Adoption of Evidence-Based Treatments in Community Settings: Obstacles and Opportunities

Abstract

Although the field has witnessed an increase in evidence-based treatments targeting mental illness in youth (Chorpita, 2003; Weisz et al., 1995), a considerable gap between this knowledge and the dissemination of such information into community-based settings remains apparent. This so-called science-practice gap has been widely acknowledged and often lamented in psychology (e.g., Beutler et al., 1995; Chorpita, 2003; Ollendick & Davis, 2004). In the area of child treatment, a wide range of efficacious approaches is now available (Chambless & Ollendick, 2001; Kazdin & Weisz, 2003); however, these treatments are rarely used in clinical practice (Kazdin, 2000, Kazdin et al., 1990). For example, Weisz and Kazdin (2003) reported that most evidence-based programs are behavioral or cognitive-behavioral, while nonbehavioral models are most widely used in clinical practice. This disconnect between science and service has stimulated considerable debate within the field regarding the value of most clinical research (e.g., Persons & Silberschatz, 1998) and the role of research in treatment selection (Beutler, 2004; Levant, 2004). Although a wide range of attitudes exists in the field, the debate has often pitted researchers calling for increased use of evidence-based approaches (e.g., Ollendick & Davis, 2004) against practitioners criticizing these approaches and highlighting clinical judgment as a more appropriate foundation of practice (e.g., Levant, 2004).