Perceptions of 'Evidence-Based Practice' among the Consumers of Adolescent Substance Use Treatment

Several national organisations in the USA have recently developed educational materials that encourage substance use disorder treatment consumers to seek out approaches supported by scientific evidence in order to promote the use of "evidence-based practice" (EBP). This study aimed to explore how adolescents (young people age 12-17 years) with substance use disorders and their caregivers perceive, understand, and react to the concept of EBP.

Qualitative focus groups and structured interviews were conducted with 29 caregivers and 24 adolescents with substance use disorders in the Northeastern USA. Discussions explored four themes: a) familiarity with EBP, b) assumptions about what EBP means, c) impressions of EBP after reading a common definition, and d) recommended terms to describe EBP in educational materials. Participants' responses were transcribed and qualitatively analysed by two independent coders.

Only two of the 53 participants had ever heard the term EBP, and only one was able to define it correctly. Common assumptions about the term "evidence-based" were that it referred to treatment based on the patient's medical history, legal evidence of substance use, or the clinician's prior experience. The misperception that EBP was associated with legal evidence was common among adolescents involved in the justice system. After reading a common definition of EBP, most participants thought that the approach sounded inflexible. Alternative terms the participants recommended to educate potential treatment consumers about EBP included proven, successful, better, and therapy that works.

Results suggest that future efforts to educate treatment consumers should use the phrase EBP with caution and emphasise the flexibility of the approach.