Can an SLP practice all areas of clinical service delivery?
Evidence-based Practices (EBP) Evidence-based practice (EBP) is the objective, balanced, and responsible use of current research and the best available data to guide policy and practice decisions, such that outcomes for consumers are improved. Used originally in the health care and social science fields, evidence-based practice focuses on ...
What are the five essential skill sets for EBP implementation?
Single-subject experimental designs (SSEDs) represent an important tool in the development and implementation of evidence-based practice in communication sciences and disorders. The purpose of this article is to review the strategies and tactics of SSEDs and their application in speech-language pathology research.
What is the role of the SLP in the counseling process?
· Barriers to EBP Change. Time and knowledge: When asked what they need more of, busy clinicians will often say time is their priority. Lack of time is often cited as a barrier to implementing EBP. In addition, uncertainty or lack of knowledge about the EBP process is also a barrier, which includes critiquing and appraising the literature related ...
What is an SLP’s scope of practice?
Terms in this set (22) To provide patient care of the highest quality, nurses utilize an evidence-based practice approach because evidence-based practice is. a. A guide for nurses in making clinical decisions. b. Based on the latest textbook information. c. Easily attained at the bedside.
How many scenarios have been shown to effectively treat psychological symptoms?
There are dozens, if not hundreds, of scenarios in which one or more therapies have been shown to effectively treat psychological symptoms.
What is the most well known form of treatment for psychological issues?
Cognitive Behavioral Therapy, or CBT, is perhaps the most well-known and widely accepted form of treatment for many psychological issues.
What is the purpose of the expansion of the definition of psychotherapy?
This expansion of the definition is particularly important in the context of psychotherapy where the effectiveness of the treatment is in large part determined by the patient’s investment and belief in the efficacy of the treatment.
How many books are there on evidence based therapy?
If you want to explore the more in-depth discussions of Evidence-Based Therapy and how to incorporate it into your own practice, consider picking up these five books on EBT.
Is DBT good for BPD?
As a side note, DBT may benefit more than just patients with BPD; there is also evidence that DBT may be an effective treatment for other psychological issues, including patients struggling with intellectual disabilities, but more research is needed to determine its effectiveness (McNair et al., 2017).
Is DBT a good treatment for BPD?
Dialectical Behavior Therapy (DBT) is also an evidence-based treatment, as it has been shown to be effective for relieving the symptoms and improving outcomes for patients with both borderline personality disorder (BPD) and substance abuse (Linehan et al., 1999) as well as for patients with trichotillomania (Keuthen et al., 2011).
Is evidence based therapy cost effective?
Research has shown that Evidence-Based Therapy is indeed cost-effective (Emmelkamp et al., 2014), likely due to the decrease in time spent receiving treatment compared to those undergoing treatment plans which may or may not be effective. In fact, some commentators have even argued that, along with the push for Evidence-Based Therapy, ...
What is a SLP?
The speech-language pathologist ( SLP) is defined as the professional who engages in professional practice in the areas of communication and swallowing across the life span. Communication and swallowing are broad terms encompassing many facets of function.
Why are SLPs important?
As our global society is becoming more connected, integrated, and interdependent, SLPs have access to a variety of resources, information technology, diverse perspectives and influences (see, e.g., Lipinsky, Lombardo, Dominy, & Feeney, 1997 ). Increased national and international interchange of professional knowledge, information, and education in communication sciences and disorders is a means to strengthen research collaboration and improve services. SLPs
What is the role of SLPs in the world?
SLPs play critical roles in health literacy; screening, diagnosis, and treatment of autism spectrum disorder; and use of the International Classification of Functioning, Disability and Health (ICF; World Health Organization [WHO], 2014) to develop functional goals and collaborative practice.
What is swallowing in a document?
Communication includes speech production and fluency, language, cognition, voice, resonance, and hearing. Swallowing includes all aspects of swallowing, including related feeding behaviors. Throughout this document, the terms communication and swallowing are used to reflect all areas.
What are the factors that affect speech pathology?
Personal Factors: These are the internal influences on an individual's functioning and disability and are not part of the health condition. Personal factors may include, but are not limited to, age, gender, ethnicity, educational level, social background, and profession. Relevant examples in speech-language pathology might include an individual's background or culture, if one or both influence his or her reaction to communication or swallowing.
What is the definition of activity in speech pathology?
Activity and Participation: Activity refers to the execution of a task or action. Participation is the involvement in a life situation. Relevant examples in speech-language pathology include difficulties with swallowing safely for independent feeding, participating actively in class, understanding a medical prescription, and accessing the general education curriculum.
How many domains of practice are there in speech pathology?
The scope of practice in speech-language pathology comprises five domains of professional practice and eight domains of service delivery.
What is a multiple baseline study?
Multiple-baseline and multiple-probe designs are appropriate for answering research questions regarding the effects of a single intervention or independent variable across three or more individuals, behaviors, stimuli, or settings. On the surface, multiple-baseline designs appear to be a series of AB designs stacked on top of one another. However, by introducing the intervention phases in a staggered fashion, the effects can be replicated in a way that demonstrates experimental control. In a multiple-baseline study, the researcher selects multiple (typically three to four) conditions in which the intervention can be implemented. These conditions may be different behaviors, people, stimuli, or settings. Each condition is plotted in its own panel, or leg, that resembles an AB graph. Baseline data collection begins simultaneously across all the legs. The intervention is introduced systematically in one condition while baseline data collection continues in the others. Once responding is stable in the intervention phase in the first leg, the intervention is introduced in the next leg, and this continues until the AB sequence is complete in all the legs.
How many SSED studies are needed to be evidence based?
The WWCH panel recommended that an intervention have a minimum of five supporting SSED studies meeting the evidence standards if the studies are to be combined into a single summary rating of the intervention's effectiveness. Further, these studies must have been conducted by at least three different research teams at three different geographical locations and must have included a combined number of at least 20 participants or cases (see O'Neill, McDonnell, Billingsley, & Jenson, 2011, for a summary of different evidence-based practice guidelines on replication). The panel also suggested the use of some type of effect size to quantify intervention effects within each study, thereby facilitating the computation of a single summary rating of the evidence in favor of the invention (a discussion of the advantages and disadvantages of SSEDs and effects sizes follows later). In the next section, the specific types of SSEDs are described and reviewed.
Why is the change in level evident?
The change in level is evident, in part, because there is no overlap between the phases, meaning that the lowest data point from the intervention phase is still higher than the highest data point from the baseline phase. Open in a separate window. FIGURE 1.
What are the three parameters of a level?
Once the data in all conditions have been obtained, they are examined for changes in one or more of three parameters: level, trend (slope), and variability. Level refers to the average rate of performance during a phase. Panel A of Figure 1 shows hypothetical data demonstrating a change in level. In this case, the average rate of performance during the baseline phase is lower than the average rate of performance during the intervention phase. Figure 1 also illustrates that the change in level occurred immediately following the change in phase. The change in level is evident, in part, because there is no overlap between the phases, meaning that the lowest data point from the intervention phase is still higher than the highest data point from the baseline phase.
Who wrote the alternating treatments design?
Barlow DH, Hayes SC. The alternating treatments design: One strategy for comparing the effects of two treatments in a single subject. Journal of Applied Behavior Analysis. 1979;12:199–210. [ PMC free article] [ PubMed] [ Google Scholar]
What is the issue of interpreting effects directly in relation to practice in terms of eventual empirically based decision making for
Finally, related to several different comments in the preceding sections regarding practical significance, there is the issue of interpreting effects directly in relation to practice in terms of eventual empirically based decision making for a given client or participant. At issue here is not determining whether there was an effect and its standardized size but whether there is change in behavior or performance over time—and the rate of that change. Riley-Tillman and Burns (2009) argued that effect size estimates may make valuable contributions for future quantitative syntheses; however, for a given practitioner, data interpretation and subsequent practice decisions are driven more by slope changes, not by average effect sizes. Nontrivial practice issues, such as special education eligibility, entitlement decisions, and instructional modification, depend on repeated measurement of student growth (i.e., time series data) that is readily translatable into single-subject design logic with judgment aids in the form of numerical slope values and aim lines.
What are the advantages of randomization in SSED?
One potential additional advantage to incorporating randomization into an SSED is that the data series can be analyzed using randomization tests ( Bulte & Onghena, 2008; Edgington, 1996; Todman & Dugard, 2001) that leverage the ease and availability of computer-based resampling for likelihood estimation. Exact p values are generated, and the tests appear to be straightforward ways to supplement the visual analysis of single-subject data. It should be noted, however, that randomization tests in and of themselves do not necessarily address the problem of autocorrelation.
What are the barriers to EBP?
Time and knowledge: When asked what they need more of, busy clinicians will often say time is their priority. Lack of time is often cited as a barrier to implementing EBP. In addition, uncertainty or lack of knowledge about the EBP process is also a barrier, which includes critiquing and appraising the literature related to the clinical problem being addressed.
What is the role of administration in EBP?
Also, administration plays a key role in developing an organizational culture that supports EBP. Changing the way we practice is really changing a behavior, but behavior change isn’t easy.
How does evidence based practice work?
The evidence-based practice (EBP) process starts with a clinical question and then proceeds to searching and critically appraising the evidence. Once you have determined that a practice change is necessary, the next step is to integrate that evidence with clinical expertise and patient preferences and values. The last step in EBP is to evaluate the outcomes and disseminate the results. On paper, this flows in an orderly fashion. As clinicians, however, we know that it’s not often that easy or straightforward to change clinical practice. We often face barriers that can make it hard to change, but strategies exist to help facilitate practice change.
What is EBP in nursing?
Evidence-based practice (EBP) is a guide for nurses to structure how to make accurate, timely, and appropriate clinical decisions. A textbook relies on the scientific literature, which is often outdated by the time the book is published and is not the most reliable source for EBP.
Why do nurses use evidence based practice?
To provide patient care of the highest quality, nurses utilize an evidence-based practice approach because evidence-based practice is#N#a. A guide for nurses in making clinical decisions.#N#b. Based on the latest textbook information.#N#c. Easily attained at the bedside.#N#d. Always right for all situations.
What is systematic review?
In a systematic review or meta-analysis, an independent researcher reviews all of the RCTs conducted on the same clinical question and reports whether the evidence is conclusive, or if further study is needed. A single RCT is not as conclusive as a review of several RCTs on the. same question.
What is the difference between Medline and Embase?
The Agency for Healthcare Research and Quality (AHRQ) includes clinical guidelines and evidence summaries. MEDLINE includes studies in medicine, nursing, dentistry, psychiatry, veterinary medicine, and allied health. EMBASE includes biomedical and pharmaceutical studies. PsycINFO deals with psychology and related health care disciplines.
Does Expert opinion have the robustness of an RCT?
problems and their perceptions of illness. It does not usually have the robustness of an RCT. Expert opinion is on the bottom of the hierarchical pyramid of evidence
What is the gold standard for research?
Individual RCTs are the gold standard for research. A peer-reviewed article means that a panel of experts has reviewed the article; this is not a research method. Qualitative research is valuable in identifying information about how patients cope with or manage various health.
Is EBP appropriate for all settings?
EBP is not to be blindly applied without using good judgment and critical thinking skills. It is not appropriate for all settings. Click again to see term 👆. Tap again to see term 👆. In caring for patients, it is important for the nurse to realize that evidence-based practice is. a.
How did MDT improve patient care?
The addition of the latter group of professionals improved the quality of cancer care by preventing and diminishing treatment side-effects, which in turn improved patient adherence and compliance to therapies (2). The natural evolution of this approach was the development of oncological functional units: disease-site specific cancers focused on the management and provision of services for cancer patients (3). These units integrate a multidisciplinary committee and include all the departments involved in a patient's care with the aim of facilitating the intervals and interactions between the different professionals, hence reducing time to diagnosis and/or commencement of treatment.
What is the role of a nurse in MDT?
One of the nurse aims is to work with and coordinate all the professionals that compose the MDT during the overall process of patient care. For the patient and family, the nurse represents the cornerstone from the diagnosis until the follow-up and has major supportive role until the resolution of acute toxicity.
What is the role of a nurse specialist?
One of the most important roles of the nurse specialist is to offer urgent assistance to patients and families through a direct connection during daytime (i.e., a mobile phone that allows the patient/family to contact the nurse). This will allow the nurse to: resolve patient questions or concerns; help managing side-effects and symptoms; and screen for potentially severe problems that require urgent attention and/or reference to the emergency room. Moreover, it allows the treating physicians to be aware of any significant event, symptom or toxicity at all times and plan visits and/or modify treatments accordingly.
When did the multidisciplinary approach emerge in oncology?
The multidisciplinary approach emerged in oncology in the mid-1980s, when the addition of chemotherapy to radiotherapy and/or surgery was proven to improve survival. In the meantime, organ-preservation strategies started to develop in HNC with the use of new available therapeutic techniques (1). The MDT initially consisted in a regulated committee that reviewed all new cancer patients and agreed on the therapeutic plan proposed by medical and radiation oncologist and surgical specialists based on their clinical expertise and the evidence available to date.
What is a multidisciplinary team in oncology?
A multidisciplinary team (MDT) in oncology is defined as the cooperation between different specialized professionals involved in cancer care with the overarching goal of improving treatment efficiency and patient care. Head and neck cancer (HNC) involves multiple and biologically distinct diseases that require different therapeutic approaches. Patient symptoms and treatment side-effects as well as physical and psychological impact will vary according to cancer location and treatment plan. Joining the efforts from different professionals is thought to improve patient management in contrast with the old idea of a global treatment offered by a single physician.
What is the role of a multidisciplinary team?
The core function of a multidisciplinary team (MDT) is to bring together a group of healthcare professionals from different fields in order to determine patients' treatment plan. Most of head and neck cancer (HNC) units are currently led by MDTs that at least include ENT and maxillofacial surgeons, radiation and medical oncologists. HNC often compromise relevant structures of the upper aerodigestive tract involving functions such as speech, swallowing and breathing, among others. The impairment of these functions can significantly impact patients' quality of life and psychosocial status, and highlights the crucial role of specialized nurses, dietitians, psycho-oncologists, social workers, and onco-geriatricians, among others. Hence, these professionals should be integrated in HNC MDTs. In addition, involving translational research teams should also be considered, as it will help reducing the existing gap between basic research and the daily clinical practice. The aim of this comprehensive review is to assess the role of the different supportive disciplines integrated in an MDT and how they help providing a better care to HNC patients during diagnosis, treatment and follow up.
What is the role of a nurse in clinical guidelines?
The nurse must ensure that nursing care is incorporated into the design and implementation of clinical guidelines.
Why are psychotherapy notes kept separately from the general record?
Psychotherapy notes, which may include more detailed or sensitive client information, must be kept separately from the general record in order to be afforded heightened protection under the Health Insurance Portability and Accountability Act (HIPAA) Privacy Rule . For example, health insurers cannot obtain them without a completely voluntary patient authorization. The extent to which psychotherapy notes are protected from patient requests for access varies because state laws that give patients greater access to their records can preempt the Privacy Rule provision providing no access to psychotherapy notes. APA's Legal and Regulatory department provides guidance and current updates on HIPAA-related issues.
What are the factors that influence the amount of detail kept in a psychological record?
Recognizing that psychologists work in diverse settings, APA's Record Keeping Guidelines list basic components of the psychological record—general file information, documentation of service and specific information related to the individual characteristics of the treatment . Various factors may influence the amount of detail kept in records. These can include the client's wishes for more limited records; the service context or setting; legal and regulatory mandates; and contractual requirements of third-party payers.
What information is included in a crisis management record?
Other information: A variety of other types of information may be included in the record, such as assessment data, crisis management documentation, consultation with other professionals, and telephone and email contacts.
What is documentation of service?
Documentation of service: This includes the date, duration and type of service that the psychologist provides and should be updated for each substantive contact with a client. Such documentation may include a description of the treatment modality or specific intervention and an assessment of the client's current level of functioning. Recognizing that clients and other professionals may review these records, the practitioner may want to be sensitive to the language he or she uses to describe the patient.
How many APA guidelines are there?
The APA guidelines are designed to "educate psychologists and provide a framework for making decisions regarding professional record keeping.". There are 13 guidelines in all, each followed by a rationale and examples that illustrate how the guideline may be applied in practice. The guidelines appear online.
When did the APA change its record keeping guidelines?
APA revised its Record Keeping Guidelines in 2007 in response to evolving technologies, the advent of electronic health records, the impact of the Health Insurance Portability and Accountability Act and the complexities of record keeping in various organizational settings.
Do psychologists need a record keeping system?
If you answered yes to any of these questions, it may be time to seek advice from APA's Record Keeping Guidelines. A clear, well-organized record-keeping system is essential for psychologists who provide treatment, psychotherapy, assessment and consultation services. But setting up such systems can be challenging.
What Is Evidence-Based Therapy? A Definition
The Goals and Benefits of Evidence-Based Therapy
- Two of the main goals behind evidence-based practice are: 1. increased quality of treatment, and 2. increased accountability. Meeting these goals will make it more likely that patients will only pay for and undergo treatments that have shown to be effective (Spring, 2007). Research has shown that Evidence-Based Therapy is indeed cost-effective (Emm...
Examples of Interventions Used in Evidence-Based Therapy
- There are dozens, if not hundreds, of scenarios in which one or more therapies have been shown to effectively treat psychological symptoms. Listing them all would make for an extremely long read; instead, consider these examples and continue looking for more in the areas that interest you.
The Five Best Books on Evidence-Based Therapy
- If you want to explore the more in-depth discussions of Evidence-Based Therapy and how to incorporate it into your own practice, consider picking up these five books on EBT.
A Take-Home Message
- When it comes to any treatment plan for any sort of problem, your major concern is probably about the effectiveness of the treatment. Although questions about cost-effectiveness, ease of compliance with the treatment, and the treatment’s impact on your lifestyle may be high on your list, the most important question to ask is probably “But does it actually work?” The field of thera…
Introduction
Statement of Purpose
- The purpose of the Scope of Practice in Speech-Language Pathologyis to 1. delineate areas of professional practice; 2. inform others (e.g., health care providers, educators, consumers, payers, regulators, and the general public) about professional roles and responsibilities of qualified providers; 3. support SLPs in the provision of high-quality, e...
Definitions of Speech-Language Pathologist and Speech-Language Pathology
- Speech-language pathologists, as defined by ASHA, are professionals who hold the ASHA Certificate of Clinical Competence in Speech-Language Pathology (CCC-SLP), which requires a master's, doctoral, or other recognized postbaccalaureate degree. ASHA-certified SLPs complete a supervised postgraduate professional experience and pass a national examination as describ…
Framework For Speech-Language Pathology Practice
- The overall objective of speech-language pathology services is to optimize individuals' abilities to communicate and to swallow, thereby improving quality of life. As the population of the United States continues to become increasingly diverse, SLPs are committed to the provision of culturally and linguistically appropriate services and to the consideration of diversity in scientifi…
Domains of Speech-Language Pathology Service Delivery
- The eight domains of speech-language pathology service delivery are collaboration; counseling; prevention and wellness; screening; assessment; treatment; modalities, technology, and instrumentation; and population and systems.
Speech-Language Pathology Service Delivery Areas
- This list of practice areas and the bulleted examples are not comprehensive. Current areas of practice, such as literacy, have continued to evolve, whereas other new areas of practice are emerging. Please refer to the ASHA Practice Portalfor a more extensive list of practice areas. Fluency 1. Stuttering 2. Cluttering Speech Production 1. Motor planning and execution 2. Articul…
Domains of Professional Practice
- This section delineates the domains of professional practice-that is, a set of skills and knowledge that goes beyond clinical practice. The domains of professional practice include advocacy and outreach, supervision, education, research, and administration and leadership.
References
- American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders(5th ed.). Washington, DC: Author. American Speech-Language-Hearing Association. (2005). Evidence-based practice in communication disorders [Position statement]. Available from www.asha.org/policy/. American Speech-Language-Hearing Association. (2014). Interprofession…
Resources
- American Speech-Language-Hearing Association. (n.d.). Introduction to evidence-based practice. Retrieved from www.asha.org/Research/EBP/Evidence-Based-Practice/ American Speech-Language-Hearing Association. (n.d.). Practice Portal. Available from /practice-portal/ American Speech-Language-Hearing Association. (1991).A model for collaborative service delivery for stu…