The Evidence‐Based Practice Movement
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The Evidence-Based Practice
Movement
EDWARD W. GONDOLF
Abstract
The evidence-based practice movement, particularly in the criminal justice field, has
meant an increasingly influential role for social science research. Experimental program evaluations, considered to be the “gold standard,” are helping to assess the
effectiveness and efficiency of interventions amid the need to cut costs. However,
there continues to be questions about the implementation and conception of experimental designs in the “real-world,” and to be resistance to such program evaluations
from many practitioners. Several remedies have emerged including statistical modeling, multiple methods, and consensus panels to promote broader dialogue regarding
program effectiveness. The ideal maybe to return evidence-based practice to more of
a collaborative process rather than a bottom-line verdict.
INTRODUCTION
One of the significant social science trends in the last decade or so has been
the increasing prominence of social science in determining intervention
programs and policy development. Applied social science, of course, has
had a long-standing role in these arenas, but often been diffused by politics,
irrelevance, or impracticality. That role today has been heightened in child
welfare, substance abuse, homelessness, impoverished family, and domestic
violence cases, however, because of the increasing attention to effectiveness
and efficiency—and the pragmatism that underlies that. It has been particularly pronounced in the criminal justice field given the soaring cost of
intervention amid contracting state budgets.
This trend has been encapsulated in what has become known as the
evidence-based practice movement. At its heart is the call for experimental
program evaluations, similar to those used in the medical field to test the
effectiveness of medications and medical procedures. The experimental
evaluations compare the outcome of subjects randomly assigned to a
treatment (or experimental) group and to a nontreatment (or control) group.
Emerging Trends in the Social and Behavioral Sciences. Edited by Robert Scott and Stephen Kosslyn.
© 2015 John Wiley & Sons, Inc. ISBN 978-1-118-90077-2.
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EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES
In accord with basic scientific principles, this sort of design brings us closest
to attributing the cause of an outcome to the treatment or intervention,
independent of subject characteristics or other mediating factors. The results
then give us “evidence” as to whether a program is effective in its aim of
ameliorating a certain set of behaviors.
This application of social science can help determine which programs warrant implementation and referrals, endorsement and promotion, and funding and other resources. It can also aid in refereeing competing approaches
making “success” claims to potential clients. In these ways, experimental
evaluations can help bring greater consistency in practices and programs
and offer accountability to clients, the public, and funders. I am most familiar with domestic violence intervention in the criminal justice field and can
attest that evidence-based practice is having a major impact on court referrals, funding allocations, program standards, and rehabilitation approaches
for counseling and education programs receiving court-mandated offenders,
often referred to as batterer intervention.
A recent special issue of a criminology journal devoted to evidence-based
practice summarized the extent of the movement this way: “The emergence
of the evidence-based movement is arguably one of the most significant
developments to occur in criminal and juvenile justice over the past
20 years.” However, the author adds “It also would be in error to assume
that the evidence-based movement has been embraced unconditionally
or universally in the research community” (Przybylski, 2012, pp. 1, 7).
Many practitioners tend, furthermore, to view evidence-based practice as
disruptive and imposing.
In this essay, I review the nature and contributions of evidence-based
practice in more detail, with reference to its relationship to criminal justice
intervention. The methodological and conceptual issues associated with the
research underlying evidence-based practice are then discussed, along with
the resistance from practitioners to the implementation of such practice.
However, rather than dismissing evidence-based practice, I conclude with
recommendations for conducting, applying, and furthering the social
science on which it is based, and for reconciling the concerns of researchers
and practitioners who question some apparent misuses and their impacts.
WHAT IS EVIDENCE-BASED PRACTICE?
The concept of evidence-based practice was actually introduced in the early
1990s into the medical field with the explicit mission of bringing greater consistency to medical treatments, medications, and procedures (Gilgun, 2005).
Physicians were obviously educated at different times and under different
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philosophies, and beholden to their own theories and, in some cases, outdated approaches. The introduction of evidence-based practice was a way
to help standardize and invigorate practice. The objective was to develop a
feedback loop, of sorts, among researchers and practitioners. Practitioners
posed questions about effectiveness that researchers investigated; the results
were interpreted and applied by the practitioners, and new questions posed.
Admittedly, the intended process evolved into a more researcher-directed
format in order to ensure greater objectivity, rigor, and focus in the research.
Randomized clinical trials (RCTs) have, as a result, become more the norm for
medical research. (In RCT, subjects are randomly assigned into different treatment models or medication options and a nontreatment or placebo option.)
This type of experimental design may, furthermore, include a double-blind
condition in which both the patient and the physician are unaware of which
medication is being administered. In this way, potential bias or influence of
the physician is controlled. Researcher–practitioner partnerships and collaboration, of course, continue to be valued and even necessary, but to a lesser
degree than in the process orientation of the initial conception.
For these reasons, experimental program evaluations have been dubbed,
“The Gold Standard,” and are emulated by social scientists, criminologist,
and policy makers as the ideal for “evidence-based practice,” as well as by
medical practitioners (Dunford, 2000; Sherman, 2009). As early as 1996, the
National Academy of Sciences concluded that “randomized, controlled outcome studies are needed to identify the program and community features
that account for the effectiveness of legal or social service interventions with
various groups of offenders” (Crowell & Burgess, 1996, p. 140). The Division
of Experimental Criminology of the American Criminology Association, and
its accompanying journal of the same name, has helped to reinforce and further this ideal.
As we discuss later, there are, however, obstacles, challenges, and limitations that often prevent the experimental ideal from being realized. Thus, the
“evidence” often has to include quasi-experimental evaluations and observational studies to formulate evidence-based practice. Some state and federal agencies, and professional and foundation organizations, have therefore
calibrated the evidence in terms of evidence-based programs, promising programs, supported programs, model programs, and so on, based on the extent
and rigor of the available research. There is also the distinction of “specific
evidence,” which is based on research of the particular program in question, and lesser “generic evidence,” which is based on related or similar programs. Agencies and organizations have then cataloged the rated practices
in clearinghouse, blueprint, program guide, and “what works” reports for
practitioners and policy-makers to consult in determining which programs
to support and implement.
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META-ANALYSES AND EFFECT SIZES
An increasingly popular tool associated with identifying evidence-based
practice is meta-analysis (Durlak & Lipsey, 1991). This statistical computation summarizes the effect of several program evaluations as a whole.
Researchers first identify the most rigorous studies based on preset criteria, which generally means relying heavily on experimental program
evaluations. They then calculate a standardized measure of effect size for
the combined single-site evaluations (Cohen’s d, with the value of 0 to 1,
is the most commonly used). The results represent a summary of all the
evaluations that are included and may also detect variations across program
sites and approaches, and research designs and methods.
Interestingly, different meta-analyses in any one field may produce varying
results as a result of different inclusion criteria and interpretations of the
coefficients. There are, for instance, at least seven meta-analyses that have
been conducted on batterer program evaluations. The majority has shown
little or no program effect compared to nontreatment controls, reflecting
the outcomes of five available experimental evaluations. One more recent
meta-analysis from the notable Cochrane Collaboration, however, indicated
that the evaluations were too problematic to formulate a conclusion one way
or the other (Smedslund, Dalsbo, Steiro, Winsvold, & Clench-Aas, 2007).
Systematic reviews of the broader research identify program effectiveness
with a series of contingencies, such as sufficient court oversight and supplemental services. They tend to consider other research designs, observational
studies, and statistical modeling on nonexperimental data (discussed further
in the following sections) that are not included in meta-analyses.
Meta-analyses and especially their effect sizes are often presented or used
as a convenient bottom-line verdict on programs and policies. There is, however, continued discussion over how best to interpret the effect sizes. The
authors of one of the meta-analysis of batterer programs adds a further cautionary note: “One of the greatest concerns when conducting a meta-analysis
is the ease at which the ‘bottom-line’ is recalled and the extensive caveats for
caution are forgotten or ignored” (Babcock, Green, & Robie, 2004, p. 1046).
This is a concern that could be applied to research findings in general, but is
particularly acute with regard to evidence-based practice.
THE DEBATE OVER EVIDENCE-BASED PRACTICE
Despite its potential contributions, the evidence-based practice movement is meeting with some objections and controversy. The criticisms of
evidence-based practice seem to fall into three main categories: one, the
implementation challenges of the experimental “gold standard,” two, the
conceptual issues associated with experimental designs that neglect program
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context, and three, the resistance of practitioners to adopting or fully embracing research results. The overarching concern is that the evidence-based
practice movement has become too dependent on experimental program
evaluation—an evaluation design that is not always as rigorous as it would
appear when implemented. As Robert Sampson, Former President of the
American Society of Criminology, charges: “Criminological [experimental]
randomists have overreached in their claims and generated their own
folklores, or what I think are more appropriately referred to as myths. Experimental myths are more than just stories or part of a tradition—they have
become actively institutionalized in the routine workings of criminology”
(Sampson, 2010, p. 490).
METHODOLOGICAL CONCERNS
There is a fundamental concern about the difficulties in conducting experimental evaluations in “real-world” settings. Randomized assignment of subjects to treatment and nontreatment groups is frequently impractical, yet randomization is the lynchpin of experimental designs. Subjects often will not
consent to the assignment for a number of reasons, practitioners (or judges in
court settings) will override some assignments based on case needs, and subjects tend to drop out of mandatory treatments or interventions undercutting
the “experimental” treatment group. Follow-ups with subjects can, moreover, be logistically difficult to achieve and compounded by resistance to sensitive questions. At its core, there are proverbial ethical concerns, especially
over the possibility of putting some subject in a nontreatment control group
that deprives them of treatment that may benefit them. There are many more
such challenges to negotiate leaving one prominent researchers to re-term
experimental program evaluation as the “bronze standard” instead of the
“gold” (Berk, 2005), and another to insist that any sense of Olympic medals
should be dropped altogether (Sampson, 2010).
Rehabilitation programs with court-referred offenders present a particular
challenge in this regard. Dropout rates to an experimental treatment option
tend to run between 40 and 60% turning the experimental option into an
“intention-to-treat” option rather than “treatment-received.” We do not
know, therefore, the outcome of actually receiving the treatment, or its full
“dose,” and whether supplemental treatments or incentives would account
for a better outcome of the experimental group. With all these potential
implementation issues, experimental designs may be more compromised
than their status suggests and warrant qualification and discussion.
One study of 500 evaluations of behavioral treatment programs for adolescents demonstrated that the greater the implementation problems, the lower
the effect size of the program compared to a control group (Durlak & DuPre,
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2008). Several other studies have revealed, moreover, that the vast majority
of the published program evaluations in the criminal justice field, in particular, fail to sufficiently acknowledge the implementation problems and qualify their results accordingly (Mears, 2003). Making such information explicitly available could in itself help practitioners more appropriately gauge the
research implications.
A number of instruments have been developed to systematically examine
the extent and nature of the implementation problems and help to offset the
issue of underreported shortcomings and limitations—they simply need to
be more widely used, according to their proponents. One of the most comprehensive is the Consolidated Standards for Reporting Trails (CONSTORTs)
introduced in 1996 to improve reporting of experimental clinical trials particularly in the medical field. CONSORT tables offer a clear summary of the
strengths and weaknesses across 22 implementation issues that include randomization, intention to treat, effect size, conflict of interest, subject withdrawal and dropouts, and adverse or “uncontrollable” events.
CONCEPTUAL ISSUES
A hotly debated conceptual issue goes beyond the methodological concerns
raised previously: To what degree does the biomedical model (e.g., giving
a dose of medication and observing its physical effects) apply to what are
more accurately considered to be “social interventions”? That is, many of the
program “treatments” are embedded in systems of referral, screening, court
oversight, supplemental services, community collaborations, coordinating
councils, and so on. A community’s police response, employment level, and
cultural norms may be influences as well. All of these components impact
the subject pool, level of dropout, treatment quality, and thus outcomes of a
program evaluation.
Consequently, a contingent of researchers argues for more complex and
sophisticated research designs that account for the program context. As
Smyth and Schorr (2009) write in their report on evaluating child welfare
programs, “The evaluation tools have to be able to incorporate not only a
program’s work, but how that program fits with other interventions. In other
words, some of the very factors and situations that the experimental method
controls may need, instead, to be explicitly folded into an evaluation”
(p. 18). The researchers conclude that, as a result, “the dogma of experimental designs is ultimately detrimental to program development and social
intervention” (p. 21).
There are several alternatives being used to remedy these concerns. An analytical approach to address the conceptual issues, and also many of the implementation issues, is statistical modeling—specifically the use of instrumental
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variable analysis and propensity score analysis. The goal of both analytic
approaches is to simulate experimental conditions by controlling for potential differences in subject characteristics across the comparison groups, such
as program completers versus dropouts. That is, the analyses attempt to balance two nonequivalent groups on measured subject characteristics in order
to produce a more accurate estimate of the effects of a treatment. Addressing
nonexperimental data in this way avoids the difficulties and disruptions of
randomization and thus allows for more “real-world” or naturalistic circumstances. Instrumental variable analysis additionally controls for contextual
program factors, and propensity score analysis produces outcomes for subgroups or types of subjects as well as the sample as a whole.
These two methods have been used extensively in education, agriculture,
public health, and economics, especially when experimental research is
impractical or too difficult to implement. Criminal justice researchers have
also begun to use them in order to approximate equivalent comparison
groups of criminal offenders (Angrist, 2006). The main shortcoming is that
both analytic approaches require extensive subject characteristics and a
large sample size, which are not essential in well-implemented experiments.
Some critiques argue, as well, that statistical modeling, even under the
best circumstances fails to establish truly equivalent comparison groups,
and to create reliable measures for program context. The proponents of
statistical modeling claim, on the other hand, that the modeling effort is
worthwhile considering the inherent “naiveté” of experimental designs and
“the promising developments in the theory and practice of non-experimental
evaluations” (Heckman & Smith, 1995, pp. 108–109).
Another way to address the context of “social interventions” is through
multisite program evaluations. In this approach, program evaluations are
conducted concurrently in different community settings to see if the results
hold up across variations in settings. Multisite studies of alcohol treatments,
depression therapies, and criminal rehabilitation, in fact, have overturned
some of the conclusions drawn from single-site evaluations, as a result.
Participants assigned to a particular treatment have better outcomes in one
city, but poorer outcomes in another. Multisite studies of this sort are, however, very costly to implement, complicated to supervise, and sometimes
difficult to interpret.
Multiple methods are also increasingly recommended to help represent
the broader intervention and its context (Government Accountability Office,
2009). This might include direct observations of rehabilitation programs,
court transactions, and probation procedures, as well as open-ended interviews with staff and community leaders. While determining what effect is
attributable to the batterer program remains problematic, descriptive information regarding the context can help qualify and interpret a program’s
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outcomes. It also can bring a deeper understanding of the intervention in
question—how it works or why it does not work.
There are, additionally, increasing recommendations for system analysis
in the evaluation field (Kelly, 2007). Systems analysis is, of course, a broad
term but is commonly used in business management to represent the operations of an entire corporation and its component parts. It is also a perspective
increasingly brought to public health projects considered to be an “open system” interacting with a variety of other service agencies, informal networks,
and the community at large. A 2007 special issue of the American Journal of
Community Psychology was devoted entirely to the topic. Textbooks, such
as Fourth Generation Evaluation (Guba & Lincoln, 1990), are also available to
help design a systems approach to program evaluations.
The criminal justice field has been applying a system perspective in its
notion of “community coordinated response” to sex offenders, domestic violence cases, prisoner re-entry, and substance abuse cases. The assumption is
that a variety of criminal justice and community service components interact
together for “successful” outcomes in these cases. In the domestic violence
field, this approach is reflected in the “system audits” to monitor the actions
and coordination of the system components, such as the response to 911 calls,
police arrests, court actions, case monitoring, offender rehabilitation, victim
services, and case management. There is also increasing evidence that the
components of a community coordinate response improve batterer program
outcomes (Gondolf, 2012).
PRACTITIONER RESISTANCE
A recent published roundtable on court innovations highlights a third area of
concern about evidence-based practice. It noted a “cultural suspicion of anything academic” among practitioners despite the need for decision-making
based on data and the self-reflection that promotes (Berman, 2008, p. 99). The
pressure for practitioners to “live in the moment” adds to the tension in a
practical way. Crises order the day and tend to preclude long-term planning,
according to the roundtable panel. As a result, “There is almost a complete
disconnect between practice and the parallel university of research” (Berman,
2008, p. 103).
Practitioner resistance to evidence-based practice may also come from
the frustrations with limited resources and staffing, inconsistencies in court
referral and oversight, and administrative shortcomings and ineptness.
Practitioners tend to think in global terms—that is, they consider broader,
multifaceted, and entangled relationships, and are sensitive to a variety
of idiosyncrasies, exceptions, and contingencies among their program
participants. We frequently hear as well that the evaluated programs do not
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apply to the circumstances of their particular program, or their program
has evolved or changed substantially since the program evaluations of
the evidence-based practice. As a result, so-called judgment-based or
clinical-based practice may be more the de facto rule (Pollio, 2006).
An additional practitioner concern is the tendency of evidence-based practice to put forth a bottom-line or authoritative verdict. That is, research findings are too often reduced to a seemingly categorical statement about what
works and consequently betrays the complexity, nuance, and qualifications
of research. The more severe critics fear, moreover, an autocratic hierarchy
of experimental researchers end up dictating policy (or at least influencing
it heavily) to marginalized practitioners (Pollio, 2006). Practitioners counter
that their “evidence” derived through clinical observation, practitioner experience, and case studies are generally excluded from the consideration of
evidence-based practice.
Well-aired in the mental health literature is also the challenge of translating
evidence-based recommendations directly into practice (Westen, Stirman, &
DeRubeis, 2006). Most experimental evaluations rely on manualized treatment to ensure the integrity of what is being tested, while most clinicians
favor flexibility with diverse clients and circumstances. Evidence-based practice has done poorly when applied to people from nondominant cultures and
ethnic groups. As a number of critiques also point out, program evaluations
with community-based services serving minorities are few in part because
those services tend to be under-resourced and not “research ready”.
Research results can be downright confusing to practitioners, as a few
examples from the domestic violence field illustrate. The noted Minneapolis
police study of the 1980s and its replications seemed to disagree on the
impacts of arrest in domestic violence cases (Garner & Maxwell, 2000); a more
recent multisite evaluation of judicial oversight of domestic violence cases
produced mixed results that run counter to the experience of the practitioners involved in the study (Visher, Harrell, & Yahner, 2008). Our own multisite
evaluation of batterer programs, using statistical modeling, counters the
experimental program evaluations that suggest no effect (Gondolf, 2012).
PRACTITIONER INPUT
The academics writing about practitioner resistance propose a democratized interaction between researchers and practitioners, and reinstate the
process orientation of its initial conception (Holmes, Murray, Perron, & Rali,
2006). “Research readiness” among practitioners, or “critical consumers” of
research, is needed to give feedback and respond critically. Under the heavy
workloads and crisis-driven schedules of most practitioners, this sort of
“research readiness” is difficult to achieve and maintain. There are efforts in
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many fields to compensate for a lack of training in research basics through
professional conferences, technical assistance, and research briefs, but the
gulf continues to be a substantial one to bridge.
In turn, researchers also would benefit from greater “practice wisdom” in
order to appreciate the outlook and experience of those affected by their
research. One federal agency, coupled with a national nonprofit organization,
convened a series of seminars joining leading researchers and practitioners
to frankly debate the evidence-based practice research and its application to
batterer intervention. The summary reports have then been disseminated to
inform and engage others in the cross-training experience.
Finally, there are grant solicitations for practitioner-initiated research that
enable unique and distinguished programs to develop their own documentation and evaluations. Federal agencies have, as well, issued solicitations
for long-term research-practitioner collaborations addressing criminal justice interventions, beyond the more superficial cooperative agreements that
accompany program evaluations and research.
In medical settings, consensus panels are also established for new innovations and treatments. A variety of researchers and practitioners, along with
administrators and advocates, convene to discuss reviews of the research,
practitioner experience, and administrative issues. There is some wrangling
to sort out what might be the “best practice” based on a number of criteria that may include patient satisfaction and program feasibility, as well as
research evidence. It generally suggests a systematic sorting of researcher
and practitioner recommendations, and an emerging consensus around certain practices. This approach may extend to establishing program standards
or guidelines, or “standard of care,” for the field. Some argue, however, that
standards have relied too much on practitioners and advocates rather than on
the evidence-based research, as is the case with regard to domestic violence
batterer programs.
RECOMMENDATIONS
This overview is not meant to dismiss or undercut the evidence-based
practice movement. Rather the intent is to broaden and refine it. The call
for evidence-based practice arises out of a need for more substantiation,
accountability, efficiency, and effectiveness in intervention and treatment. It
contributes a logical, rational, and systemic thinking to important questions
that are sometimes skewed by personal philosophy, limited observation,
and political intents. This sort of thinking, ideally, brings more objectivity to
policy and program development.
As discussed previously, there are inevitably challenges and misuses, and
even distortions of evidence-based practice. Critics for instance object to
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the exclusive reliance on experimental evaluation, the bottom-line verdicts
regarding effectiveness, and the disruptive impositions of research on
practice. The extent and impact of these issues are admittedly debatable,
but the wide range of researchers raising them at least warrants pause and
caution. In response, a host of remedies attempt to address the concerns, but
need to be more vigorously introduced, especially to practitioners caught
unwittingly by bottom-line assertions.
Critics recommend that researchers be more forthright in acknowledging
the limitations of their work and alternative interpretations of it. Practitioners
have, in particular, called for more attention to the nuance and complexity
of outcomes, the mediating effects of context, and more familiarity with the
“real-world” experience of intervention. These concerns might entail more
extensive data collection and sophisticated computer modeling. On the other
hand, practitioners are in need of more “research readiness” both in terms
of their understanding of research demands and their program’s ability to
accommodate them. If they are to truly collaborate or be more involved in the
research, they need to be conversant in basic research principles, as well as
their more global and idiosyncratic appreciation of their clients. All this begs
for cross-training and shared conferences that federal and regional agencies
have convened.
Federal and state agencies have posed some additional alternatives to
develop more “grounded” research and evidence. They have stipulated
documentation of collaborations with practitioners (beyond “drive-by”
practitioner sign-offs), practitioner-initiated research projects, technical
assistance to establish program research-readiness, and research review and
dissemination procedures that ensure practitioner response and input. One
might argue that these efforts do not preclude experimental evaluations,
rather they supplement them. They usually entail different research designs
and approaches (e.g., case studies, action research, longitudinal follow-ups,
and community ethnography) that follow the recommendation of policy
commissions calling for diversifying the sources of evidence.
In addition, there are structural inducements for integrating research
knowledge and clinical experience more broadly—as well as a findings
from different research methodologies and approaches. The medical field,
in particular, has long-standing consensus panels that bring together practitioners and researchers to review research and its applications to clinical
settings. Similar committees and commissions have convened to develop
“best practices” or “what works” that represent agreement of research
and practitioners over what appears to be most effective intervention or
treatment. Standards of care or program standards have been negotiated
in most fields, often with stakeholders as well as practitioners, researchers,
and insurance companies or state funders. These ventures certainly help to
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impose an exchange and collaboration, but accounts of some of these efforts
expose the difficulties in establishing an ideal partnership.
Ultimately, the question is how to realize the ideal of “evidence-based”
practice as a process—one that is a collaborative feedback loop of researchers
and practitioners. One in which properly qualified research findings are part
of a discourse rather than policy pronouncement. Such process-based partnerships do exist in the domestic violence field, as well as others, and have
been documented and forwarded as models to emulate. All of this takes us
back—and also forward—to the founding principles of evidence-based practice in the early 1990s. The lingering question is whether these principles can
reconcile the increasingly entrenched factions, specifically in the domestic
violence field—and beyond.
REFERENCES
Angrist, J. (2006). Instrumental variables methods in experimental criminological
research: What, why, and how? Journal of Experimental Criminology, 1, 23–44.
Babcock, J., Green, C., & Robie, C. (2004). Does batterers’ treatment work? A
meta-analytic review of domestic violence treatment outcome research. Clinical
Psychology Review, 23, 1023–1053.
Berk, R. (2005). Randomized experiments as the bronze standard. Journal of Experimental Criminology, 1, 416–433.
Berman, G. (2008). Learning from failure: A roundtable on criminal justice innovation. Journal of Court innovation, 1, 97–122.
Crowell, N., & Burgess, A. (1996). Understanding violence against women. Washington,
DC: National Academy Press.
Dunford, F. (2000). Determining program success: The importance of employing
experimental research designs. Crime and Delinquency, 46, 425–434.
Durlak, J., & DuPre, E. (2008). Implementation Matters: A review of research on the
influence of implementation on program outcomes and the factors affective implementation. American Journal of Community Psychology, 41, 327–350.
Durlak, J., & Lipsey, M. (1991). A practitioner’s guide to meta-analysis. American
Journal of Community Psychology, 19, 291–332.
Garner, J., & Maxwell, C. (2000). What are the lessons of the police arrest studies?
Journal of Aggression, Maltreatment & Trauma, 4, 83–114.
Gilgun, J. (2005). The four cornerstones of evidence-based practice in social work.
Research on Social work Practice, 15, 52–61.
Gondolf, E. (2012). The future of batterer programs: Reassessing evidence-based practice.
Boston, MA: Northeastern University Press.
Government Accounting Office (2009). Program evaluation: A variety of rigorous methods can help identify effective interventions, Report to Congressional Requestors,
No. 424. Washington, DC: U. S. Government Accounting Office. Retrieved from
www.gao.gov/new.items/d1030.pdf.
Guba, E., & Lincoln, Y. (1990). Fourth generation evaluation. Thousand Oaks, CA: Sage
Publications.
The Evidence-Based Practice Movement
13
Heckman, J., & Smith, J. (1995). Assessing the case for social experiments. Journal of
Economic Perspectives, 9, 85–110.
Holmes, D., Murray, S., Perron, A., & Rali, G. (2006). Deconstructing the evidencebased discourse in health sciences. International Journal of Evidence Based Healthcare,
4, 180–186.
Kelly, J. (2007). The system concept and systemic change: Implications for community psychology. American Journal of Community Psychology, 39, 415–418.
Mears, D. (2003). Research and interventions to reduce domestic violence revictimization. Trauma, Violence and Abuse, 4, 127–147.
Pollio, D. (2006). The art of evidence-based practice. Research on Social Work Practice,
16, 224–232.
Przybylski, R. (2012). Editor’s introduction. Justice Research and Policy, 4, 1–15.
Sampson, R. (2010). Gold standard myths: Observations on the experimental turn in
quantitative criminology. Journal of Quantitative Criminology, 26, 489–500.
Sherman, L. (2009). Evidence and liberty: The Promise of experimental criminology.
Criminology and Criminal Justice, 9, 5–28.
Smedslund, G., Dalsbo, T., Steiro, A., Winsvold, A., & Clench-Aas, J. (2007). Cognitive behavioural therapy for men who physically abuse their female partner. The Cochrane Databasae of Systematic Reviews, Issue 4, Article No. CD006048
(www.cochranelibrary.com).
Smyth, K., & Schorr, L. (2009). A lot to lose: A call to rethink what constitutes “evidence” in finding social interventions that work. Harvard Kennedy School of Government Working Paper Series, Harvard University, Cambridge, MA. Retrieved
from www.hks.harvard.edu/socpol/publications_main.html.
Visher, C., Harrell, A., & Yahner, J. (2008). Reducing intimate partner violence: An
evaluation of a comprehensive justice system–community collaboration. Criminology and Public Policy, 7, 495–523.
Westen, D., Stirman, S., & DeRubeis, R. (2006). Are research patients and clinical trials representative of clinical practice?. In J. Norcross, L. Beutler & R. Levant (Eds.),
Evidence-based practices in mental health: Debate and dialogue on the fundamental questions (pp. 161–189). Washington, DC: American Psychological Association.
FURTHER READING
Gondolf, E. (2002). Batterer intervention systems: Issues, outcomes, and recommendations.
Thousand Oaks, CA: Sage Publications.
Scott, R., & Shore, A. (1979). Why sociology does not apply: A study of the use of sociology
in public policy. New York, NY: Elsevier.
Sherman, L. (1992). Policing domestic violence: Experiments and dilemmas. New York,
NY: Free Press.
EDWARD W. GONDOLF SHORT BIOGRAPHY
Edward W. Gondolf, EdD, MPH, is currently a research associate and former research director for the Mid-Atlantic Addiction Research and Training
14
EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES
Institute (MARTI), based at Indiana University of Pennsylvania (USA). His
most noted book Batterer Intervention Systems (2001) summarizes a 7-year
evaluation of batterer intervention systems in four cities funded by the US
Centers for Disease Control, and a related NIJ study using the longitudinal
data to identify risk factors for re-assault. Under grants from the National
Institute of Justice (NIJ), he more recently evaluated the effectiveness of specialized counseling for African-American men, a study of case management
for domestic violence offenders, and a 4-year evaluation of supplemental
mental health treatment for batterer program participants. Dr. Gondolf’s current book, The Future of Batterer Programs: Reassessing Evidence-Based Practice
(2012), addresses the debate over the effectiveness of batterer programs and
the means to improving it.
RELATED ESSAYS
The Role of Data in Research and Policy (Sociology), Barbara A. Anderson
Models of Nonlinear Growth (Methods), Patrick Coulombe and James P.
Selig
Expertise (Sociology), Gil Eyal
Quantile Regression Methods (Methods), Bernd Fitzenberger and Ralf
Andreas Wilke
Why Do States Sign Alliances? (Political Science), Brett Ashley Leeds
Structural Equation Modeling and Latent Variable Approaches (Methods),
Alex Liu
Why Do Governments Abuse Human Rights? (Political Science), Will H.
Moore and Ryan M. Welch
Causation, Theory, and Policy in the Social Sciences (Sociology), Mark C.
Stafford and Daniel P. Mears
The Social Science of Sustainability (Political Science), Johannes Urpelainen
Trends in the Analysis of Interstate Rivalries (Political Science), William R.
Thompson
Translational Sociology (Sociology), Elaine Wethington
-
The Evidence-Based Practice
Movement
EDWARD W. GONDOLF
Abstract
The evidence-based practice movement, particularly in the criminal justice field, has
meant an increasingly influential role for social science research. Experimental program evaluations, considered to be the “gold standard,” are helping to assess the
effectiveness and efficiency of interventions amid the need to cut costs. However,
there continues to be questions about the implementation and conception of experimental designs in the “real-world,” and to be resistance to such program evaluations
from many practitioners. Several remedies have emerged including statistical modeling, multiple methods, and consensus panels to promote broader dialogue regarding
program effectiveness. The ideal maybe to return evidence-based practice to more of
a collaborative process rather than a bottom-line verdict.
INTRODUCTION
One of the significant social science trends in the last decade or so has been
the increasing prominence of social science in determining intervention
programs and policy development. Applied social science, of course, has
had a long-standing role in these arenas, but often been diffused by politics,
irrelevance, or impracticality. That role today has been heightened in child
welfare, substance abuse, homelessness, impoverished family, and domestic
violence cases, however, because of the increasing attention to effectiveness
and efficiency—and the pragmatism that underlies that. It has been particularly pronounced in the criminal justice field given the soaring cost of
intervention amid contracting state budgets.
This trend has been encapsulated in what has become known as the
evidence-based practice movement. At its heart is the call for experimental
program evaluations, similar to those used in the medical field to test the
effectiveness of medications and medical procedures. The experimental
evaluations compare the outcome of subjects randomly assigned to a
treatment (or experimental) group and to a nontreatment (or control) group.
Emerging Trends in the Social and Behavioral Sciences. Edited by Robert Scott and Stephen Kosslyn.
© 2015 John Wiley & Sons, Inc. ISBN 978-1-118-90077-2.
1
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EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES
In accord with basic scientific principles, this sort of design brings us closest
to attributing the cause of an outcome to the treatment or intervention,
independent of subject characteristics or other mediating factors. The results
then give us “evidence” as to whether a program is effective in its aim of
ameliorating a certain set of behaviors.
This application of social science can help determine which programs warrant implementation and referrals, endorsement and promotion, and funding and other resources. It can also aid in refereeing competing approaches
making “success” claims to potential clients. In these ways, experimental
evaluations can help bring greater consistency in practices and programs
and offer accountability to clients, the public, and funders. I am most familiar with domestic violence intervention in the criminal justice field and can
attest that evidence-based practice is having a major impact on court referrals, funding allocations, program standards, and rehabilitation approaches
for counseling and education programs receiving court-mandated offenders,
often referred to as batterer intervention.
A recent special issue of a criminology journal devoted to evidence-based
practice summarized the extent of the movement this way: “The emergence
of the evidence-based movement is arguably one of the most significant
developments to occur in criminal and juvenile justice over the past
20 years.” However, the author adds “It also would be in error to assume
that the evidence-based movement has been embraced unconditionally
or universally in the research community” (Przybylski, 2012, pp. 1, 7).
Many practitioners tend, furthermore, to view evidence-based practice as
disruptive and imposing.
In this essay, I review the nature and contributions of evidence-based
practice in more detail, with reference to its relationship to criminal justice
intervention. The methodological and conceptual issues associated with the
research underlying evidence-based practice are then discussed, along with
the resistance from practitioners to the implementation of such practice.
However, rather than dismissing evidence-based practice, I conclude with
recommendations for conducting, applying, and furthering the social
science on which it is based, and for reconciling the concerns of researchers
and practitioners who question some apparent misuses and their impacts.
WHAT IS EVIDENCE-BASED PRACTICE?
The concept of evidence-based practice was actually introduced in the early
1990s into the medical field with the explicit mission of bringing greater consistency to medical treatments, medications, and procedures (Gilgun, 2005).
Physicians were obviously educated at different times and under different
The Evidence-Based Practice Movement
3
philosophies, and beholden to their own theories and, in some cases, outdated approaches. The introduction of evidence-based practice was a way
to help standardize and invigorate practice. The objective was to develop a
feedback loop, of sorts, among researchers and practitioners. Practitioners
posed questions about effectiveness that researchers investigated; the results
were interpreted and applied by the practitioners, and new questions posed.
Admittedly, the intended process evolved into a more researcher-directed
format in order to ensure greater objectivity, rigor, and focus in the research.
Randomized clinical trials (RCTs) have, as a result, become more the norm for
medical research. (In RCT, subjects are randomly assigned into different treatment models or medication options and a nontreatment or placebo option.)
This type of experimental design may, furthermore, include a double-blind
condition in which both the patient and the physician are unaware of which
medication is being administered. In this way, potential bias or influence of
the physician is controlled. Researcher–practitioner partnerships and collaboration, of course, continue to be valued and even necessary, but to a lesser
degree than in the process orientation of the initial conception.
For these reasons, experimental program evaluations have been dubbed,
“The Gold Standard,” and are emulated by social scientists, criminologist,
and policy makers as the ideal for “evidence-based practice,” as well as by
medical practitioners (Dunford, 2000; Sherman, 2009). As early as 1996, the
National Academy of Sciences concluded that “randomized, controlled outcome studies are needed to identify the program and community features
that account for the effectiveness of legal or social service interventions with
various groups of offenders” (Crowell & Burgess, 1996, p. 140). The Division
of Experimental Criminology of the American Criminology Association, and
its accompanying journal of the same name, has helped to reinforce and further this ideal.
As we discuss later, there are, however, obstacles, challenges, and limitations that often prevent the experimental ideal from being realized. Thus, the
“evidence” often has to include quasi-experimental evaluations and observational studies to formulate evidence-based practice. Some state and federal agencies, and professional and foundation organizations, have therefore
calibrated the evidence in terms of evidence-based programs, promising programs, supported programs, model programs, and so on, based on the extent
and rigor of the available research. There is also the distinction of “specific
evidence,” which is based on research of the particular program in question, and lesser “generic evidence,” which is based on related or similar programs. Agencies and organizations have then cataloged the rated practices
in clearinghouse, blueprint, program guide, and “what works” reports for
practitioners and policy-makers to consult in determining which programs
to support and implement.
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EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES
META-ANALYSES AND EFFECT SIZES
An increasingly popular tool associated with identifying evidence-based
practice is meta-analysis (Durlak & Lipsey, 1991). This statistical computation summarizes the effect of several program evaluations as a whole.
Researchers first identify the most rigorous studies based on preset criteria, which generally means relying heavily on experimental program
evaluations. They then calculate a standardized measure of effect size for
the combined single-site evaluations (Cohen’s d, with the value of 0 to 1,
is the most commonly used). The results represent a summary of all the
evaluations that are included and may also detect variations across program
sites and approaches, and research designs and methods.
Interestingly, different meta-analyses in any one field may produce varying
results as a result of different inclusion criteria and interpretations of the
coefficients. There are, for instance, at least seven meta-analyses that have
been conducted on batterer program evaluations. The majority has shown
little or no program effect compared to nontreatment controls, reflecting
the outcomes of five available experimental evaluations. One more recent
meta-analysis from the notable Cochrane Collaboration, however, indicated
that the evaluations were too problematic to formulate a conclusion one way
or the other (Smedslund, Dalsbo, Steiro, Winsvold, & Clench-Aas, 2007).
Systematic reviews of the broader research identify program effectiveness
with a series of contingencies, such as sufficient court oversight and supplemental services. They tend to consider other research designs, observational
studies, and statistical modeling on nonexperimental data (discussed further
in the following sections) that are not included in meta-analyses.
Meta-analyses and especially their effect sizes are often presented or used
as a convenient bottom-line verdict on programs and policies. There is, however, continued discussion over how best to interpret the effect sizes. The
authors of one of the meta-analysis of batterer programs adds a further cautionary note: “One of the greatest concerns when conducting a meta-analysis
is the ease at which the ‘bottom-line’ is recalled and the extensive caveats for
caution are forgotten or ignored” (Babcock, Green, & Robie, 2004, p. 1046).
This is a concern that could be applied to research findings in general, but is
particularly acute with regard to evidence-based practice.
THE DEBATE OVER EVIDENCE-BASED PRACTICE
Despite its potential contributions, the evidence-based practice movement is meeting with some objections and controversy. The criticisms of
evidence-based practice seem to fall into three main categories: one, the
implementation challenges of the experimental “gold standard,” two, the
conceptual issues associated with experimental designs that neglect program
The Evidence-Based Practice Movement
5
context, and three, the resistance of practitioners to adopting or fully embracing research results. The overarching concern is that the evidence-based
practice movement has become too dependent on experimental program
evaluation—an evaluation design that is not always as rigorous as it would
appear when implemented. As Robert Sampson, Former President of the
American Society of Criminology, charges: “Criminological [experimental]
randomists have overreached in their claims and generated their own
folklores, or what I think are more appropriately referred to as myths. Experimental myths are more than just stories or part of a tradition—they have
become actively institutionalized in the routine workings of criminology”
(Sampson, 2010, p. 490).
METHODOLOGICAL CONCERNS
There is a fundamental concern about the difficulties in conducting experimental evaluations in “real-world” settings. Randomized assignment of subjects to treatment and nontreatment groups is frequently impractical, yet randomization is the lynchpin of experimental designs. Subjects often will not
consent to the assignment for a number of reasons, practitioners (or judges in
court settings) will override some assignments based on case needs, and subjects tend to drop out of mandatory treatments or interventions undercutting
the “experimental” treatment group. Follow-ups with subjects can, moreover, be logistically difficult to achieve and compounded by resistance to sensitive questions. At its core, there are proverbial ethical concerns, especially
over the possibility of putting some subject in a nontreatment control group
that deprives them of treatment that may benefit them. There are many more
such challenges to negotiate leaving one prominent researchers to re-term
experimental program evaluation as the “bronze standard” instead of the
“gold” (Berk, 2005), and another to insist that any sense of Olympic medals
should be dropped altogether (Sampson, 2010).
Rehabilitation programs with court-referred offenders present a particular
challenge in this regard. Dropout rates to an experimental treatment option
tend to run between 40 and 60% turning the experimental option into an
“intention-to-treat” option rather than “treatment-received.” We do not
know, therefore, the outcome of actually receiving the treatment, or its full
“dose,” and whether supplemental treatments or incentives would account
for a better outcome of the experimental group. With all these potential
implementation issues, experimental designs may be more compromised
than their status suggests and warrant qualification and discussion.
One study of 500 evaluations of behavioral treatment programs for adolescents demonstrated that the greater the implementation problems, the lower
the effect size of the program compared to a control group (Durlak & DuPre,
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EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES
2008). Several other studies have revealed, moreover, that the vast majority
of the published program evaluations in the criminal justice field, in particular, fail to sufficiently acknowledge the implementation problems and qualify their results accordingly (Mears, 2003). Making such information explicitly available could in itself help practitioners more appropriately gauge the
research implications.
A number of instruments have been developed to systematically examine
the extent and nature of the implementation problems and help to offset the
issue of underreported shortcomings and limitations—they simply need to
be more widely used, according to their proponents. One of the most comprehensive is the Consolidated Standards for Reporting Trails (CONSTORTs)
introduced in 1996 to improve reporting of experimental clinical trials particularly in the medical field. CONSORT tables offer a clear summary of the
strengths and weaknesses across 22 implementation issues that include randomization, intention to treat, effect size, conflict of interest, subject withdrawal and dropouts, and adverse or “uncontrollable” events.
CONCEPTUAL ISSUES
A hotly debated conceptual issue goes beyond the methodological concerns
raised previously: To what degree does the biomedical model (e.g., giving
a dose of medication and observing its physical effects) apply to what are
more accurately considered to be “social interventions”? That is, many of the
program “treatments” are embedded in systems of referral, screening, court
oversight, supplemental services, community collaborations, coordinating
councils, and so on. A community’s police response, employment level, and
cultural norms may be influences as well. All of these components impact
the subject pool, level of dropout, treatment quality, and thus outcomes of a
program evaluation.
Consequently, a contingent of researchers argues for more complex and
sophisticated research designs that account for the program context. As
Smyth and Schorr (2009) write in their report on evaluating child welfare
programs, “The evaluation tools have to be able to incorporate not only a
program’s work, but how that program fits with other interventions. In other
words, some of the very factors and situations that the experimental method
controls may need, instead, to be explicitly folded into an evaluation”
(p. 18). The researchers conclude that, as a result, “the dogma of experimental designs is ultimately detrimental to program development and social
intervention” (p. 21).
There are several alternatives being used to remedy these concerns. An analytical approach to address the conceptual issues, and also many of the implementation issues, is statistical modeling—specifically the use of instrumental
The Evidence-Based Practice Movement
7
variable analysis and propensity score analysis. The goal of both analytic
approaches is to simulate experimental conditions by controlling for potential differences in subject characteristics across the comparison groups, such
as program completers versus dropouts. That is, the analyses attempt to balance two nonequivalent groups on measured subject characteristics in order
to produce a more accurate estimate of the effects of a treatment. Addressing
nonexperimental data in this way avoids the difficulties and disruptions of
randomization and thus allows for more “real-world” or naturalistic circumstances. Instrumental variable analysis additionally controls for contextual
program factors, and propensity score analysis produces outcomes for subgroups or types of subjects as well as the sample as a whole.
These two methods have been used extensively in education, agriculture,
public health, and economics, especially when experimental research is
impractical or too difficult to implement. Criminal justice researchers have
also begun to use them in order to approximate equivalent comparison
groups of criminal offenders (Angrist, 2006). The main shortcoming is that
both analytic approaches require extensive subject characteristics and a
large sample size, which are not essential in well-implemented experiments.
Some critiques argue, as well, that statistical modeling, even under the
best circumstances fails to establish truly equivalent comparison groups,
and to create reliable measures for program context. The proponents of
statistical modeling claim, on the other hand, that the modeling effort is
worthwhile considering the inherent “naiveté” of experimental designs and
“the promising developments in the theory and practice of non-experimental
evaluations” (Heckman & Smith, 1995, pp. 108–109).
Another way to address the context of “social interventions” is through
multisite program evaluations. In this approach, program evaluations are
conducted concurrently in different community settings to see if the results
hold up across variations in settings. Multisite studies of alcohol treatments,
depression therapies, and criminal rehabilitation, in fact, have overturned
some of the conclusions drawn from single-site evaluations, as a result.
Participants assigned to a particular treatment have better outcomes in one
city, but poorer outcomes in another. Multisite studies of this sort are, however, very costly to implement, complicated to supervise, and sometimes
difficult to interpret.
Multiple methods are also increasingly recommended to help represent
the broader intervention and its context (Government Accountability Office,
2009). This might include direct observations of rehabilitation programs,
court transactions, and probation procedures, as well as open-ended interviews with staff and community leaders. While determining what effect is
attributable to the batterer program remains problematic, descriptive information regarding the context can help qualify and interpret a program’s
8
EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES
outcomes. It also can bring a deeper understanding of the intervention in
question—how it works or why it does not work.
There are, additionally, increasing recommendations for system analysis
in the evaluation field (Kelly, 2007). Systems analysis is, of course, a broad
term but is commonly used in business management to represent the operations of an entire corporation and its component parts. It is also a perspective
increasingly brought to public health projects considered to be an “open system” interacting with a variety of other service agencies, informal networks,
and the community at large. A 2007 special issue of the American Journal of
Community Psychology was devoted entirely to the topic. Textbooks, such
as Fourth Generation Evaluation (Guba & Lincoln, 1990), are also available to
help design a systems approach to program evaluations.
The criminal justice field has been applying a system perspective in its
notion of “community coordinated response” to sex offenders, domestic violence cases, prisoner re-entry, and substance abuse cases. The assumption is
that a variety of criminal justice and community service components interact
together for “successful” outcomes in these cases. In the domestic violence
field, this approach is reflected in the “system audits” to monitor the actions
and coordination of the system components, such as the response to 911 calls,
police arrests, court actions, case monitoring, offender rehabilitation, victim
services, and case management. There is also increasing evidence that the
components of a community coordinate response improve batterer program
outcomes (Gondolf, 2012).
PRACTITIONER RESISTANCE
A recent published roundtable on court innovations highlights a third area of
concern about evidence-based practice. It noted a “cultural suspicion of anything academic” among practitioners despite the need for decision-making
based on data and the self-reflection that promotes (Berman, 2008, p. 99). The
pressure for practitioners to “live in the moment” adds to the tension in a
practical way. Crises order the day and tend to preclude long-term planning,
according to the roundtable panel. As a result, “There is almost a complete
disconnect between practice and the parallel university of research” (Berman,
2008, p. 103).
Practitioner resistance to evidence-based practice may also come from
the frustrations with limited resources and staffing, inconsistencies in court
referral and oversight, and administrative shortcomings and ineptness.
Practitioners tend to think in global terms—that is, they consider broader,
multifaceted, and entangled relationships, and are sensitive to a variety
of idiosyncrasies, exceptions, and contingencies among their program
participants. We frequently hear as well that the evaluated programs do not
The Evidence-Based Practice Movement
9
apply to the circumstances of their particular program, or their program
has evolved or changed substantially since the program evaluations of
the evidence-based practice. As a result, so-called judgment-based or
clinical-based practice may be more the de facto rule (Pollio, 2006).
An additional practitioner concern is the tendency of evidence-based practice to put forth a bottom-line or authoritative verdict. That is, research findings are too often reduced to a seemingly categorical statement about what
works and consequently betrays the complexity, nuance, and qualifications
of research. The more severe critics fear, moreover, an autocratic hierarchy
of experimental researchers end up dictating policy (or at least influencing
it heavily) to marginalized practitioners (Pollio, 2006). Practitioners counter
that their “evidence” derived through clinical observation, practitioner experience, and case studies are generally excluded from the consideration of
evidence-based practice.
Well-aired in the mental health literature is also the challenge of translating
evidence-based recommendations directly into practice (Westen, Stirman, &
DeRubeis, 2006). Most experimental evaluations rely on manualized treatment to ensure the integrity of what is being tested, while most clinicians
favor flexibility with diverse clients and circumstances. Evidence-based practice has done poorly when applied to people from nondominant cultures and
ethnic groups. As a number of critiques also point out, program evaluations
with community-based services serving minorities are few in part because
those services tend to be under-resourced and not “research ready”.
Research results can be downright confusing to practitioners, as a few
examples from the domestic violence field illustrate. The noted Minneapolis
police study of the 1980s and its replications seemed to disagree on the
impacts of arrest in domestic violence cases (Garner & Maxwell, 2000); a more
recent multisite evaluation of judicial oversight of domestic violence cases
produced mixed results that run counter to the experience of the practitioners involved in the study (Visher, Harrell, & Yahner, 2008). Our own multisite
evaluation of batterer programs, using statistical modeling, counters the
experimental program evaluations that suggest no effect (Gondolf, 2012).
PRACTITIONER INPUT
The academics writing about practitioner resistance propose a democratized interaction between researchers and practitioners, and reinstate the
process orientation of its initial conception (Holmes, Murray, Perron, & Rali,
2006). “Research readiness” among practitioners, or “critical consumers” of
research, is needed to give feedback and respond critically. Under the heavy
workloads and crisis-driven schedules of most practitioners, this sort of
“research readiness” is difficult to achieve and maintain. There are efforts in
10
EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES
many fields to compensate for a lack of training in research basics through
professional conferences, technical assistance, and research briefs, but the
gulf continues to be a substantial one to bridge.
In turn, researchers also would benefit from greater “practice wisdom” in
order to appreciate the outlook and experience of those affected by their
research. One federal agency, coupled with a national nonprofit organization,
convened a series of seminars joining leading researchers and practitioners
to frankly debate the evidence-based practice research and its application to
batterer intervention. The summary reports have then been disseminated to
inform and engage others in the cross-training experience.
Finally, there are grant solicitations for practitioner-initiated research that
enable unique and distinguished programs to develop their own documentation and evaluations. Federal agencies have, as well, issued solicitations
for long-term research-practitioner collaborations addressing criminal justice interventions, beyond the more superficial cooperative agreements that
accompany program evaluations and research.
In medical settings, consensus panels are also established for new innovations and treatments. A variety of researchers and practitioners, along with
administrators and advocates, convene to discuss reviews of the research,
practitioner experience, and administrative issues. There is some wrangling
to sort out what might be the “best practice” based on a number of criteria that may include patient satisfaction and program feasibility, as well as
research evidence. It generally suggests a systematic sorting of researcher
and practitioner recommendations, and an emerging consensus around certain practices. This approach may extend to establishing program standards
or guidelines, or “standard of care,” for the field. Some argue, however, that
standards have relied too much on practitioners and advocates rather than on
the evidence-based research, as is the case with regard to domestic violence
batterer programs.
RECOMMENDATIONS
This overview is not meant to dismiss or undercut the evidence-based
practice movement. Rather the intent is to broaden and refine it. The call
for evidence-based practice arises out of a need for more substantiation,
accountability, efficiency, and effectiveness in intervention and treatment. It
contributes a logical, rational, and systemic thinking to important questions
that are sometimes skewed by personal philosophy, limited observation,
and political intents. This sort of thinking, ideally, brings more objectivity to
policy and program development.
As discussed previously, there are inevitably challenges and misuses, and
even distortions of evidence-based practice. Critics for instance object to
The Evidence-Based Practice Movement
11
the exclusive reliance on experimental evaluation, the bottom-line verdicts
regarding effectiveness, and the disruptive impositions of research on
practice. The extent and impact of these issues are admittedly debatable,
but the wide range of researchers raising them at least warrants pause and
caution. In response, a host of remedies attempt to address the concerns, but
need to be more vigorously introduced, especially to practitioners caught
unwittingly by bottom-line assertions.
Critics recommend that researchers be more forthright in acknowledging
the limitations of their work and alternative interpretations of it. Practitioners
have, in particular, called for more attention to the nuance and complexity
of outcomes, the mediating effects of context, and more familiarity with the
“real-world” experience of intervention. These concerns might entail more
extensive data collection and sophisticated computer modeling. On the other
hand, practitioners are in need of more “research readiness” both in terms
of their understanding of research demands and their program’s ability to
accommodate them. If they are to truly collaborate or be more involved in the
research, they need to be conversant in basic research principles, as well as
their more global and idiosyncratic appreciation of their clients. All this begs
for cross-training and shared conferences that federal and regional agencies
have convened.
Federal and state agencies have posed some additional alternatives to
develop more “grounded” research and evidence. They have stipulated
documentation of collaborations with practitioners (beyond “drive-by”
practitioner sign-offs), practitioner-initiated research projects, technical
assistance to establish program research-readiness, and research review and
dissemination procedures that ensure practitioner response and input. One
might argue that these efforts do not preclude experimental evaluations,
rather they supplement them. They usually entail different research designs
and approaches (e.g., case studies, action research, longitudinal follow-ups,
and community ethnography) that follow the recommendation of policy
commissions calling for diversifying the sources of evidence.
In addition, there are structural inducements for integrating research
knowledge and clinical experience more broadly—as well as a findings
from different research methodologies and approaches. The medical field,
in particular, has long-standing consensus panels that bring together practitioners and researchers to review research and its applications to clinical
settings. Similar committees and commissions have convened to develop
“best practices” or “what works” that represent agreement of research
and practitioners over what appears to be most effective intervention or
treatment. Standards of care or program standards have been negotiated
in most fields, often with stakeholders as well as practitioners, researchers,
and insurance companies or state funders. These ventures certainly help to
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EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES
impose an exchange and collaboration, but accounts of some of these efforts
expose the difficulties in establishing an ideal partnership.
Ultimately, the question is how to realize the ideal of “evidence-based”
practice as a process—one that is a collaborative feedback loop of researchers
and practitioners. One in which properly qualified research findings are part
of a discourse rather than policy pronouncement. Such process-based partnerships do exist in the domestic violence field, as well as others, and have
been documented and forwarded as models to emulate. All of this takes us
back—and also forward—to the founding principles of evidence-based practice in the early 1990s. The lingering question is whether these principles can
reconcile the increasingly entrenched factions, specifically in the domestic
violence field—and beyond.
REFERENCES
Angrist, J. (2006). Instrumental variables methods in experimental criminological
research: What, why, and how? Journal of Experimental Criminology, 1, 23–44.
Babcock, J., Green, C., & Robie, C. (2004). Does batterers’ treatment work? A
meta-analytic review of domestic violence treatment outcome research. Clinical
Psychology Review, 23, 1023–1053.
Berk, R. (2005). Randomized experiments as the bronze standard. Journal of Experimental Criminology, 1, 416–433.
Berman, G. (2008). Learning from failure: A roundtable on criminal justice innovation. Journal of Court innovation, 1, 97–122.
Crowell, N., & Burgess, A. (1996). Understanding violence against women. Washington,
DC: National Academy Press.
Dunford, F. (2000). Determining program success: The importance of employing
experimental research designs. Crime and Delinquency, 46, 425–434.
Durlak, J., & DuPre, E. (2008). Implementation Matters: A review of research on the
influence of implementation on program outcomes and the factors affective implementation. American Journal of Community Psychology, 41, 327–350.
Durlak, J., & Lipsey, M. (1991). A practitioner’s guide to meta-analysis. American
Journal of Community Psychology, 19, 291–332.
Garner, J., & Maxwell, C. (2000). What are the lessons of the police arrest studies?
Journal of Aggression, Maltreatment & Trauma, 4, 83–114.
Gilgun, J. (2005). The four cornerstones of evidence-based practice in social work.
Research on Social work Practice, 15, 52–61.
Gondolf, E. (2012). The future of batterer programs: Reassessing evidence-based practice.
Boston, MA: Northeastern University Press.
Government Accounting Office (2009). Program evaluation: A variety of rigorous methods can help identify effective interventions, Report to Congressional Requestors,
No. 424. Washington, DC: U. S. Government Accounting Office. Retrieved from
www.gao.gov/new.items/d1030.pdf.
Guba, E., & Lincoln, Y. (1990). Fourth generation evaluation. Thousand Oaks, CA: Sage
Publications.
The Evidence-Based Practice Movement
13
Heckman, J., & Smith, J. (1995). Assessing the case for social experiments. Journal of
Economic Perspectives, 9, 85–110.
Holmes, D., Murray, S., Perron, A., & Rali, G. (2006). Deconstructing the evidencebased discourse in health sciences. International Journal of Evidence Based Healthcare,
4, 180–186.
Kelly, J. (2007). The system concept and systemic change: Implications for community psychology. American Journal of Community Psychology, 39, 415–418.
Mears, D. (2003). Research and interventions to reduce domestic violence revictimization. Trauma, Violence and Abuse, 4, 127–147.
Pollio, D. (2006). The art of evidence-based practice. Research on Social Work Practice,
16, 224–232.
Przybylski, R. (2012). Editor’s introduction. Justice Research and Policy, 4, 1–15.
Sampson, R. (2010). Gold standard myths: Observations on the experimental turn in
quantitative criminology. Journal of Quantitative Criminology, 26, 489–500.
Sherman, L. (2009). Evidence and liberty: The Promise of experimental criminology.
Criminology and Criminal Justice, 9, 5–28.
Smedslund, G., Dalsbo, T., Steiro, A., Winsvold, A., & Clench-Aas, J. (2007). Cognitive behavioural therapy for men who physically abuse their female partner. The Cochrane Databasae of Systematic Reviews, Issue 4, Article No. CD006048
(www.cochranelibrary.com).
Smyth, K., & Schorr, L. (2009). A lot to lose: A call to rethink what constitutes “evidence” in finding social interventions that work. Harvard Kennedy School of Government Working Paper Series, Harvard University, Cambridge, MA. Retrieved
from www.hks.harvard.edu/socpol/publications_main.html.
Visher, C., Harrell, A., & Yahner, J. (2008). Reducing intimate partner violence: An
evaluation of a comprehensive justice system–community collaboration. Criminology and Public Policy, 7, 495–523.
Westen, D., Stirman, S., & DeRubeis, R. (2006). Are research patients and clinical trials representative of clinical practice?. In J. Norcross, L. Beutler & R. Levant (Eds.),
Evidence-based practices in mental health: Debate and dialogue on the fundamental questions (pp. 161–189). Washington, DC: American Psychological Association.
FURTHER READING
Gondolf, E. (2002). Batterer intervention systems: Issues, outcomes, and recommendations.
Thousand Oaks, CA: Sage Publications.
Scott, R., & Shore, A. (1979). Why sociology does not apply: A study of the use of sociology
in public policy. New York, NY: Elsevier.
Sherman, L. (1992). Policing domestic violence: Experiments and dilemmas. New York,
NY: Free Press.
EDWARD W. GONDOLF SHORT BIOGRAPHY
Edward W. Gondolf, EdD, MPH, is currently a research associate and former research director for the Mid-Atlantic Addiction Research and Training
14
EMERGING TRENDS IN THE SOCIAL AND BEHAVIORAL SCIENCES
Institute (MARTI), based at Indiana University of Pennsylvania (USA). His
most noted book Batterer Intervention Systems (2001) summarizes a 7-year
evaluation of batterer intervention systems in four cities funded by the US
Centers for Disease Control, and a related NIJ study using the longitudinal
data to identify risk factors for re-assault. Under grants from the National
Institute of Justice (NIJ), he more recently evaluated the effectiveness of specialized counseling for African-American men, a study of case management
for domestic violence offenders, and a 4-year evaluation of supplemental
mental health treatment for batterer program participants. Dr. Gondolf’s current book, The Future of Batterer Programs: Reassessing Evidence-Based Practice
(2012), addresses the debate over the effectiveness of batterer programs and
the means to improving it.
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