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There are various ways to search for evidence related to your practice question. You could, for example, conduct an exhaustive literature search in a scholarly fashion. Unless you are currently a student, however, your busy practice demands probably don't leave enough time for that. Moreover, you probably lack access to some of the resources that students and academicians have, such as a university library and a research librarian (not to mention significant time to spend there) or a subscription to expensive professional literature databases. Fortunately, if you have access to a more popular search engine such as Google, Yahoo!, or Bing, you might find some of the evidence you need there. For example, if you enter the search term exposure therapy or EMDR, Google, Yahoo!, or Bing will list a large number of links to websites on those treatment modalities.

TABLE 2.1 The PICO Framework

P	Patient (or client), population, or problem	This is the part of the question where you would specify your client, the problem or need that you are addressing through services, and the key characteristics that you think might have an important impact on the intervention or assessment tool that you choose. For example, some interventions have demonstrated different effects across different racial or ethnic populations, and some assessment instruments have not been developed to be used for clients with varied languages and cultures. This is important information to consider as you search for research and you consider the relevancy of the findings for your client.
IC	Intervention comparison	For example, you may be trying decide between using two different parent training interventions – or you may be thinking about adding a new depression screening instrument versus using clinical interviews to identify clients who need depression treatment. Choosing an intervention and a comparison is a good reminder that EIP questions involve making a practice decision; therefore, there should be at least two different options between which you will be deciding. The comparison isn't always an active treatment. You might simply ask whether the intervention you're interested in is better than not intervening at all. Either way, the question should have real implications for directing what you actually do in practice.
O	Outcome	This is what you're hoping to see change as a result of your intervention or assessment efforts. You may be hoping to reduce child behavior problems among your clients, or more accurately detect moderate to severe depression. It's helpful to be specific and avoid broad outcomes that are hard to assess such as general wellbeing.

Most of the sites, however, will not enable you to read the original research studies yourself. Instead, they'll present summaries of the research and perhaps offer EIP guidelines. In Chapter 8 we describe a rigorous approach to searching and synthesizing research called a systematic review. That chapter describes which attributes to look for in a research review to give you a sense of the quality of the review.

You should be cautious and exercise some healthy skepticism when encountering websites that tout particular treatment approaches or other tools that you might use in your practice. Some sites, for example, might have a vested interest in promoting or debunking a particular treatment modality you are investigating. Table 2.2 lists five of the first 10 links that came up when we entered the search term EMDR in Google. The first two entries provide a brief, unbiased summary of the evidence supporting the effectiveness of EMDR as well as some of the questions and controversies about that evidence. The third and fourth entries are websites for organizations that promote EMDR. If you go to the third and fourth sites, you will find information about the effectiveness of EMDR (including mention of some prestigious organizations that have designated it an effective treatment for posttraumatic stress), but you will not find any mention of the questions and controversies about its effectiveness. The fifth site provides an overview of those controversies and questions. If you go to any of the last three links, you will see a slanted discussion that attempts to either support or refute EMDR's effectiveness. (We say this not to imply that we disagree with the points made in that discussion. In fact, we happen to believe that EMDR is effective under certain circumstances. It's just that these discussions are not written in as unbiased a manner as are the summaries at the first two sites listed in Table 2.2.)

TABLE 2.2 Web Search Example Using the Term EMDR at http://Google.com

Eye movement desensitization and reprocessing - Wikipedia, the… http://en.wikipedia.org/…/Eye_movement_desensitization_and_reprocessin…

Eye movement desensitization and reprocessing (EMDR) is a form of psychotherapy that was developed by Francine Shapiro to resolve the development of…

EMDR: Taking a Closer Look: Scientific American http://www.scientificamerican.com/article.cfm?id=emdr-taking-a-closer… Jan 3, 2008 - Can moving your eyes back and forth help to ease anxiety?

EMDR Institute, Inc. http://www.emdr.com Offers therapy. Provides a history of the approach, including a discussion of the Adaptive Processing Model. Also includes references and contact information.

EMDR International Association http://www.emdria.org

The EMDR International Association (EMDRIA) is a professional association… eye movement desensitization and reprocessing (EMDR) - The… http://www.skepdic.com/emdr.html May 16, 2011 - Discusses the usefulness of eye movement in treatments. Focuses on studies and research data.

Note: Search performed using Google on October 14, 2011.