By Kieran McCartan, PhD, David Prescott, LICSW, & Alissa Ackerman, PhD.
The start of a new year is often a time of reflection and hope. We think about our experiences as well as practice over the last year and learn from poor practice as well as build upon good, existing practices. Having a solid, reliable, evidence base is central to all aspects of life, personal and professional!
Thinking back over the last 12 months, 2017 has been an interesting year to say the least with the common factor being one of ideology and “common sense” understandings winning out over an established evidence base many times. A recent example was the United States’ Centers for Disease Control emphasizing that it would not accept funding submissions that contain words such as “evidence-based”, “transgender”, etc. Although we all have ideologies, thoughts, and beliefs that govern our lives and practice, the majority of the time these are not based on facts, outcomes and analysis. Rather, these can be based on perceptions and collusion with friends, family and/or peers. This might be fine if we are deciding which diet to use, airline to fly or coffee shop to visit; but, are these the best metrics for deciding on larger, societal scale decisions? All too often it seems that we agree with science primarily when it supports our views.
This reliance on ideology has often times led – especially in northern hemisphere westernized countries – to a rejection of expert knowledge as well as evidence. In 2017, in our opinion, this resulted in a return to lay knowledge and ideologically driven theories, policies and practices. In other words, sometimes going backwards to debunked beliefs and practices!
Let us be clear here: we are not being elitist and saying that expert knowledge is the only way to develop policies and practices, because it is not. Instead, we are saying that in order to develop best practice we need to listen, to hear, and to understand all the voices in the debate without shutting any down. The transition away from evidence based policy and practice is worrying because it means that we are not listening to all the available information and are basing our ways of working purely on ideology. We want our taxes spent appropriately and we want governmental decisions to be realistic, appropriate and fit for purpose. We should want evidence based decisions, policies and practice! Why? Because it means that we are not spending time, money and resources blindly or causing harm along the way; we have an idea of what works and what does not work, therefore we can be more measured and realistic in terms of social, political, practice and policy change.
However, in many current northern and western hemisphere countries with right wing, or at least right-leaning, governments’ evidence is not the metric that they want to use in their policy and practice shifts, they want it to be ideological. Clear examples of this can be seen in the UK (via Brexit). Clear examples also abound in the USA. The best example is perhaps the election of Donald Trump during a year of campaigning not known for its reliance more on ideas than on evidence. Other examples include changes to Obama-care (which many people have found undesirable, but which provided millions of people access to healthcare), refusal for the CDC to fund research from transgender issues and the effects of gun violence, and defunding of the National Registry of Evidence-Based Programs and Practices).
In the field of sexual abuse, evidence based practice is central and needs to remain central. We have seen the cost and consequences of ideologically driven policies and practices on the ground, from funding of policies that don’t reduce risk (e.g., public registries and residence restrictions) to increasingly scarce funding for those that can reduce risk (e.g., treatment and supervision). As one example, in the state of West Virginia, probation officers specializing in supervising people who have committed sex crimes have lost their jobs at the same time as the state’s Supreme Court justices spent astronomical sums on office furniture.
Evidence tells us, if we do research well and in the most appropriate way for the question at hand, we can discern what works and what does not. Sometimes we don’t like what the research tells us and sometimes we do. Despite the outcomes of research the most important thing is that, whether we like it or not, we are called as professionals to do what actually works!