Evidence-based practice in real-world services for young people with complex needs: New opportunities suggested by recent implementation science

There is growing agreement that child and youth services have been slow to implement evidence-based practice (EBP). A variety of interrelated barriers and facilitators of EBP implementation have been recognized and investigated. Key categories include the attitudes of providers, the characteristics of client populations, the characteristics of usual practice, organizational factors, and resource availability. Implementation scientists are investigating these factors, seeking to bridge the gap between clinical science and practice. Much of this work has been conducted in the context of behavioral health services for children and young people. This paper provides a purposeful review of this research from the perspective of decision-makers in agencies serving young people with multiple and complex psychosocial needs. It is argued that major barriers to EBP may be mitigated if ways can be found to transcend the oppositional construction that has characterized the discourses of EBP versus practice wisdom. A conceptual approach to such integration is offered. New lines of implementation research are offering opportunities for practical action by decision-makers consistent with this integrative approach.

Research highlights
► EBP implementation efforts seek to integrate clinical science with practice wisdom.
► Clinical science is mostly concerned with therapeutic ‘content’ and ‘techniques’.
► Practice wisdom is traditionally concerned with value-based ‘ways’ of practicing.
► Practice wisdom must determine how therapeutic content and techniques are organized.
► New approaches to EBP can facilitate this mode of integration.