Evidence-Based Practices Do Not Exist

The original process model of evidence-based practice (EBP) is described, and contrasted with the empirically supported treatments (EST) initiative which designated selected interventions as meeting some evidentiary benchmark (e.g., supported by two-well-designed randomized controlled trials). EBP does not utilize lists of ESTs, and designating a given psychotherapy as empirically supported is actually antithetical to the EBP decision-making process. Much of the resistance to EBP within social work may be attributable to confusion between EBP as it was originally conceived as a mutual decision-making process occurring between the clinician and the client, and the promulgation of lists of EST and the subsequent urging that social workers select their psychotherapies from such lists. The latter is not scientifically justifiable, nor does it taken into account other variables crucial to EBP, such as professional values, clinical expertise, client preferences and values, and available resources. EBP as it was originally conceived has much to add to the practice of clinical social work.