The term “evidence-based” practice originated in the medical field to describe treatments and practices that have been shown to be effective based on the results of replicated, rigorous research with randomized, controlled trials (RCT) and meta-analyses and systematic peer reviews. The term has since been adopted in fields outside of medicine including education, mental and behavioral health, and other social services. Evidence-based practices in the social sciences should demonstrate evidence of an intervention’s impact on specified outcomes in studies with RCTs or strong quasi-experimental (with pre/post-test and comparison group, but no randomization) design, and be published in peer-reviewed journals or detailed evaluation reports.
There has been very limited research on the effectiveness of crisis intervention programs. This is largely due to the challenges of conducting such research including the infeasibility of randomization, difficulty collecting relevant and accurate data due to the nature of crisis situations, and ethical considerations (e.g., need for informed and voluntary consent, involvement of vulnerable populations and individuals in distress).
The research that has been conducted on the effectiveness of crisis intervention programs, including Pro-ACT, shows reductions in the incidence of seclusion/restraint and positive changes in staff attitudes. However, none of that research meets the requirements for Evidence-based Practices. Limitations of the existing research include a limited number of settings and client types, absence of equivalent comparison groups, and the presence of potentially significant confounding variables (e.g., changes in documentation and debriefing practices, primary plan management, routines and policies as well as other culture change initiatives). None of the existing research on the effectiveness of crisis intervention programs has been subjected to peer review.
Pro-ACT Training is, however, a Best Practice. Best practices are generally accepted methods that have proven themselves over time. While Best Practices do not have the rigorous research basis of Evidence-based Practices, they do reflect a careful consideration of relevant, clinical research and a thorough review of standard discipline-specific practices and approaches.
Pro-ACT Training emphasizes critical thinking and continued assessment to meet the needs of clients while increasing safety and minimizing risks. The focus is on preventing crises through respectful interactions with clients grounded in current concepts of trauma-informed care, intervening at the earliest possible point in the assault crisis cycle using reasonable force response, implementing a robust documentation/debriefing process to identify improvements in client supports, and encouraging a culture that supports ongoing training and professional development.