Categorising the strength of the research evidence

⇒ Back to 'Evidence based interventions that work'

Several significant guidelines were reviewed, and incorporated into the weighting given to each intervention. Initially Fonagy and colleagues’ (2015) substantial review was consulted. This recent and robust document guided the formation of the information sheets, as its earlier edition did for Dunnachie’s (2007) work. The recommendations of Fonagy and his colleagues were augmented and supplemented with New Zealand and Australian guidelines. Those with an aspect or focus related to Māori and/or Pacific peoples were prioritised. Recommendations from The Matrix (2015) were also consulted with regard to each diagnosis. Descriptions of diagnostic criteria were drawn directly from the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013).

If the evidence for a particular intervention was remarkably strong or compelling, and/or if all significant documents (mentioned above) recommended a particular intervention, it was placed in the ‘gold’ category. If evidence was less compelling, or one of the reviews had considered the intervention as second-line, it was placed in the ‘silver’ category. If the intervention was emerging, and/or had little supportive evidence (but was not contra-indicated), it was placed in the ‘bronze’ category. Finally, if one of the reviews mentioned had deemed an intervention to be unsafe or unsupported by evidence, it was placed in the ‘not recommended’ category. As stated in the caveat associated with each matrix of recommendations in the information sheets, health professionals are strongly encouraged to consult the foundational documents for more extensive information about the evidence for a particular intervention. Information sheets provide a succinct summary and, inevitably, some of the richness of the context of the findings is lost.

Each of the information sheets distils the key points from a selection of authoritative sources from around the world and importantly, New Zealand where this literature exists. These sources are as follows:

A robust source of information about evidence-based interventions is provided by Fonagy and colleagues’ (2015) book “What Works for Whom? A Critical Review of Treatments for Children and Adolescents”. The authors have methodically summarised meta-analyses and reviews and their conclusions and recommendations are incorporated into the information sheets.

The Scottish government have recently (2015) updated “The Matrix”, a comprehensive series of evidence tables relating to effective interventions for mental health disorders. The key findings have been incorporated into the information sheets.

Internationally, there are several sources of robust and well respected recommendations for evidence-based interventions, which have been reviewed in the preparation of the information sheets, and can be consulted for more detailed information. These include:

  • National Institute for Health and Care Excellence (NICE)
  • Cochrane library (Cochrane Database of Systematic Reviews)
  • Substance Abuse and Mental Health Services Administration (SAMHSA)
  • American Academy of Child and Adolescent Psychiatry (AACAP) practice parameters