Translated from the Portuguese original. Read the original (Português)
Evidence-based practice (EBP) is a way of choosing treatments that combines three things: the best available scientific research, the experience of the person providing care, and the values and preferences of the person being treated. Instead of relying only on opinion, fads, or testimonials, EBP always asks: is there good evidence that this works?
Evidence-based practice (EBP) is the integration of the best available scientific evidence with the clinician's clinical expertise and the values and preferences of the person being treated. The concept originated in medicine (Sackett and colleagues) and was adopted by psychology through a task force of the APA (American Psychological Association) in 2006.
Want to see this applied?This entry defines the concept. If your question is practical — how do I use this to choose a therapy, and what should I ask the professional? —, the module Prática Psicológica Baseada em Evidências (Evidence-Based Psychological Practice) walks you through it step by step, including the 28 evidence-based practices for autism, one by one.
The three pillars that come together
A common mistake is to think EBP means "just follow what the studies say." That is not it. Research is one leg of the tripod — but, by itself, it does not decide anything. A good clinical decision rests on three pillars at the same time, and none of them replaces the others. Explore each one:
1. The best available scientific evidence
These are the results of well-conducted research that tested whether a treatment really helps — and for whom. The stronger the type of study, the more confidence it deserves. Example: before recommending an intervention for an autistic child, the professional checks what reviews and clinical trials show about the effectiveness of that approach, instead of simply following whatever is "trending."
2. The clinician's expertise
It is the competence of the clinician to assess each case, interpret the evidence in a real-world context, and adjust the approach based on the person's response. Research tells us what works "on average"; the clinician needs to decide what works for this person. Example: recognizing that a program worked in studies, but needs to be adapted to that patient's pace, history, and circumstances.
3. The values and preferences of the person being treated
Treatment is always done with the person, not to them. Their goals, their culture, their beliefs, and what they consider important all factor into the decision. Example: two interventions may have similar evidence, and the choice takes into account which one the family understands, accepts, and can sustain day to day.
Why "integration"?EBP is not about choosing one of the three pillars — it is about bringing them together. Evidence without listening becomes a cold protocol; listening without evidence becomes guesswork. Good practice lives at the meeting point of all three.
The hierarchy of evidence
Not all "proof" carries the same weight. A moving testimonial is not worth the same as a careful study with hundreds of people. That is why science organizes types of evidence into a hierarchy, from the strongest (at the top) to the weakest (at the bottom):
In order, from strongest to weakest:
- Systematic reviews and meta-analyses — gather and compare many studies on the same question, offering the most reliable picture;
- Randomized clinical trials — compare the treatment with a control group, randomly assigning who receives what to reduce bias;
- Observational studies — follow groups in the "real world," without randomly assigning who receives the treatment;
- Case reports — describe what happened to one person or a small number of people;
- Expert opinion — useful for guidance, but it is the weakest level when there is no data behind it.
What about in behavior analysis?When well conducted, single-subject designs (which follow the same person closely, comparing periods with and without the intervention) also produce strong evidence. In other words: the hierarchy helps you think, but careful study design is what really counts.
How to recognize pseudoscience
Wherever there is suffering, someone will promise an easy fix. Knowing how to spot warning signs protects you against treatments that are ineffective, expensive, or even harmful. Be wary when a proposal:
- promises a "cure" or makes miraculous claims;
- shows an absence of data to back up what it claims;
- relies only on testimonials and anecdotes ("it worked for me");
- refuses peer review — that is, avoids having its results examined by other scientists.
Beware of the promise of a "cure"In autism and mental health, the goal of a good intervention is not to "fix" the person, but to expand autonomy, communication, and well-being. Any proposal that guarantees a quick or definitive cure deserves suspicion — and the question you should always ask: where is the evidence?
Why this matters
Choosing interventions with evidence behind them is not about clinging to rules — it is care and respect. In autism and mental health, choosing what science supports protects the person from treatments that do not work, that waste time and money, or that can cause harm. EBP puts the person at the center: it integrates what research shows, what the clinician knows, and what matters to the person being treated.
Test your understanding
Quick quiz
Three questions to reinforce the concept. You'll see the explanation right away.
Further reading
- APA Presidential Task Force on Evidence-Based Practice. "Evidence-based practice in psychology". American Psychologist, 2006.
- Sackett, D. L. et al. "Evidence based medicine: what it is and what it isn't". BMJ, 1996.
This entry is educational and does not replace assessment, diagnosis or treatment by a qualified health professional. Every person is unique — for a specific case, seek individual guidance.