Where are we heading with EBTs?

As noted in the history section, EBTs in mental health and in medicine continue to be a source of some controversy.

We are clearly in the early stages of moving EBTs into practice. Although some of the objections to EBTs reflect the natural tendency of practitioners to resist change, other concerns are based on the cost of training and implementation, or on concerns about the appropriateness of existing EBTs for a clinic population. These concerns will need to be addressed on a larger systemic level than that of the individual provider agency.

While advocates of Systems of Care sometimes see themselves at cross purposes with advocates of EBTs, it appears to us that an effective System of Care must employ effective treatment models. At the same time, EBTs will be useless unless they are delivered by a system that engages children and families and effectively prioritizes and addresses their needs.

As the evidence base grows, the number of EBTs designed for different client groups in different target problems is increasing. Although EBTs are still not widely taught in graduate and professional schools, we anticipate this will change before long. As the number of distinct but look-alike EBTs proliferates, there will probably be consolidation into more comprehensive evidenced-based treatment systems, which will help practitioners address the kind of complex problems that clinic patients typically experience. The field will also need to develop ways to keep new knowledge flowing to practitioners, so that EBTs do not become static pockets of crystallized practice, a new orthodoxy that paradoxically becomes an impediment to further progress.

Some state or county mental health systems have made efforts to encourage the use of EBTs, and we should explore what is and is not working for them. You can read more on this topic from the publications page of the National Association of State Mental Health Program Directors (NASMHPD).