Diving into EBP: An Experiment in Conversation Part 7

Hannah: What about professional relationships with people whose clinical experiences and/or philosophy are very different from your own? You mentioned support from professionals and parents who believe our methodology. I know there are professionals with whom I have interacted who have practiced very differently from me (and likely whose clinical expertise is very different from mine). Maybe cultivating that type of relationship is one way that we could become more enthusiastic about an approach? That is, the conversation we may have with someone in which we examine a treatment approach may be more motivating and valid than an internal dialogue in which we potentially avoid asking difficult questions.

Diving into EBP: An Experiment in Conversation Part 6

Alaina: I think I see us showing a lot of allegiance to asking the question, “Is this really working?” but that I, at least, ask the question grudgingly and with trepidation rather than enthusiastically. To riff on your question, what are the resources that we need to enthusiastically confront an approach that we love, but that we are beginning to see holes in? Maybe these three things:
- a path, or a roadmap, so that we have a process to follow for engaging in intellectual confrontation.
- support from the people we work with, especially colleagues and clients’ parents, who may have come to believe in the same treatment approaches we are now wanting to discard/modify.
- a personal commitment to pursuing the truth.
What other resources could we shore up, so that we would start excitedly, gladly, and enthusiastically looking for flaws in the treatment approaches that we love the best?

Diving into EBP: An Experiment in Conversation Part 5

Hannah: Yes! I totally agree about how painful it may to confront a belief in a treatment approach. We have invested time, cognitive and creative energy personalizing it for a client, so in one sense, it has become personal for us, too. I think one of the biggest realizations I had when I first became a clinician (and it was a realization that emerged slowly) was just how “personally” I could take therapy even if I was thoughtful about leaving “work” at work. But to answer your question, I don’t think it necessarily has to be painful. There is a word in your question that is important, “ongoing.” It seems reasonable that we want to find the solution that is going to be the perfect approach for our client. But, perhaps the perfect approach is not the end but the means, or the process, that we use to get there. We know our client is dynamic, so maybe we will begin to love the ongoing questioning of ‘is this really working’ when we accept that our approach may have to change even if it previously was successful. Do you think that we resist asking those tough, “Is this really working?,” questions because confronting them requires more of our resources?