We want to make adaptions to an evidence-based practice, is that acceptable?

Evidence-based practices sometimes do not fit perfectly into a clinic. When the evidence is developed for an intervention it might be limited and may not match the clinic where it is to be implemented. Maybe the schedule of delivery (weekly for 2 hours) and the target population (individuals with depression with no comorbidities) do not match the clinic. These differences (between the usual care clinic and the academic setting where efficacy was established) need to be addressed through some adaptions. It is very important to consider the relationship between adaption and fidelity. There can be tension here, but fidelity to core components of the intervention is key. For example, the educational content of a social skills training program might need to remain intact, but the delivery schedule could be adapted from 1 hour each week to 2 hours biweekly to lessen travel to the clinic. Or, this same social skills training program might need to be adapted to be culturally appropriate for the clinic population, which might entail different examples for skills training and different homework assignments while holding consistent with the skills to be developed. The most typical adaptions are in response to delivering the interventions to a new target population, a new community setting, or a need for a culturally appropriate program. The nature of an adaption might include tailoring or tweaking content, adding elements, skipping elements, shortening/condensing or lengthening/extending the delivery of the content, reordering of content, repeating elements, or loosening the structure. An excellent recent paper examining adaptions to evidence-based practices is here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6158804/

You might also consider consultation from an expert at SMI Adviser.

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