4 Reasons Why You May Not Be Getting Evidence-Based Care
Re-posted from the Cleveland Center for Eating Disorders (CCED) blog archives and updated with additional Emily Program client thoughts. CCED and The Emily Program partnered in 2014. Contributions by Sarah Emerman.
Every year our understanding of the brain and eating disorders improves. However, there are still a limited number of truly evidence-based treatment for our patients. The search for evidence-based care may feel overwhelming and sometimes futile. Unfortunately, moving in the direction of care that is not evidence-based reduces the likelihood that clients will achieve recovery. There are several reasons why providers may offer care not based on the literature or published data:
- The provider may be trained in only one particular form of therapy. Providers tend to practice in the mode in which they feel most comfortable, even though that type of therapy may be more helpful for some illnesses than others. A patient may therefore receive care that is not evidence-based because their provider does not have an orientation to evidence-based care.
- Lack of adherence. Evidence-based care can be challenging to sustain. It usually requires a practice that may be manual based, require expensive or difficult to get supervision, and highly specialized training. Clinicians may be aware of and desire to practice evidence-based care but may not have the resources to provide it.
- Bias. Some providers have belief systems about causation, free will, mind, body, culture or multiple other issues that make it difficult for them to believe and accept the literature as it currently exists. Unfortunately, belief systems do influence providers practice and may prevent them from gaining most current knowledge.
- Over-reliance on experience. Study after study has shown that therapists’ experiences with their own successes or lack of success may shape the way they provide treatment. There may be a tendency to reject scientific literature for personal experience, which may not be effective for others.
No provider gets up in the morning not wanting to do their best and every provider wants to help their patients find recovery as best they can. But it is only when this desire is paired with a good understanding of the scientific literature that good evidence-based treatment can occur.
ABOUT THE AUTHOR
Mark Warren, M.D.
Dr. Mark Warren (he/him) is the Chief Medical Officer of Accanto Health, the parent company of The Emily Program and Gather Behavioral Health. His primary focus enhancing patient safety and providing comprehensive treatment that addresses both the physical and psychological aspects of eating disorders. Working alongside our executive team and our medical staff, Dr. Warren is dedicated to helping all of our patients embark on a path toward a meaningful and joyful life.
Dr. Warren is a Distinguished Fellow of the American Psychiatric Association and a Fellow of the Academy of Eating Disorders, where he co-founded the special interest group (SIG) for Professionals and Recovery and the SIG for Males and Eating Disorders. He is a two-time recipient of the Exemplary Psychiatrist Award of the National Alliance for the Mentally Ill, and a winner of the Woodruff Award. He has published and spoken extensively on males and eating disorders, professionals and recovery, and DBT and FBT in the treatment of eating disorders.
Dr. Warren is a founding member and former co-chair of the Academy of Eating Disorders Medical Care Standards Committee and serves on the FEAST Medical Advisory Board and The Visiting Committee of the Case Western Francis Payne Bolton School of Nursing.
Having personally experienced an eating disorder as a young man, Mark feels privileged to be working in the field of eating disorders for over two decades.