4.B.3
Evidence-based consulting and better group decisions
Énoncé de compétence 4.B.3 d’ASPPB : Apply evidence-based psychological theories and decision-making strategies when consulting
A consultant's recommendations should rest on the best available research, combined with expertise and the characteristics of the people served, which is APA's definition of evidence-based practice. That covers what to recommend, such as dropping practices shown not to help, and how to help groups decide, since research shows predictable ways in which group discussion loses information. Structured problem solving keeps both tied to data.
Notions clés
- Evidence-based practice
- APA's policy integrates the best available research with clinical expertise in the context of patient characteristics, culture and preferences. In consultation it means checking that a requested intervention has support before endorsing it.
- Practices that do not help
- A Cochrane review found that single-session individual debriefing after trauma did not prevent PTSD, with one trial showing higher risk at a year, and concluded that compulsory debriefing should cease. Evidence can argue against what a consultee requests.
- Hidden profiles
- When members each hold unique facts, groups tend to discuss what everyone already knows. A meta-analysis found such groups far less likely to reach the best solution than groups with full information, and pooling unique information improved decisions.
- Production blocking
- In open brainstorming only one person speaks at a time, which interrupts others' idea generation. Having people generate ideas individually or in parallel before discussion offsets this.
- Structured problem solving
- Define the problem in observable terms, analyze what maintains it, choose options against agreed criteria, implement and then evaluate with data, revising if the results fall short.
Exemple commenté
The leadership team of a residential treatment center must choose one of three aftercare models. The clinical, nursing, education and family liaison leads each know things the others do not, and past decisions have followed the director's first opinion.
- Before the meeting, agree on decision criteria drawn from the research on each model and from what families need.
- Ask each lead to write down, beforehand, the facts from their own area that bear on the choice, so unique information reaches the table.
- Run the discussion in rounds in which each lead presents their information before anyone states a preference, with the director speaking last.
- Record the decision with the evidence behind it and agree how outcomes will be tracked, so the choice can be revisited if aftercare results disappoint.
Bring research into what the group decides and structure how it decides, so that no member's knowledge is lost.
Vérifiez vos acquis
A consultant notices that a hospital committee keeps discussing facts all members already know while ignoring what only one member knows. Which step best addresses this?
Sources
- APA Presidential Task Force on Evidence-Based Practice (2006), Evidence-based practice in psychology, American Psychologist, 61(4), 271-285 (PMID 16719673), Abstract: research, clinical expertise and patient characteristics as the elements of evidence-based practice
- Rose, Bisson, Churchill and Wessely (2002), Psychological debriefing for preventing post traumatic stress disorder (PTSD), Cochrane Database of Systematic Reviews, CD000560 (PMID 12076399), Main results and reviewers' conclusions: no reduction in PTSD; increased risk at one year in one trial; compulsory debriefing should cease
- Lu, Yuan and McLeod (2012), Twenty-five years of hidden profiles in group decision making: A meta-analysis, Personality and Social Psychology Review, 16(1), 54-75 (PMID 21896790), Abstract: groups mentioned more common than unique information; hidden profile groups eight times less likely to find the solution; information pooling related to decision quality
- Nijstad and Stroebe (2006), How the group affects the mind: A cognitive model of idea generation in groups, Personality and Social Psychology Review, 10(3), 186-213 (PMID 16859437), Abstract: turn taking (production blocking) interferes with idea generation
- Bergan and Kratochwill (1990), Behavioral Consultation and Therapy, Problem identification, problem analysis, plan implementation and plan evaluation