Making it Work: Strategies for Success

The Making it Work section of the Resource Guide provides several strategies that help families and youth make an Evidence-Based Culture a reality that works for them in their community and according to their cultures. Some questions that families may desire the answers to before they begin their journey towards an Evidence-Based Culture are included below.

Families and youth want services and supports that work for them, but how do we know what works? Treatments for children's mental, emotional, and/or behavioral disorders that are proven to work through scientific research are often called Evidence-Based Practices (EBP).

To become an Evidence-Based Practice, a treatment usually has to have three things:

Evidence (proof) that it works through scientific research
At least one Comparison Group Study (e.g., a study in which a group of people receiving the treatment are compared with a group of people not receiving the treatment)
A Treatment Manual that says how the treatment is done

If an EBP "works," does it create the results families want for their children or that youth want for themselves? There are many points of view about what treatment goals (e.g., outcomes) are right for any one child or youth with mental, emotional, or behavioral disorders and his or her family. For example, if an EBP reduces juvenile justice encounters and improves school attendance, it may not be the right thing for a family more concerned with keeping their child alive and reducing suicidal ideations. Families usually know their children better than anyone else. Youth know themselves. Therefore, the goals set by families or youth should take priority over the goals of available EBPs.

So, if an EBP works to create the same goals a family or youth are seeking, how do they know it will work for them specifically? An EBP that has been proven to work in a clinical research setting may or may not work in a community setting. The children or youth may be different, the providers may differ in skills or abilities, and the setting in which the practice is delivered may be different from the original setting for the EBP. (For more information, see Family-Driven and Youth Guided .)

Adaptations can be made when needed if there is ongoing evaluation to track results. When Evidence-Based Practices first emerged in the early 1990's, there was concern that an EBP would be a "treatment in a can" (i.e., no flexibility in application). There was great concern that values held by families, youth, and their advocates, such as individualized services and supports and cultural competence, would be lost. Today, we are learning what adaptations (changes) can be made to an EBP before it is no longer an EBP. For example, an Evidence-Based Practice developed and tested on young men in an urban setting may require some adaptations before it can be implemented in a rural area. Or if an EBP originally proven to work on depression is going to be applied to young people with depression and substance abuse, changes or adaptations may be required.

An important role for families and youth is advocating for and participating in continued evaluation of the treatment to be sure it does, in fact, work as implemented.

In the following sections, you can learn more about how to make sure the outcomes you want are, in fact, the goals of services, supports, or treatments that are provided:

Family-Driven and Youth Guided Systems
Families and Youth as Providers and Evaluators
Family and Youth Advocacy

These sections also provide more ideas about how you, as a family member or youth, can make your community embrace a family-driven and youth guided approach to Evidence-Based Practices.