research for Evidence-Informed Practice - Allen Rubin - Страница 28

Rubin's experiences illustrate that being scientific is not an end unto itself in EIP. More importantly, it is a means. That is, proponents of EIP don't urge practitioners to engage in the process just because they want them to be scientific. They want them to be more scientifically oriented and less authority based because they believe that being informed by evidence is the best way to help clients. In that sense, EIP is seen as both a client-centered and compassionate endeavor.

Imagine, for example, that you have developed some pain from overdoing your exercising. You've stopped exercising for several weeks, but the pain does not subside. So you ask a few of your exercise companions if they know of any health professionals who are good at treating the pain you are experiencing. One friend recommends an acupuncturist who will stick needles in you near various nerve endings. The other recommends a chiropractor who will manipulate your bones and zap you with a laser device. On what grounds will you choose to see either or neither of these professionals? Our guess is that before you subject yourself to either treatment you'll inquire as to the scientific evidence about its potential to cure you or perhaps harm you. You'll do so not because you worship science as an end unto itself, but because you want to get better and not be harmed.

Needless to say, you have some self-compassion. What about the compassion of the two professionals? Suppose you make a preliminary visit to both to discuss what they do before you decide on a treatment. Suppose you ask them about the research evidence regarding the likelihood that their treatment will help you or harm you. Suppose one pooh-poohs the need for research studies and instead says he is too busy to pay attention to such studies – too busy providing a treatment that he has been trained in, has always done, and that he believes in. Suppose the other responds in a manner showing that she has taken the time to keep up on all the latest studies and explains clearly to you the likely benefits of the approaches she uses versus other treatment options that you might pursue. We suspect that because the latter professional took the time and effort to be informed by the evidence, and transparent about the reasons why she delivers the intervention that she does, you would perceive her to be more compassionate. You might therefore be more predisposed to choose her.

But human service interventions, such as alternative forms of psychotherapy, don't involve poking people with needles, manipulating their bones, or zapping them with lasers. At least not yet! If you are familiar with such controversial treatments as touch field therapy or rebirthing therapy, you might wonder what's next. You might also have read about a child's death that resulted from rebirthing therapy (Crowder & Lowe, 2000). Human service interventions can be harmful without causing physical damage. For example, the studies we alluded to in discussing family therapy training found that certain intervention approaches for schizophrenia had unintended harmful effects. Instead of increasing the amount of time between relapses of schizophrenia, they decreased it (Anderson et al., 1986; Simon et al., 1991).

Moreover, providing an ineffective intervention to people who are suffering – even if that intervention does not make matters worse – is harmful if we miss the opportunity to have alleviated their suffering with an available intervention that has been scientifically shown to be more effective.